Category: Cancer

Cancer Follow-up Care Needs Improvement

With greater long-term cancer survival, previous standards of cancer follow-up care and support may no longer meet current needs.

The side-effects of anticancer medicines and impacts of the illness itself that sometimes persist after the end of treatment can hinder  a return to normal life after beating cancer. A study presented at the ESMO Congress 2021 showed that a significant proportion of survivors continue to suffer from burdensome symptoms for several years and reveal widespread dissatisfaction with the assistance provided.

Prof Dorothy Keefe, CEO of Australia’s national cancer agency, Cancer Australia, chair of the congress’s supportive and palliative care track, not involved in the study, underlined its importance in a context where survivorship research has lagged behind research on cancer treatment. “This is probably due to the increase in survival rates itself lagging behind the introduction of new therapies, but also to a lack of prioritisation compared to the need to develop a cure,” Keefe said, and highlighted the scale of the issue today: “We now have millions of cancer survivors in Australia, hundreds of millions around the world – and an ever-increasing number who could potentially have long-term side-effects.”

One of the most common symptoms experienced by patients and survivors alike is cancer-related fatigue (CRF), a persistent sense of exhaustion, not alleviated by sleep or rest and significantly interferes with the person’s usual functioning. The FiX study initially evaluated the patterns, severity and management of CRF among 2508 patients with 15 different types of cancer two years after the discovery of their illness. In a follow-up survey, 36 potential long-term problems, completed by participants around four years after diagnosis, almost 40% of survivors continued to report fatigue that they rated as a moderate or severe burden. As well as fatigue, over 40% of patients reported loss of physical capacity as a burden and over one third suffered from trouble sleeping, sexual problems, joint pains and anxiety.

Although there are recommendations for managing side-effects like CRF, study author Dr Martina Schmidt from the German Cancer Research Centre (DKFZ) in Heidelberg, Germany, drew attention to their lack of implementation and reported that more than one in three affected individuals in the study evaluated the support they were offered for fatigue as poor. “Despite increasing awareness of the effectiveness of mitigating measures like exercise to reduce fatigue, patients are still too often left alone to seek help for symptoms that cannot be directly addressed with medicines in the same way as something like pain, for which satisfaction with the support received was high in our study.”

Prof Keefe commented on the results, saying: “This research shows that a staggeringly high number of patients still suffer from significant health issues years after being declared disease-free. Their dissatisfaction with the care available is a wake-up call that we should be paying more attention to these individuals, trying to understand the mechanisms at play in order to identify interventions that could help them to better recover.”

According to Dr Schmidt, cancer follow-up care should therefore also incorporate more systematic screening for additional symptoms that can burden patients. “The first step should be to make sure that patients themselves are better informed about these potential issues early on, so they know that conditions like CRF are not only expected, but often manageable and that they should not wait for symptoms to disappear on their own,” she said.

Recognising that possible models of long-term support remain largely untested, Keefe further advocated that all patients should be provided with a survivorship care plan when they reach the end of their treatment. “Going forward, we need to develop these models of care in a way that minimises the burden on healthcare systems, implement them and research their impact so that we can come back in five years’ time and evaluate whether they have made a difference for cancer survivors,” she concluded.

Source: European Society for Medical Oncology

Plant Virus-based Treatment Protects Against Lung Tumours

Image source: CDC/Unsplash

Using a virus that grows in black-eyed pea plants, nanoengineers developed a new treatment that could keep metastatic cancers at bay from the lungs. 

Not only did the treatment slow tumour growth in the lungs of mice with either metastatic breast cancer or melanoma, it also prevented or drastically minimised the spread of these cancers to the lungs of healthy mice that were challenged with the disease. The research was published in Advanced Science.

Researchers developed an experimental treatment that combats metastatic spread. This involves a plant virus called the cowpea mosaic virus, harmless to animals and humans, but which the body still registers as a foreign invader, thus triggering an immune response that could also boost the body’s cancer-fighting ability.

The idea is to use the plant virus to help the body’s immune system recognise and destroy cancer cells in the lungs. The virus itself is not infectious in our bodies, but it has all these danger signals that alarm immune cells to go into attack mode and search for a pathogen, said Nicole Steinmetz, professor of nanoengineering at the University of California San Diego.

To draw this immune response to lung tumours, Prof Steinmetz’s lab engineered nanoparticles made from the cowpea mosaic virus to target a protein in the lungs. The protein, called S100A9, is expressed and secreted by immune cells that help fight infection in the lungs. Overexpression of S100A9 has been observed to play a role in tumour growth and spread.

“For our immunotherapy to work in the setting of lung metastasis, we need to target our nanoparticles to the lung,” said Prof Steinmetz. “Therefore, we created these plant virus nanoparticles to home in on the lungs by making use of S100A9 as the target protein. Within the lung, the nanoparticles recruit immune cells so that the tumors don’t take.”

“Because these nanoparticles tend to localise in the lungs, they can change the tumor microenvironment there to become more adept at fighting off cancer — not just established tumors, but future tumors as well,” said Eric Chung, a bioengineering PhD student in Steinmetz’s lab who is one of the co-first authors on the paper.

To make the nanoparticles, the researchers infected black-eyed pea plants with cowpea mosaic virus, and harvested the virus in the form of ball-shaped nanoparticles. They then fixed S100A9-targeting molecules to the particles’ surfaces.

The researchers performed both prevention and treatment studies. In the prevention studies, they first injected the plant virus nanoparticles into the bloodstreams of healthy mice, and then later injected either triple negative breast cancer or melanoma cells into these mice. Treated mice showed a dramatic reduction in the cancers spreading to their lungs compared to untreated mice.

In the treatment studies, the researchers administered the nanoparticles to mice with metastatic tumours in their lungs. The treated mice exhibited smaller lung tumours and survived longer than untreated mice.

Prof Steinmetz envisions that the treatment could be useful after tumourectomy. “It wouldn’t be meant as an injection that’s given to everyone to prevent lung tumours. Rather, it would be given to patients who are at high risk of their tumors growing back as a metastatic disease, which often manifests in the lung. This would offer their lungs protection against cancer metastasis,” she said.

More detailed immunotoxicity and pharmacology studies are needed before this can progress to a treatment. Future studies will also explore combining this with standard cancer therapies such as chemotherapy.

Source: University of California – San Diego

Second or Third-degree Relatives Still Share Colon Cancer Risk

Colon cancer cells. Source: National Cancer Institute on Unsplash

A new study has found that having second- or third-degree relatives with colorectal cancer increases a person’s risk of developing the disease.

Early colonoscopy screening is often recommended for first-degree relatives of someone diagnosed with early-onset (before age 50) colorectal cancer, cases of which have been increasing significantly over the past few decades. But the study suggests that early screening may be beneficial for second- and third-degree relatives as well.

The study reviewed more than 1500 early-onset colon cancer cases in the Utah Cancer Registry,found that first-degree relatives of someone diagnosed with early-onset colorectal cancer are 6 times more likely to be diagnosed with colorectal cancer before age 50, while second-degree relatives (aunts, grandparents etc) are 3 times likelier and third-degree relatives (first cousins etc) 1.56 times likelier.

“Our study provides new insight into the magnitude of risk for more distant relatives of colorectal cancer cases, and in particular, for relatives of cases who were diagnosed before age 50,” said first author Heather Ochs-Balcom, associate professor of epidemiology and environmental health, UB School of Public Health and Health Professions. “This work is important given the rising rates of early-onset colorectal cancer.”

There was also 2.6-fold higher risk of colorectal cancer at any age if they have a first-degree relative with early-onset colon cancer. The risk is 1.96 and 1.3 times greater for second- and third-degree relatives, respectively. In addition, the risk for all degrees of relatives for early-onset colon cancer is higher than the risk for colon cancer at any age.

The findings, published in Cancer Epidemiology, suggest that early colonoscopy screening may be beneficial for second-degree relatives and possibly third-degree relatives, in addition to first-degree relatives of individuals diagnosed with colorectal cancer before age 50.

The researchers also point out that relatives may benefit from being more aware of their extended family history and sharing this information with their physician when making cancer-screening decisions.

Source: University at Buffalo

Childhood Cancer Survivor Set to Break Barriers in Space

Hayley Arcenaux, seated furthest left, is the Medical Officer for the Inspiration4 flight. She is a survivor of childhood cancer and works as a physician assistant at St Jude’s Children’s Hospital, for which the flight is raising funds and awareness.

The first chartered spaceflight into orbit, scheduled for launch on September 15, will have a crewmember who is both a childhood cancer survivor and physician assistant as part of the crew. 

The three-day long mission aboard a SpaceX Dragon spacecraft was chartered by entrepreneur Jared Isaacman. Dubbed Inspiration4, the flight is in fact also raising money and awareness for St Jude Children’s Hospital, which was given two of the four seats on the spacecraft. The funds raised for the hospital are believed to have exceeded the cost of the flight.

Isaacman offered the first seat to 29 year-old Hayley Arceneux, who works as a physician assistant at St Jude’s and will be the medical officer for the flight. She was also a patient at the very same hospital. At age 10, she was diagnosed with osteosarcoma, the most common primary paediatric bone malignancy. In addition to a dozen rounds of chemotherapy, she had a limb-sparing operation which replaced her knee and inserted a titanium reinforcing rod in her femur. This will make her the first person with a prosthetic in space. Such a medical history would have immediately disqualified her for astronaut selection with any of the government-run space agencies like NASA.

In an interview with The Cut, she described her work as a physician assistant at St Jude’s: “I work inpatient… with leukaemia and lymphoma patients specifically. The majority of them received their cancer diagnoses pretty recently, so a big part of  my role is helping to educate and support families through the beginning of treatment. I help them understand, What is cancer? What does the treatment process look like? What should I expect?

“We also manage the kids while they are in treatment. If they get an infection or if they get a fever, we take that really seriously. So I’ll manage their IV antibiotics or other treatment-related complications that can occur.. I check on patients, assess labs, order tests, update families on the results, order meds for outpatients. It is a lot of coordinating and educating. It’s hard, but it’s the greatest job in the world.”

St Jude’s held an auction for the other crew seat that Isaacman offered. The winning bidder declined the seat and gifted it to data engineer Christopher Sembroski. The final seat was won in an entrepreneurial competition by Dr Sian Proctor, a geologist and pilot who narrowly missed out on being chosen as a NASA astronaut. 

Speaking about the auction, Richard C. Shadyac Jr, president and chief executive of American Lebanese Syrian Associated Charities, which raised fund for St Jude’s, said: “The impact of the Inspiration4 mission has been immeasurable, serving as an incredible platform to educate and engage millions in the movement to find cures and deliver care for childhood cancer and other catastrophic diseases through accelerated research and treatment. The auction is a critical component of the overall campaign as it enables us to reach new audiences and supporters as we work to fulfill our mission.”

So far, $100 million has been raised for St Jude’s.

While in space, the crew will conduct experiments such as examining fluid shifts in zero gravity using ultrasound, as well as other medical experiments including measuring blood glucose levels — in order to help expand space travel to those with diabetes.

A documentary has been made of the crew’s training, and is available to stream on Netflix.

Less than Half of Community Oncologists Use Biomarker Testing

Photo by Robina Weermeijer on Unsplash

A survey found that less than half of community oncologists surveyed indicated using biomarker testing to guide patient discussions, compared to 73% of academic clinicians.

Recent advances have substantially altered the management of lung cancer but, there is a concern these new methods, which include biomarker testing, will not be used equally throughout the health care system and worsen disparities that may already be entrenched.

To determine this, the Association of Community Cancer Centers (ACCC), led by Leigh Boehmer, Pharm.D., chief medical officer, developed a US oncology clinician-facing survey instrument.

To help guide clinicians in the use of biomarker testing, the College of American Pathologists, the IASLC, and the Association for Molecular Pathology published the 2018 CAP/IASLC/AMP Molecular Testing Guidelines for Lung Cancer. Dr. Boehmer reported that of the 99 responses collected, only 40 percent indicated they were “very” or “extremely familiar” with the 2018 Guidelines.

The researchers found that clinicians were most confident in selecting appropriate tests to use, interpreting test results, and prognosticating based on test results, but less confident in determining when to order testing and coordination of care. This lack of communication was echoed in focus groups, Dr Boehmer reported.

Clinicians are most likely to order biomarker testing to make more accurate treatment decisions and inform patient discussions, but only 48% of community clinicians indicated that they use biomarker testing to guide patient discussions compared to 73% of academic clinicians.

Asked about preferences when making a final testing decision, 41% of clinicians prefer that they share responsibility with the patient while 52% prefer to make the final decision themselves. Only 6% prefer that the patient make the final decision. Focus groups suggested that clinicians perceive that patients rarely understand what testing entails and how it affects treatment options.

To make more informed decisions about biomarker testing, clinicians indicated that they need more information on financial resources, as well as education around both published guidelines and practical implications of clinical data. Sixty-seven percent of clinicians provide printed educational materials to their patients. When asked what resources their patients need most, 27% said their patients need handouts or educational resources, followed by psychosocial support (23%) and financial assistance (22%).

“This study identifies key areas of ongoing clinician need related to biomarker testing, including increased guideline familiarity, practical applications of guideline-concordant testing, and how to optimally help coordinate multidisciplinary care,” said Dr. Leigh Boehmer, Pharm.D. “Professional organisations and advocacy groups should focus on developing impactful education materials and tools for improving patient-clinician discussions about biomarker testing.”

Source: International Association for the Study of Lung Cancer

Elevated Cancer Risk in 9/11 Responders 20 Years On

Image by David Mark from Pixabay

Associations between responders exposed to toxins at the World Trade Center (WTC) collapse site and increased cancer risk continue to be observed 20 years after the tragic event.

Thousands of rescue workers and first responders were exposed to toxins (asbestos, polychlorinated biphenyls, benzene, dioxins) in the aftermath of the World Trade Center attacks on September 11, 2011. Two studies recently published in Occupational & Environmental Medicine reported on the cancer incidence rates among the WTC Health Program General Responder Cohort.

According to the first study, male New York City firefighters exposed to the WTC site had higher rates of all cancers 13% increase and a younger median age at diagnosis (55.6 vs 59.4 years) compared with male non-WTC-exposed firefighters.

The WTC-exposed firefighters had increased rates of a number of cancers, the highest of which was thyroid cancer (153%) reported Mayris Webber, DrPH, of the Bureau of Health Services at the Fire Department of the City of New York, and colleagues.

The second study from Charles Hall, PhD, of Albert Einstein College of Medicine in the Bronx, and colleagues, found that, beginning in 2007, rescue/recovery workers at the WTC site had a 24% increased risk for prostate cancer compared with the general population in New York State.

Webber and colleagues noted that all firefighters are repeatedly exposed to occupational hazards, including known carcinogens. Their 2016 study found no difference between WTC-exposed firefighters and a group of non-WTC-exposed firefighters from three other cities. The current study extended follow-up to allow for detection of cancers up to 15 years after WTC site exposure.

In this analysis of 10 786 WTC-exposed firefighters and 8813 non-WTC-exposed firefighters, prostate cancer was the most commonly diagnosed cancer among both groups.

In comparison to the US male population, all-cancer incidence among exposed firefighters was “higher than expected”, an increase of 9% even after adjustment for possible surveillance bias.

The researchers adjusted for earlier detection made possible through free screenings, but elevated rates persisted for all cancers (7%), prostate cancer (28%), non-Hodgkin lymphoma (21%), and thyroid cancer (111%).

Webber and colleagues acknowledged that assessment of cancer risk among WTC-exposed firefighters is complex, as “these firefighters were subject to carcinogenic exposures, while also enduring enormous physical and mental burdens related to the attacks.”

“Evidence is slowly accruing about cancer and other long latency illnesses in relation to WTC exposure, although much remains to be determined,” they added.

Research has shown a lag of 10 to 20 years from exposure to a carcinogen to prostate cancer diagnosis. While WTC exposure was known to be linked to prostate cancer risk among responders, the length of time between exposure and cancer diagnosis was unknown.

Among the 54 394 rescue/recovery workers in the study, 1120 prostate cancer cases were diagnosed from 2002 to 2015.

The median time from the attacks to a diagnosis was 9.4 years, with the majority (66%) of cases diagnosed from 2009 to 2015.

Higher screening rates among first responders may have contributed to the increased incidence of prostate cancer seen in the study, the researchers acknowledged.

Comparing the responders who arrived earliest to the site with those who arrived later revealed a positive, monotonic, dose-response association with the early (2002-2006) and late (2007-2015) periods.

“The increased hazard among those who responded to the disaster earliest or were caught in the dust cloud suggests that a high intensity of exposure may have played some role in premature oncogenesis,” Hall and colleagues wrote. “Our findings support the need for continued research evaluating the burden of prostate cancer in WTC responders.”

Source: MedPage Today

Common Chemical in Medical Products Linked to Breast Cancer

Photo by Bill Oxford on Unsplash

Researchers in Japan have found that widely used chemicals called photoinitiators cause breast tumours to accelerate in mice. 

Photoinitiators, which release reactive molecules in response to UV radiation,  are used in a wide range of products, including plastics, paints, inks, and adhesives. Photoinitiators are present in common objects as well as in medical products and instruments such as dental fillers and containers.

Recent studies have demonstrated several health hazards associated with photoinitiators, raising safety concerns. In particular, the presence of these compounds in clinical instruments, routinely used for treating high-risk individuals such as cancer patients, has become a major cause for concern. Previous research has shown that three photoinitiators commonly found in plastics and paints 1-HCHPK, MBB, and MTMP show oestrogen-like effects on cultured breast cancer cells, increasing their proliferation. Found in marketed injection solutions, the clear link between oestrogen activity and breast cancer made determining their effect a priority.

In a study published in Current Research in Toxicology, lead researcher Dr Yoichi Kawasaki and Prof Toshiaki Sendo from Okayama University examined how exposure to 1-HCHPK, MBB, and MTMP affected the growth of transplanted breast cancer tumours in mice. They found that all three compounds caused a faster increase in the growth of breast tumors, within 13 weeks of treatment. “This study extends our previous findings and shows that in addition to promoting the proliferation of breast cancer cells in culture, these photoinitiators also increase the growth of breast tumours in live animals. This implies that they could also potentially hasten disease progression in breast cancer patients,” explained Dr Kawasaki.    

The study results show that 1-HCHPK, MBB, and MTMP have oestrogen-like activity and could thus act as hormonal disruptions. Given oestrogen’s role in regulating reproductive function in both men and women, such disruptions could affect not only patients with breast cancer, but also healthy individuals. While the researchers intend to explore the effects of photoinitiators on reproduction in future research, the present study informs breast cancer management, as well as making urgent call-to-action to eliminate toxic materials from medical equipment.

“Photoinitiators have helped us improve the quality of several commonly used products. But it is time we reconsider whether their benefits outweigh their risks, and our findings are an important milestone in encouraging this conversation. We hope that it will prompt more intensive research and stricter regulations on what materials can be adopted for commonly used products, especially those with medical applications,” said Dr Kawasaki.

Source: EurekAlert!

Many Lung Cancer Patients Choose Euthanasia Without Exploring Treatment

Photo by Adam Birkett on Unsplash

A Canadian study of lung cancer patients who opted for “medical assistance in dying” often proceeded without consultation with their radiation oncologist or medical oncologist.

In a Canadian study of 45 individuals diagnosed with lung cancer who used medical assistance in dying (also known as physician-assisted suicide), about 20% did not have a radiation oncologist involved when making the decision and 22% did not have a consultation with a medical oncologist, said Sara Moore, MD, of Ottawa Hospital Research Institute of the University of Ottawa.

Since 2016, about 60% of those seeking to end their life through legal means introduced in Canada had been diagnosed with cancer, Dr Moore explained in a presentation at the virtual World Conference on Lung Cancer.

Driven by loss of autonomy, control and dignity
The designated discussant, Monica Malec, MD, a geriatric and palliative care physician at the University of Chicago, said this was the first study to evaluate medical assistance in dying in patients with lung cancer, oncologists’ involvement, and treatment history.

“The demand for medical assistance in dying is increasing and is becoming more readily available to patients,” Dr Malec said. “Patients are seeking this option despite the availability of more effective and more tolerable treatment options. Existing literature suggests that loss of autonomy, control, and dignity are the primary drivers for seeking medical assistance in dying rather than uncontrolled symptoms, and the decision to pursue medical assistance in dying may occur pre-illness.”

Moore noted that while lung cancer accounts for 20%-25% of all cancer deaths overall, in the current study 17.5% of the patients had lung cancer diagnoses. “Lung cancer comprises slightly fewer medical assistance in dying cases than expected compared to lung cancer death rates,” she said.

Improved treatments disregarded
“Biomarker-driven targeted therapy and immunotherapy offer effective and tolerable new treatments, but a subset of patients undergo medical assistance in dying without accessing — or, in some cases, without being assessed for — these treatment options,” Dr Moore continued. “Most patients were assessed by an oncology specialist, though less than half received systemic therapy.”

“Given the growing number of efficacious and well-tolerated treatment options in lung cancer, consultation with an oncologist may be reasonable to consider for all patients with lung cancer who request medical assistance in dying,” she said.

The researchers screened data from the Ottawa region, and identified 256 patients with a cancer diagnosis who had used medical assistance in dying. Of these, 45 patients had a lung cancer diagnosis.About 85% had a history of tobacco smoking, and 36% were current smokers at the time they sought medical assistance in dying, Moore reported. Thirteen of these patients had no biopsy confirmation of their disease, but almost all (91%) opting for medical assistance in dying were diagnosed with metastatic disease. Average age was 72 years, and 64% (29 of 45 patients) were women, even though men are more often diagnosed with lung cancer, Dr Moore noted. 
Limitations included being limited to only a single region, and a lack of information on patients’ decision-making process.

Source: MedPage Today

Bone Marrow Cell Mutations That Protect Against Cancers

Source: NIH

People with shortened telomeres caused by rare disorders may be more likely to have blood cancers such as leukaemia or myelodyplastic syndrome (MS). Now researchers have discovered several “self-correcting” genetic mutations in bone marrow that may protect such patients from these cancers.

In a study published in the Journal of Clinical Investigation, these mutations can serve as biomarkers to indicate if patients with short telomere syndromes (STS) are likely to develop blood cancers.

“These are the most common cancers we see in patients with short telomere syndromes,” said Mary Armanios, MD, director of the Telomere Center and professor of oncology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. “We know that at a certain point, the cells of patients with shortened telomeres either become cancerous or stay healthy.”

Dr Armanios and her team suspected that a self-correcting mechanism in areas of the body with high cell turnover, such as bone marrow, was allowing normal cells to turn malignant. Instead, it appears this mechanism protects against cells from becoming cancerous.

As over 300 billion blood cells are produced in the bone marrow daily, the researchers suspected they could find evidence of cellular self-correction in this area of the body, especially amid the spongey interior of bones, where quick adaptation is crucial for high-volume cell production.
The researchers tested the bone marrow and blood cells of 84 study participants divided into three groups: Those with STS and MS or leukaemia; those with short telomere syndromes and no MS or leukemia; and those in the control group without short telomere syndromes or any cancers.

Using ultra-deep genetic sequencing which picks up hard-to-detect mutations, Armanios and her team observed genetic mutations and self-correction in several telomere-associated genes. Nearly a quarter of patients with STS had these mutations, some even showing multiple mutations.

One such mutation in a gene called TERT enables the production of crucial parts of telomerase, which stabilises telomeres. By boosting telomerase production and overwriting faulty copies of the TERT gene, the researchers found that bone marrow cells seemed to self-correct to avoid becoming cancerous.

“Our findings speak to the versatility of the bone marrow and other areas with high cell turnover in the body,” says Armanios. “Such advantageous mutations provide the body with a better chance to protect itself. These findings may be important in the screening process of shortened telomere patients so that we can predict who may be protected from cancer.”

Source: John Hopkins Medicine

HPV Vaccine to Cause Drop in Oropharyngeal Cancers

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