American Cancer Society updates guideline for HPV vaccination

July 08, 2020

The American Cancer Society (ACS) has updated its guideline for HPV vaccination, adapting a 2019 update from the Federal Advisory Committee on Immunization Practices (ACIP). The ACS first issued a guideline for routine use of the HPV vaccine in 2007, with an update issued in 2016. This third version of the guideline is published in CA: A Cancer Journal for Clinicians, the ACS's flagship medical journal.

For the update, members of the ACS's Guideline Development Group (GDG) participated in content review of two new 2019 ACIP recommendations, and were charged to propose any modification or adaptation after reviewing the evidence evaluated by ACIP and its interpretation, as well as some recent studies and considerations related to implementation efforts to increase rates of population coverage and on-time vaccination. While there was broad general agreement, there were also some areas of difference between the ACIP recommendations and judgments of the GDG in the context of cancer prevention aims and nationwide efforts to increase vaccine utilization.

The ACS's update addresses three key issues: The ACS adaptation emphasizes that vaccination may be routinely offered at age 9-12; it endorses harmonization of catch-up vaccination for all individuals through age 26 while continuing to include a qualifying statement about reduced effectiveness of vaccination at older ages (i.e. young adults as compared to teens and pre-teens); and does not endorse the recommendation for shared clinical decision-making about vaccination for adults aged 27-45 years.

Age to begin vaccination Qualifying Statement: Routine HPV vaccination between ages 9-12 years is expected to achieve higher on-time vaccination rates, resulting in increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine at age 9 or 10 years.

Catch-up vaccination Qualifying Statement: Providers should inform individuals aged 22-26 that vaccination may be less effective in lowering their cancer risk.

Adult vaccination Qualifying statement: ACS does not endorse shared clinical decision-making for adults ages 27-45 due to the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision-making on patients and clinicians, and the lack of sufficient guidance on selection of individuals who might benefit.

"We're seeing evidence that starting vaccination at age 9 or 10 has potential benefits that are expected to lead to higher vaccination rates, resulting in increased numbers of cancers prevented compared to starting at ages age 11 and 12," said Debbie Saslow, PhD, managing director, HPV & GYN Cancers. "It's for that reason we felt it was important to say that starting at age 9 or 10 is more than OK; it's preferable to achieve the full cancer-preventing potential of this vaccine."

The ACS decision not to endorse shared clinical decision-making for vaccination between ages 27 and 45 was based primarily on the minimal cancer prevention benefit expected from vaccination of individuals in that age range. In addition, there has been a global shortage of HPV vaccine that is expected to continue for the next several years.

"The combination of HPV vaccination and cervical cancer screening has the potential to prevent tens of thousands of cancers caused by HPV each year in this country and to eliminate cervical cancer as a public health problem in the coming decades," conclude the authors. "Vaccination of all children between ages 9 and 12 years will prevent >90% of the cervical, oropharyngeal, anal, vaginal, vulvar, and penile cancers that are caused by HPV and, combined with screening and the treatment of cervical precancers, can lead to the first elimination of a cancer in history."
-end-
Article: Saslow D, Andrews K, Manassaram-Baptiste D, Smith RA, Fontham E. Human Papillomavirus Vaccination 2020 Guideline Update: American Cancer Society Guideline Adaptation. CA: Cancer J Clin 2020 doi: 10.3322/caac.21616

The full guideline is published at: https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21616

American Cancer Society

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.