costs related to skin cancers ( 71, 74). In this regard, in the
United States, the FDA has proposed a policy change to
ban the use of indoor UV tanning devices by individuals
younger than age 18. It is estimated that if this rule were
implemented it could avert 62,000 melanoma cases and
$343 million in treatment costs ( 38).
Persistent infection with a number of pathogens—bacteria,
viruses, and parasites that cause disease—increases a person’s
risk for several types of cancer (see Table 4, p. 34). The most
recent estimate is that 15 percent of all new cancer cases
diagnosed worldwide in 2012 were attributable to pathogens
( 76), the most common of which were Helicobacter pylori,
human papillomavirus (HPV), hepatitis B virus (HBV),
hepatitis C virus (HCV), and Epstein-Barr virus (EBV)
( 76). Thus, individuals can significantly lower their risks
for certain types of cancer by protecting themselves from
infection with cancer-associated pathogens or by obtaining
treatment, if available, to eliminate an infection (see sidebar
on Preventing or Eliminating Infection with the Four Main
Cancer-causing Pathogens, p. 35).
• Protects against infection with HPV6, 11, 16, 18, 31, 33, 45, 52, and 58.
• FDA approved in 2014 for
- preventing anal, cervical, vaginal, and vulvar cancers and precancers, as well as genital warts.
- vaccination of females ages 9 to 26 and males ages 9 to 15.
The U.S. Centers for Disease Control and Prevention (CDC) and the
Advisory Committee on Immunization Practices (ACIP) announced
updated guidelines for HPV vaccination in October, 2016.
According to the new recommendations ( 82):
• Two doses of HPV vaccine, given at least 6 months apart, are now recommended for adolescents
younger than age 15 (except immunocompromised persons), rather than three doses.
• Three doses of HPV vaccine are still recommended for teenagers and young adults
ages 15 to 26 and for people with weakened immune systems.
Updated HPV Vaccination Recommendations
Although there are three FDA-approved HPV vaccines, only one
(Gardasil 9) is currently being
distributed in the United States.
3strains of HPV can cause cancer: HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 66. 13
The updated recommendations are based on recent clinical data showing that, in younger adolescents,
two doses of the vaccine trigger an immune response equivalent to that produced by three doses among
adolescent girls and young women ( 83) (see Simplifying the HPV Vaccination Schedule, p. 54).
36 AACR CANCER PROGRESS REPORT 2017
More than 38,000
were diagnosed each year
in the United States from
2008 to 2012 ( 81).