Source: Medscape Medical News
I know what you’re thinking. Yes, HPV (human papillomavirus or genital warts) is a sexually transmitted disease which has been related with a specific cancer. Evidence appears to be mounting (sorry, I had to) that the incidence of oral HPV cancer has increased since the 70’s. According to statistics in the International Journal of Cancer (2009: 125:362-366) rates of HPV related oropharyngeal (mouth and throat) cancer were 23.3% in the 1970’s, 57% in the 199o’s and up to 93% in 2006-20007.
Why the increase in oral cancer? According to researchers it’s due to an increase in oral in general. Yes, some things do write themselves. Apparently it can take from 15 to 30 years for HPV to develop into cancer. While there is some concession that much of this is speculation as people are not necessarily candid in providing such information to researchers, the implications for treatment could be significant.
It is medically accepted that HPV causes cancer. In fact, the molecular mechanisms are well known enough for the development of the available HPV vaccine. Currently, the HPV vaccine is targeted to young women for the prevention of cervical cancer, which can originate from HPV. The vaccine was also recently approved for use with young men to prevent genital wart infection.
But could the same vaccine eventually be used to prevent against HPV-related oral cancer? Well, one would expect that it might, however, genital surfaces and fluids do differ from oral surfaces and fluids so no one is actually certain. The efficacy of the currently available HPV vaccine appears clear. But is it cost effective? That is, will big pharma seek to develop a vaccine for something potentially ineffective and potentially socially problematic.
Not as unusual as it might seem given our Puritanical heritage. Remember, if the studies correlating sexual behavior with increased incidence of oral HPV are correct this would seem to limit the transmission of this type of cancer to an act still defined as sodomy in many states in the United States and criminalized in some.
Perhaps the only other social-medical parallel would be with the medical marijuana debates going on in most states. Where medicine and societal “norms” or “values” intersect is where we start getting into problem territory. The manufacturers and marketers of the HPV vaccine took a lot of criticism for essentially targeting school-aged girls. When one finally “gets over” the fact that school-aged girls are sexually active the criticism seems nonsensical. A vaccine which could potentially prevent women from dying in their middle age from cancer inherently seems like a worthy investment. We will follow the emerging debate on this one.
~Posted by D.M. Schwadron, Esquire