Last month, actor Michael Douglas caused a stir in the media when he suggested his throat cancer might have been caused by oral sex.
He could be right. Although smoking and alcohol use have long been regarded as the key risk factors, new research indicates that HPV, a sexually transmitted virus, is now the leading cause of mouth and throat cancers in the United States.
But there's an important take-away message to this story: Some cancers caused by HPV can be prevented easily, with a simple series of three vaccinations.
Since 2000, scientists have known that certain strains of HPV are responsible for nearly all cervical cancer in women. But newer studies indicate HPV can cause other types of cancer as well. Recent findings have also linked HPV to oral, head/neck, anal, vaginal, vulvar and penile cancers, and even some cases of lung cancer.
About half of all Americans will become infected with HPV at least once during their lifetime. The most common visible symptom of an HPV infection is genital warts, although the majority of HPV infections do not display symptoms.
That's why the Centers for Disease Control and Prevention recommends that boys and girls alike be vaccinated against HPV. Ideally, they should be vaccinated between the ages of 11 and 12. Vaccination can be initiated as early as age 9, and the U.S. Food and Drug Administration has approved the vaccine to be given up to age 26.
Yet HPV vaccination rates remain low. In Eastern Kentucky, the percentage of women who die from cervical cancer is significantly greater than in the rest of state or the nation as a whole. But the percentage of girls and young women in Eastern Kentucky who receive the full three doses of the HPV vaccine is lower than both the state and national averages.
The University of Kentucky's Rural Cancer Prevention Center, a CDC-funded project, has conducted research over the past four years around the acceptance of the HPV vaccine. In an initial study, conducted in 2009, UK researchers found they literally could not give the vaccine away to young women in Eastern Kentucky.
A community advisory board was assembled to guide research into improving acceptance of the vaccine and completion of the three-shot series. Researchers learned that in order to increase acceptance they had to promote the vaccine in a culturally acceptable manner.
They hosted community hog-roasts, where local people helped promote the vaccine. They developed a DVD, designed to encourage completion of the three-shot series, to be shown to young women when they took the first shot. Numerous school systems sent home consent forms to parents to get permission for school nurses to provide the vaccine to their children.
Researchers at the center hope that if a community is engaged in the process and allowed to direct the delivery of the necessary change, outcomes can be achieved that will lead to a healthier population.
Tom Collins is the associate director of the University of Kentucky Rural Cancer Prevention Center.