have been responsible for almost 39,000 new cases of cancer in
the U.S. in 2010 and more than 9,500 deaths ( 36).
As a result of several decades of research, we now know that
persistent infection with certain strains of HPV can cause cervical
cancer, a substantial proportion of anogenital cancers, and some
head and neck cancers ( 33). This information led to the
development of a clinical test that detects the presence of cancer-causing types of HPV. The test, when combined with a standard
Papanicolaou (Pap) test for cervical cancer, enables earlier
identification of women at high risk for cervical cancer and safely
extends cervical cancer screening intervals ( 37).
Determining which strains of HPV can cause cervical cancer also
fueled the development of vaccines to prevent persistent infection
with these HPV types. The FDA has approved two vaccines for use
in females aged nine to 25 years old for the prevention of cervical
cancer caused by high-risk HPV strains. Both vaccines are highly
effective at preventing precancerous cervical lesions caused by
these HPV strains ( 36). The FDA also approved one of the vaccines,
Gardasil, for use in females aged nine to 26 for the prevention of
vulvar and vaginal precancerous lesions as well as for the
prevention of HPV-associated anal cancer in both males and
females aged nine to 26 (see Sidebar on HPV Vaccine Usage).
Future studies will determine whether the vaccines also reduce the
risk for head and neck cancers caused by HPV.
Our increasing knowledge about infectious causes of cancer
provides opportunities for tremendous progress in reducing the
health care and economic burden of certain cancers, like that
Figure 13: Energetic Causes of Cancer. Exposure to ionizing
radiation is linked to the development of certain cancers, in particular,
leukemias and cancers of the breast, lungs, brain and thyroid ( 39). The
majority of ionizing radiation to which the U.S. population is exposed is
natural background radiation; the rest comes from man-made
sources, most prominently medical x-rays; adapted from ref. 39.
experienced by Shaundra L. Hall. Continued research in this area
holds great promise for our conquest of certain cancers, but it will
not have the desired effects without comprehensive approaches to
public education and public health policy implementation—both of
which are essential if cancer prevention advances are to be
deployed to all those who could benefit.
HPV Vaccine Usage
• Coverage for one dose of HPV vaccine for girls increased by
only 4. 4 percentage points to about 49 percent ( 48.7% in
2010 vs 44.3% in 2009).
• For girls who received the recommended three doses of
HPV vaccine, coverage increased five points to just 32
percent (32% in 2010 vs. 26.7% in 2009).
• Of the girls who began the HPV vaccine series, 30% did not
receive all three doses.
• Completion of the three-dose HPV series was lower among
blacks and Hispanics than non-Hispanic whites
• Health insurance coverage for three doses of HPV vaccine
was lower for those living below poverty.
• Poor and minority teens are less likely to receive all three
recommended doses of the HPV vaccine.
• The CDC estimates that 1.4% of males age 13–17 years
have received at least one dose of HPV vaccine.
Adapted from the CDC National Immunization Survey – 2010 Teen Survey
available here: http://www.cdc.gov/mmwr/preview/mmwrhtml/