{"id":1813,"date":"2020-06-14T18:35:14","date_gmt":"2020-06-14T18:35:14","guid":{"rendered":"https:\/\/magazines.uthscsa.edu\/cancer-center\/?p=1813"},"modified":"2020-06-16T20:59:03","modified_gmt":"2020-06-16T20:59:03","slug":"physicians-increasing-hpv-vaccine-rates-for-populations-with-greatest-cancer-risk","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/cancer-center\/2020\/06\/14\/physicians-increasing-hpv-vaccine-rates-for-populations-with-greatest-cancer-risk\/","title":{"rendered":"Physicians increasing HPV vaccine rates for populations with greatest cancer risk"},"content":{"rendered":"

In 2006, the first publicity campaigns that encouraged parents to have their teenagers vaccinated against the human papillomavirus (HPV) targeted females. At that time, of the six types of cancer caused by HPV, the only routine screening that existed was for cervical cancer via pap smears. This is still the case today.<\/p>\n

\"Allison
Allison Grimes, M.D.<\/figcaption><\/figure>\n

\u201cMost folks in the community associated HPV with cervical cancer. Unfortunately, we have not done a very good job educating the community about all the other HPV-related cancers,\u201d explains Allison Grimes, M.D., assistant professor of pediatrics and investigator with the Greehey Children\u2019s Cancer Research Institute at UT Health San Antonio.<\/p>\n

Currently, 34,800 people are diagnosed with an HPV-related cancer every year in the U.S., shared Dr. Grimes, a pediatric oncologist. The family of HPV cancers includes penile, anal, oropharyngeal (head and neck), vaginal and vulvar cancers.<\/p>\n

\u201cWe did a disservice to males by advertising the HPV immunization as strictly a vaccine for females because of cervical cancer,\u201d she said.<\/p>\n

Investigators led by Dr. Grimes are on the forefront of correcting these misconceptions and promoting the vaccination of anyone ages 9 to 45. HPV vaccinations could prevent more than 90 percent of HPV-related cancers, and more than 98 percent of individuals receiving the full vaccine course develop an antibody response.<\/p>\n

Dr. Grimes\u2019 team complements the work of Amelie Ramirez, Dr.P.H., associate director for population sciences for the Mays Cancer Center. Dr. Ramirez, director of the Institute for Health Promotion Research (IHPR) and chair of Population Health Sciences at UT Health, works with community partners focusing on Latinos to disseminate health information to a population that often lacks health insurance and does not receive information in a language they understand.<\/p>\n

Dr. Ramirez said the Hispanic community is a challenge with the HPV vaccine because \u201cthere are misconceptions about what the vaccine is for. If daughters get it, will they be more promiscuous? Is the vaccine safe?\u201d<\/p>\n

Hispanic women are at higher risk than non-Hispanic women for developing some HPV-related cancers, including cervical cancer, their studies show.<\/p>\n

The IHPR team uses mass media, social media and text messaging to share information. Using role models from the community to share testimonials on these different mediums about why screening is important has proven effective, Dr. Ramirez said.<\/p>\n

IHPR also has promotoras \u2014trained bilingual community health workers \u2014 who provide small group educational sessions in zip code areas identified with high rates of cervical cancer. These sessions provide women with the most up-to-date information on the importance of screening and the HPV vaccination.<\/p>\n

\u201cToday, no woman should die from cervical cancer, as we now have all the tools to screen, treat and prevent cervical cancer,\u201d Dr. Ramirez said.<\/p>\n

The IHPR\u2019s Entre Familia program (led by Deborah Parra Medina, Ph.D., former IHPR faculty, and funded by the Cancer Prevention and Research Institute of Texas) also uses promotoras to deliver health education about the HPV vaccine and cancer prevention and help people schedule and remember vaccination appointments for girls and boys ages 11 to 17 in South Texas. Their efforts produced a 30 percent vaccination completion for the HPV vaccine over a two-year period.<\/p>\n

Dr. Grimes, meanwhile, is targeting a group described as \u201cthe most vulnerable in the community \u2014 survivors of childhood cancer.\u201d<\/p>\n

A $1 million, three-year grant from CPRIT is allowing Dr. Grimes and co-investigator Gail Tomlinson, M.D., Ph.D., co-leader of population science and prevention for the Mays Cancer Center, and grant co-director L. Aubree Shay, Ph.D., assistant professor and health services researcher at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health in San Antonio, to work with four other cancer centers in Texas to increase the vaccination rate of children, teens and young adults who had cancer as children.<\/p>\n

\u201cWe found that, compared to their age-matched peers, they were developing second cancers from HPV at an alarmingly higher rate and sooner. Female survivors of childhood cancer had a 40-fold increase of HPV-related cancers and male survivors had a 150-fold increase,\u201d she said.<\/p>\n

While those with no history of cancer developed it about 20 years after exposure, the cancer-survivor population developed the HPV-related cancer in only 10 years or less.<\/p>\n

The reasons were easy to understand. When children started seeing an oncologist, they usually stopped seeing their regular pediatrician and missed the normal vaccination schedules for 11-year-olds. Cancer center clinics did not routinely provide the vaccine, and children were not receiving it through other community-based efforts.<\/p>\n

To identify the need, they reviewed the Texas Immunization Registry. \u201cWhat we found was shocking,\u201d she said. \u201cOf all our childhood cancer survivors at our institution, not one male finished the series. Less than 10 percent had started the series. Just under 20 percent of females initiated the series but only 10 percent completed it.\u201d<\/p>\n

They had identified a \u201cgap population\u201d that community initiatives were not reaching and that was particularly vulnerable to HPV cancers. \u201cIf any group was going to be motivated to prevent cancer, it\u2019s going to be a group of patients that already had one,\u201d she said.<\/p>\n","protected":false},"excerpt":{"rendered":"

Physicians\/researchers are dedicated to educating males and childhood cancer survivors on their need for the HPV vaccine. 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