Tag: HPV

Categories : Cancer VaccinesTags :

Cervical Cancer Deaths in Young Women Plummet after Introduction of HPV Vaccine

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Cervical cancer. Credit: Scientific Animations CC4.0

Cervical cancer deaths have plunged dramatically among women under age 25, and researchers at MUSC Hollings Cancer Center believe this is likely due to HPV vaccination. Their study, published in JAMA, is the first to suggest the impact of HPV vaccination on cervical cancer deaths.

“We observed a substantial reduction in mortality – a 62% drop in cervical cancer deaths over the last decade, likely due to HPV vaccination,” said senior author Ashish Deshmukh, PhD, co-leader of the Cancer Prevention and Control Research Program. “We cannot think of any other reason that would have contributed to such a marked decline.”

The human papillomavirus, or HPV, causes nearly all cases of cervical cancer. The HPV vaccine was introduced in 2006. At first, it was available only to adolescents, but eligibility has since been expanded to include adults up to age 45 in some cases. In South Africa, an HPV vaccination programme started in 2014 for girls in public schools.

Previous studies have looked at the rates of HPV infection, precancer and cervical cancer incidence since the introduction of the vaccine, and all of those indicators have declined. The next logical step was to look at death rates, Deshmukh said.

Although cervical cancer is rare in women under age 25, it does occur. By examining deaths in this age group, researchers were able to see the early impact of the vaccine. Women who were 25 in 2021, the final year included in this study, would have been 10 years old when the vaccine was introduced.

The researchers looked at cervical cancer deaths in three-year blocks of time. Through the 1990s, there were between 50 and 60 cervical cancer deaths nationally in women under the age of 25 in each three-year block of time. During the 2019–2021 time period, there were only 13 deaths.

However, the team sounded an alarm. Healthy People 2030 has a goal of reaching an 80% HPV vaccination rate, but the Centers for Disease Control and Prevention reported earlier this year that only about 60% of 13 to 15 year olds have received the recommended doses.

“There has been a decline in HPV vaccination post COVID-19 in the most recent generation of U.S. adolescents. This is troubling as a decline in vaccination uptake would potentially lead to smaller gains,” Deshmukh said.

Source: Medical University of South Carolina

Categories : Obstetrics & GynaecologyTags :

New Cervical Cancer Test Catches Significantly More Cases

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Female reproductive system. Credit: Scientific Animations CC4.0 BY-SA

Researchers have developed a simpler and more effective screening method for cervical cancer than the method used today. A comprehensive study published in Nature Medicine shows that the test detects significantly more cancers and precancerous stages.

Most countries have a very extensive cervical cancer screening program that starts with testing for different variants of the human papillomavirus (HPV) that causes cervical cancer. In the case of an HPV-positive test, this is followed by cytological analysis, the examination of gynaecological cell samples by microscopy, which is dependent on human interpretation.

The new molecular test WID-qCIN, which could replace the cytological analysis, can automatically analyse epigenetic changes in cells. These changes, where genes are switched on or off, are influenced by factors such as environment, lifestyle, and aging, and can increase the risk of cancer and other diseases.

Fewer invasive procedures

The current study by researchers at Karolinska Institutet and the University of Innsbruck included more than 28 000 women over the age of 30 who underwent screening in Stockholm between January and March 2017. The researchers analysed a total of 2377 HPV-positive samples with the WID-qCIN test combined with a test for two high-risk HPV types (HPV 16 and 18). In this way, they were able to detect 100% of all invasive cervical cancer and 93% of all serious precancerous lesions that occurred within a year of sampling.

In addition, the new test, in combination with the HPV 16/18 test, was able to predict 69% of all cancers and precancerous lesions up to six years after the sample was taken. This can be compared with only 18% with today’s screening method.

“By integrating the WID-qCIN test into our screening programs, we would be able to identify more cancer cases while reducing the need for invasive procedures,” says Joakim Dillner, Professor of Infectious Disease Epidemiology at Karolinska Institutet and co-author of the study.

A significant improvement 

When cell changes are detected in today’s screening program, the woman undergoes a vaginal examination, a so-called colposcopy, where the gynaecologist looks at the cervix with the help of a microscope and, if necessary, takes a biopsy. The biopsy involves a surgical procedure that, among other things, can lead to negative pregnancy outcomes like premature delivery. The results of the current study suggest that implementation of the WID-qCIN test could reduce the number of colposcopy examinations by 40%.

“This would mean a significant improvement compared to today’s screening methods, which were introduced in the 1960s,” says the study’s last author Martin Widschwendter, Professor at the University of Innsbruck (Austria) and visiting Professor at Karolinska Institutet. “With its simplicity and objective assessment, the WID-qCIN test can improve the effectiveness of these programs and support the global strategy to eliminate cervical cancer.” 

Source: Karolinska Institutet

Categories : Cancer Lab Tests and ImagingTags :

New HPV Test Enables Precision Treatment

On By ModernMedia
Source: NCI on Unsplash

Researchers have made advances in improving detection of the human papillomavirus (HPV) in the bloodstream, which could further hone precision treatment of the illness.

The team sequenced circulating tumour DNA, which can lead to the detection of HPV in a person’s blood. Previous science in the field has proven that the virus, which causes cancers in the throat, mouth, and genital areas, can be found in the bloodstream but tests have had limited sensitivity. The new study enables ‘ultrasensitive’ detection, which could pave the way toward greater use of precision medicine for patients with cancers affecting these vulnerable areas of the body.

In a cohort of patients with advanced cervix cancer, the new sequencing method detected 20-fold lower levels of HPV circulating tumour DNA, making it a promising new method to monitor the disease.

The results come from the laboratory of Senior Scientist Dr Scott Bratman at Princess Margaret Cancer Center and are published in Clinical Cancer Research. “Increasingly, as clinicians we’re focused on precision medicine and making sure we’re not over-treating people while still curing them, that’s a very difficult balance to strike,” Dr Bratman said.

One way is to use liquid biopsy approaches or blood-based biomarkers, such as circulating tumour DNA, in order to monitor how the treatment is progressing, he added.

“We’re really at the cusp of a revolution from a technology, clinical implementation and standard of care standpoint, where five to 10 years from now we will not be treating everybody with the same dose of radiation and chemotherapy, and then waiting months to see if the treatment was effective,” he said. “I’m confident we will be giving much more tailored doses.”

When physicians scale back on these treatments, there is a risk of the cancer reoccurring. With more sensitive tests, reoccurrences can be detected early and patients returned to treatment.

“Patients who need more treatment will then be able to continue on, or different treatments can be added,” Dr Bratman said. “We can spare the vast majority of patients who will not need those interventions and provided them with a greater quality of life once they’re cured of the cancer.”

The work will enable further study in the field, refining the approach using larger study groups, and eventually, practice-changing clinical trials. This technique could also be applied to other cancer-causing viruses such as certain types of stomach cancer and lymphomas.

Source: Princess Margaret Cancer Center

Categories : Diseases, Syndromes and ConditionsTags :

Immune System Mutation Found in Tree-man Syndrome

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Cryo-electron microscopy structure of the human papillomavirus. Source: Wikimedia Commons CC0

A new study explores why some extremely rare cases of human papilloma virus (HPV) infections cause horn-like growths on the skin, a condition known as tree-man syndrome. 

Infection with HPV is extremely common, with most people catching it at some point and not even being aware of it due to a robust immune response, though some may experience skin or genital warts. Why only a handful of individuals react to it by developing tree-man syndrome was not well understood.

To find out why this strikes a handful and not others, Rockefeller’s Jean-Laurent Casanova examines the genetics of an otherwise healthy patient who contracted a severe case of tree-man syndrome and several family members who exhibited milder reactions to HPV. Casanova’s team identified a mutation that affects one’s reaction to HPV by decreasing the production of CD28, a molecule within the immune system that plays an important role in activating pathogen-fighting T cells.

Given the purported importance of CD28 to the immune system, the scientists were surprised that this CD28-deficient individual was healthy prior to contracting tree-man syndrome. “CD28 is thought of as a pillar of T cell immunity,” says Casanova. “The fact that this patient was otherwise healthy suggests that CD28 is largely redundant in human health. Something else is able to step up to provide protection against other infections.”

The findings, published in Cell, form a small part of Casanova’s larger work, which continues to demonstrate that the severity of  influenza, tuberculosis, COVID, and other diseases, is not solely dependent on the pathogen itself, but on genetics of the host, too.

Source: Rockerfeller University

Categories : Cancer VaccinesTags :

HPV Vaccine to Cause Drop in Oropharyngeal Cancers

On By ModernMedia
Photo by Gustavo Fring at Pexels

Vaccinations against human papillomavirus (HPV), a major cause of oropharyngeal cancers, are expected to yield significant reductions in the rates of these cancers in the US after 2045, according to a new study.

The most common sexually transmitted infectious virus worldwide, HPV infection is often silent, and while most infections clear, some are chronic and can trigger cancers including mouth and throat (oropharyngeal), and cervical cancer as they disrupt DNA and inhibit tumour-suppressor proteins in infected cells. While there is no cure for existing HPV infections, vaccines can prevent new infections. The study appears online in JAMA Oncology.

“We estimate that most of the oropharyngeal cancers from 2018 to 2045 will occur among people who are 55 years and older and have not been vaccinated,” said study lead author Yuehan Zhang, a PhD candidate in the research group of Gypsyamber D’Souza, PhD, professor in the Department of Epidemiology at the Bloomberg School.

“HPV vaccination is going to work to prevent oropharyngeal cancers, but it will take time to see that impact, because these cancers mostly occur in middle age,” Prof D’Souza said.

Oropharyngeal cancer is the most common HPV-related cancer. Vaccination, though effective in prevention, has no effect against established HPV infections or against cells that have been transformed by HPV and are on their way to forming tumours, therefore recommended mainly for the young not yet exposed to sexually transmitted HPV. (People who were adults when the vaccine became available mostly did not receive it and remain at risk for these cancers)

In the new study, researchers at the Johns Hopkins Bloomberg School of Public Health analysed national databases on oropharyngeal cancer cases and HPV vaccinations, and projected the impact of HPV vaccination on the rates of these cancers in different age groups. They estimated that the oropharyngeal cancer rate would nearly halve between 2018 and 2045 among people ages 36–45. However, they also projected that the rate in the overall population would stay about the same from 2018-2045, due to still-rising rates of these cancers in older people, where most of these cancers occur.

The results suggest, though, that by 2045 HPV vaccination will have begun to make a significant impact. “Our projections suggest that by around 2033, nearly 100 cases of oropharyngeal cancer will be prevented each year, but by 2045 that figure will have increased by about ten times,” Zhang said.

Source: Johns Hopkins University Bloomberg School of Public Health