Human papillomavirus vaccination guideline update: American Cancer Society guideline endorsement

Abstract

The American Cancer Society (ACS) reviewed and updated its guideline on human papillomavirus (HPV) vaccination based on a methodologic and content review of the Advisory Committee on Immunization Practices (ACIP) HPV vaccination recommendations. A literature review was performed to supplement the evidence considered by the ACIP and to address new vaccine formulations and recommendations as well as new data on population outcomes since publication of the 2007 ACS guideline. The ACS Guideline Development Group determined that the evidence supports ACS endorsement of the ACIP recommendations, with one qualifying statement related to late vaccination. The ACS recommends vaccination of all children at ages 11 and 12 years to protect against HPV infections that lead to several cancers and precancers. Late vaccination for those not vaccinated at the recommended ages should be completed as soon as possible, and individuals should be informed that vaccination may not be effective at older ages.

Nivolumab for previously treated unresectable metastatic anal cancer (NCI9673): a multicentre, single-arm, phase 2 study

“…6–9 Preventive vaccinations against HPV are underused, 10 with fewer than half of adolescent males and females receiving HPV vaccinations. 11 Still, the incidence of SCCA is increasing annually worldwide, 12 a trend expected to continue over the coming decades.…”

The keys to conservative treatment of early-stage squamous cell carcinoma of the tonsillar region

“…A recent French study based on several regional registries found that HPV+ patients with oropharyngeal SCC had an increased risk of metachronous SCC in various locations outside the upper airway: anal canal, cervix, vagina, penis, vulva [27]. Following several prospective randomized therapeutic trials reporting nearly 95% efficacy in preventing cervix and anal canal cancer, HPV vaccination for 11-23-year-old females, preferably before initiation of sexual activity, was introduced in more than 50 countries, using a bivalent anti-HPV-16-18 vaccine, Cervarix, and later a quadrivalent anti-HPV 6-11-16-18 vaccine, Gardasil, and finally, since 2014, a nonavalent anti-HPV 6-11-16-18-31-33-45-52-58 vaccine, Gardasil9 [24,[68][69][70].…”

“…The first is the ongoing debate about vaccination side-effects. Literature reviews [24,[68][69][70] report no significant severe toxicity associated with the various currently available vaccines but, in 2016, the North American database on side-effects in American patients reported significant elevation of various autoimmune diseases (lupus, rheumatoid arthritis, vasculitis, thrombocytopenia) following quadrivalent HPV vaccination [71]. The second problem is a lack of scientific studies demonstrating reduced risk of tonsillar region and/or tongue-base cancer onset in vaccinated populations, even if the analogy with cervical cancer makes such a result highly probable; it is estimated that not until 2060 will there be a visible significant impact of HPV vaccination on mortality from oropharyngeal SCC [24].…”

“…The fourth problem is that the rate of vaccination of girls and young women in France since the vaccination campaign was launched in 2007 has been low, at no more than 20% overall in 2016, compared to 70% in the UK and in Australia [24,69]. And the last problem is the ongoing debate about vaccination for boys, which runs up against a lack of real perceived benefit on the part not only of parents but also part of the medical community [24,69,70]. In France as early as 2014, various authors advocated boys' vaccination [73].…”

“…In France as early as 2014, various authors advocated boys' vaccination [73]. In July 2016, the American Cancer Society [70] recommended HPV vaccination for "all American children aged 11 and 12 years, so as to achieve a high-level of immune response and protect them against HPV infection, which is a factor for the development of several precancerous and cancerous states". But, in February 2016, the French Public Health Council [69], advised "vaccination of girls and young women between 11 and 23 years of age and offering HPV vaccination to males up to the age of 26 years who have or have had sexual relations with another male and also to subjects of both sexes with immune depression".…”