COMMENTARY

An Urgent Plea to Oncologists: Recommend HPV Vaccination to Your Young Patients

Maurie Markman, MD

Disclosures

November 02, 2017

Hello. I am Dr Maurie Markman from the Cancer Treatment Centers of America in Philadelphia, Pennsylvania. I am going to briefly discuss a very important, yet disquieting, report that appeared in the Journal of Clinical Oncology, entitled "Human Papillomavirus Vaccination Rates in Young Cancer Survivors."[1]

Human papilloma virus (HPV) vaccination is an extremely safe and highly effective strategy to prevent high-grade cervical dysplasia, the absolute precursor of cancer of the cervix.[2,3] There is strong, strong evidence that we will see a substantial reduction in the risk for cervical cancer in the United States and throughout the world where HPV vaccination has been used as a public health strategy.[3,4] It is also quite clear that this will be an incredibly important strategy for the prevention of what now has been demonstrated to be an epidemic of HPV-related head and neck cancers.[5]

Again, vaccination for the prevention of persistent HPV infection is an enormously positive public health strategy. Unfortunately, HPV vaccination has not been embraced as it should have been throughout the world and particularly in the United States, despite the overwhelming data on both the value and the safety of the approach.

This newly published study looked at a subset of young people in this country: adolescents who are cancer survivors. The investigators found that the rate of HPV vaccination was even lower in this population than in the general population of adolescents in this country — remarkably hard to believe.

The investigators learned that one of the major reasons for this is the lack of provider recommendation for HPV vaccination. This is extraordinary. Of course, we are concerned about general practitioners, general pediatricians, physicians who do not have experience with cancer and who may not be clear about their role in discussing HPV vaccination as a cancer prevention strategy. But in this case, we are talking about providers who are actually in the cancer arena, whether surgeons, pediatric oncologists, or other types of oncologists who have interactions with these patients. Yet, the authors state that this group of providers has not strongly advocated to have their patients and former patients receive HPV vaccination.

This is clearly a very distressing report, a situation that one can only strongly urge the healthcare community and especially the oncology community to rectify. These are young people who now may have been cured of their childhood cancers. We have strategies to prevent cervix and head and neck cancer, with an extremely effective, safe vaccination. Clearly, we need to recommend and do the best we can to achieve adequate vaccination of this population of cancer survivors.

Thank you for your attention to this very important matter. I encourage all oncologists to do what they can to rectify the distressing outcome demonstrated by this report. Thank you for your attention.

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