HPV Tied to Rare Head-and-Neck Cancer

Origins of nasopharyngeal infection may mirror tonsil cancer epidemic, researchers say

(HealthDay News) -- Human papillomavirus (HPV) appears to be linked to an increase in cases of a rare type of head and neck cancer, a new study has found.

Nasopharyngeal cancer -- a tumor that grows behind the nose and at the top of the throat, above the tonsils -- affects about one of every 100,000 people in the United States. According to the researchers, this is the first time that a connection has been made between HPV and nasopharyngeal cancer.

"We are in the middle of a tonsil cancer epidemic, seeing many patients with tonsil cancer linked to HPV," study author Dr. Carol Bradford, a professor and chairwoman of otolaryngology at the University of Michigan Medical School, said in a university news release. "It turns out that HPV may also be a new cause of this rare form of cancer that occurs in this hidden location."

Bradford and her colleagues analyzed tissue samples from five patients with nasopharyngeal cancer and found HPV in four of them. The four HPV-positive tumor samples were negative for Epstein-Barr virus, previously recognized as one of the major infectious causes of nasopharyngeal cancer.

The study was published online Sept. 15 in Head & Neck.

"Since I began studying head and neck cancer, I have wondered what the cause of Epstein-Barr-virus-negative nasopharyngeal tumors might be," Thomas Carey, a professor of otolaryngology and pharmacology, co-director of the head and neck oncology program at the university's Comprehensive Cancer Center and another author of the study, said in the news release. "This research suggests that there is a changing etiology for nasopharyngeal cancer in the North American population that may mirror the HPV-positive epidemic of tonsil cancer."

The researchers said that a larger study needs to be conducted to clarify the role of HPV in nasopharyngeal cancer.


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Cervical Cancer Vaccine Well Tolerated

Reactions such as hives called 'idiosyncratic,' study finds

(HealthDay News) -- Reactions to the vaccine designed to protect against cervical cancer are rare, and young women can tolerate subsequent doses.

That's the assessment of Australian researchers who analyzed data after more than 380,000 doses of the Gardasil vaccine were given to girls in secondary schools beginning in April 2007.

Gardasil protects against four types of human papillomavirus (HPV) that increase the risk of cervical cancer. Some ingredients of the vaccine, such as aluminum salts and yeasts, have previously been associated with hypersensitivity reactions.

The Australian researchers identified 35 schoolgirls with suspected hypersensitivity reactions, including hives, generalized rash, swelling of subcutaneous tissues (angioedema), and severe allergic reaction (anaphylaxis).

Twenty-five of the girls agreed to be referred to pediatric allergy centers for further evaluation. This included a detailed account of their reactions, such as previous doses of the vaccine, time and severity of reaction, and previous clinical history. Skin tests of HPV vaccines were conducted, and vaccine challenges were administered intramuscularly. The girls were followed-up by telephone one week after the subsequent dose, and any adverse events were noted, the researchers said.

Nineteen girls had skin testing of the Gardasil vaccine, and all were negative. Seventeen of 18 girls later "challenged" with the vaccine tolerated further doses. One girl reported a limited case of hives four hours after receiving the vaccine. Only three of the 25 evaluated girls had probable hypersensitivity to the vaccine, and the researchers concluded that true hypersensitivity is rare.

They noted that suspected hypersensitivity reactions such as hives are often "idiosyncratic" and don't increase the risk of adverse reactions in subsequent vaccinations. Girls with suspected hypersensitivity to the vaccine should be evaluated before receiving further doses, said the researchers, who called for more research into the mechanisms of hypersensitivity to the vaccine.

The study was published online Dec. 3 in the BMJ.

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The U.S. National Cancer Institute has more about HPV vaccines.

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Gardasil Protects Men Against Genital Warts: Study

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(HealthDay) A new study says the anti-cervical cancer vaccine Gardasil also reduces men's risk of genital warts, which can lead to cancer of the penis and anus. Gardasil protects against the sexually transmitted human papillomavirus (HPV).

The 30-month study of 4,065 males, ages 16 to 26, found that those who received the vaccine were 90 percent less likely to develop genital warts. The findings were presented Friday at a meeting of the European Research Organization on Genital Infection and Neoplasia, Bloomberg news reported.

The study was funded by Merck & Co., which plans to use the results to seek U.S. Food and Drug Administration approval to sell Gardasil as a vaccine for males. Currently, it's only approved in the United States to protect women against HPV, which can cause cervical cancer. Gardasil is approved for males in 40 countries.

HPV may be associated with about 1,500 cases of penile cancer and about 1,900 cases of anal cancer in men a year, according to the U.S. Centers for Disease Control and Prevention. The agency also said men who have sex with men are 17 times more likely to develop anal cancer from HPV, Bloomberg reported.

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Special Mouth Rinse Spots, Tracks Human Papillomavirus Infection

Study may lead to better diagnosis and monitoring for head/neck cancers

(HealthDay News) -- A simple mouth rinse can spot specific types of human papillomavirus, some of which cause genital warts and increase the risk of developing certain types of cancer, new research shows.

The study, published in the Nov. 1 issue of Clinical Cancer Research, reaffirms that people exposed to human papillomavirus (HPV-16), the variant that causes cervical cancer, are more likely to develop cancers of the head and neck.

The researchers followed 135 patients with head and neck cancer over five years, and found that the patients with HPV-16 positive tumors were far more likely to test positive for oral HPV-16 infections before, during, and after therapy.

Although past research has shown a strong association between cancers of the head and neck and HPV-16 infection, these researchers used genetic sequencing to confirm the link between HPV-16 infection and HPV-16 shed by tumors in patients with head and neck cancers. Patients with HPV-16 positive tumors were also more likely to test positive for all types of the virus.

"Most of the 50 percent of people who get an HPV infection at some point in their lives clear it with no problem," said study co-author Dr. Maura Gillison, an associate professor of oncology at Johns Hopkins. "The question is, how do we identify those who will have a problem from the infection with those who will not?"

Although the vaccine Gardasil has been shown to offer protection against HPV infection and thus reduce the incidence of cervical cancer, efforts to vaccinate young girls have been controversial. Some believe vaccinating young girls may encourage premarital sex or promote risky sexual behavior.

But the link between HPV infection and cancers of the head and neck has prompted many researchers to advocate vaccinating boys as well as girls. "In the future, vaccinating all young women between the ages of 9 and 26 would reduce oral cancer if HPV is indeed the cause," said Dr. Mark Werner, an obstetrician/gynecologist at William Beaumont Hospital in Royal Oak, Mich. "Maybe at some point, men or young boys will be vaccinated as well."

The study concluded that a noninvasive oral rinse may help researchers understand how different variants of the virus impact the development, outcome, and recurrence of different cancers.

"Can we use HPV oral detection for screening purposes to identify people who are at risk for this type of cancer?" asked Gillison. "The broader implications are that these can be applied to other studies."

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Cervical Cancer Vaccine Called Safe

CDC found no heightened risk of blood clots, other conditions with Gardasil

(HealthDay) -- Gardasil, the two-year-old vaccine that's designed to prevent cervical cancer, is safe, U.S. officials said Wednesday.

The U.S. Centers for Disease Control and Prevention's Immunization Safety Office said a study of 370,000 doses given to girls and young women over the past two years found no evidence that the vaccine causes an increased risk of blood clots or other serious conditions, Bloomberg News reported.

The CDC, which recommends the vaccine for girls starting at ages 11 and 12, based its findings on statistics from the Vaccine Safety Datalink, which uses medical data to test hypotheses about vaccine safety, the news service said.

"There were no associations found that suggested an elevated risk," said John Iskander, acting director for the Immunization Safety Office, told Bloomberg.

Critics of the vaccine, including some groups that worry that the inoculation could promote promiscuity, have contended that Gardasil may not be safe and could give women a false sense of security about sexually transmitted diseases.

Gardasil protects against four types of genital human papillomavirus, HPV, which is spread through sexual contact and can cause cervical cancer in women.

The U.S. study covered 190,000 girls and young women who received at least one dose of the vaccine's three-shot regimen. The CDC researchers compared medical data on those girls who got the vaccine with data for girls and young women who received other vaccines or none.

"The results are really reassuring," said Dr. Paul Offit, chief of the infectious diseases division at Children's Hospital of Philadelphia. "There's a public perception that the vaccine is not safe. This is important for countering negative information."

CDC officials had announced earlier this month that an estimated 25 percent of girls aged 11 to 17 have gotten the vaccine.

"This is very good for a first-year measurement of a new vaccine," Dr. Lance Rodewald, director of the Division of Immunization Services at the CDC' National Center for Immunization and Respiratory Diseases, said during a Oct. 9 teleconference announcing the survey. "It usually takes six to nine years to achieve the desired 90 percent coverage."

Rodewald noted that because the survey covered only young teens, many more young women have probably received the vaccine. The vaccine has been very well-tolerated, and its protection, especially when given at a younger age, is expected to last at least six years, he noted. Whether a booster shot will be needed isn't known yet.

The hope for the vaccine is that it will reduce the almost 4,000 cervical cancer deaths each year in the United States. Barriers to getting the vaccine include cost, which is about $375, although it is covered under many health insurance plans.

One side effect associated with the vaccine, fainting, resulted in the U.S. Food and Drug Administration last month requiring that vaccine manufacturer Merck & Co. add a warning to the package insert, advising doctors to watch patients for 15 minutes after the shot to be sure they don't faint.

In July, news stories said that almost 8,000 reports of adverse reactions to Gardasil -- including injection site pain and nausea -- had been filed with the CDC.

The reactions included 15 reports of death and 10 confirmed deaths, but none of the deaths has been tied to the vaccine, according to a CNN report.

After the CDC study results were released Wednesday, Merck issued the following statement: "Gardasil is an important tool to help prevent cervical cancer caused by HPV types 16 and 18 for girls and young women. About 30 women every day are diagnosed with cervical cancer in the United States. An estimated 8 out of 10 women will become infected with HPV in their lifetime. For most people, HPV clears on its own. But for some women who don't clear certain types of the virus, cervical cancer can develop. And there's no way to predict who will or won't clear the virus."

Source : HealthDay.com

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