B8.053 An Update on Human Papillomavirus

Question 1

most common HPV related cancer

Answer 1

head and neck cancers in men

Question 2

what is the transition/transformation zone

Answer 2

transition between stratified squamous to a columnar, glandular epithelium
most vulnerable to HPV related disease

Question 3

2 different sites of HPV infections

Answer 3

cutaneous > 80 types

mucosal > 40 types

Question 4

sequelae of cutaneous HPV infection

Answer 4

common hand and foot warts

Question 5

sequelae of mucosal HPV infection

Answer 5

high risk (16,18)
-cervical cancer
-anogenital cancer
-oropharyngeal cancer
-cancer precursors
-low grade cervical disease
low risk (6,11)
-genital warts
-laryngeal papillomas
-low grade cervical disease

Question 6

HPV vaccination recommendations

Answer 6

routine vaccination of adolescent females and males aged 11-12 with 2 doses
-can be started as early as 9
if over age 15, 3 doses over 6 months
"catch up" to age 26
current version in 9 valent

Question 7

HPV types included in 9 valent vaccine

Answer 7

6, 11, 16, 18, 31, 33, 45, 52, 58

Question 8

HPV 6, 11

Answer 8

genital warts

Question 9

HPV 16, 18

Answer 9

66% of cervical cancer

Question 10

HPV 31, 33, 45, 52, 58

Answer 10

15% of cervical cancer

Question 11

oral HPV prevalence in vaccinated men and women

Answer 11

lower, 4 years after at least 1 vaccine dose

Question 12

HPV vaccine efficacy

Answer 12

efficacy against initial HPV infection, genital wart, and precancerous/dysplastic changes
90% effectiveness against precancerous cervical disease over 10 years
recent studies show 0 HPV related cancers at all anatomic sites

Question 13

who gets more oral HPV?

Answer 13

men

higher rates of subsequent head and neck cancer

Question 14

main side effects of HPV vaccine

Answer 14

site reactions

syncope

Question 15

HPV vaccination rates

Answer 15

lag behind other recommended teen vaccines (Tdap, meningococcal)

Question 16

best predictor of HPV vaccination

Answer 16

provider recommendation

Question 17

why expand the age range of current HPV vaccine?

Answer 17

effective intervention
ongoing transmission of HPV into “mid adult” year
rising rates of HPV related head and neck cancers
expense of cervical cancer screening

Question 18

why not expand age range of HPV vaccine?

Answer 18

decreasing rates of new HPV infections with age
cost effectiveness
decreasing emphasis on younger age group