SEATTLE - In response to low national vaccination rates for the human papillomavirus, or HPV, Fred Hutchinson Cancer Research Center has joined with the 68 other U.S. National Cancer Institute-designated cancer centers in issuing a statement urging for increased vaccination in adolescent girls and boys for the prevention of many types of HPV-related cancers in adulthood. The virus, which is sexually transmitted, impacts nearly all men and women at some point in their lives and can lead to cervical, anal, vaginal, penile, vulvar, and head and neck cancers.
Fred Hutch and the other cancer centers named in the statement collectively recognize insufficient vaccination as a public health threat and call upon the nation's physicians, parents and adolescents to take advantage of this rare opportunity to prevent many types of cancer.
"The HPV vaccine is an amazing public health advance, but it doesn't guarantee eradication of HPV. It's important to remember that the vaccine works best in those who haven't been infected with the virus, which means, essentially, people who are not yet sexually active," said Dr. Gary Gilliland, president and director of Fred Hutch, whose researchers played a pivotal role in both discovering HPV's association with cancer and paving the way for the development of the vaccine.
Dr. Gary Gilliland is president and director of Fred Hutch. Credit: Photo by Robert Hood / Fred Hutch
The vaccine's roots lie in the laboratory of Dr. Denise Galloway, associate director and member of the Human Biology Division at Fred Hutch, as well as laboratories in Australia and the National Institutes of Health, where Galloway and fellow investigators accomplished the groundbreaking step of getting a key viral gene to assemble into particles that look like HPV, which became the basis of the vaccine.
Galloway and colleagues began studying HPV's utility as a tool for understanding how normal cells turn abnormal. Viruses disrupt cellular pathways in much the same way as cancers do, so studying them illuminates parallel cellular processes.
In 1992, Galloway made a breakthrough discovery when she and her colleagues found that they could use one viral gene, called L1, from the same type of HPV that causes plantar warts, and get it to self-assemble and form virus-like particles. This eventually led to the development of virus-like particles for the cancer-causing types of HPV, which then became the underpinning of the vaccine.
Despite the effectiveness of the vaccine in preventing HPV infection, vaccination rates remain low across the U.S., with under 40 percent of girls and just over 21 percent of boys receiving the recommended three doses. Research shows there are a number of barriers that must be overcome to improve vaccination rates, including a lack of strong recommendations from physicians and parents not understanding that this vaccine protects against several types of cancer.
"When I joined Fred Hutch in 1978, we didn't know what caused cervical cancer, and now we have a vaccine that can prevent HPV infections and the cancers they cause. It is incredibly gratifying to have been part of that discovery," Galloway said. "Wouldn't it be great if there was a high rate of vaccine usage to actually eliminate HPV-caused cancers?"
According to the Centers for Disease Control and Prevention, HPV infections are responsible for approximately 27,000 new cancer diagnoses each year in the U.S. Several vaccines are available that can prevent the majority of HPV-related cancers.
To discuss strategies for increasing HPV vaccination rates, experts from the NCI, CDC, American Cancer Society and more than half of the NCI-designated cancer centers met in a summit at MD Anderson Cancer Center last November. During this summit, cancer centers shared findings from 18 NCI-funded environmental scans, or detailed regional assessments, which sought to identify barriers to increasing immunization rates in pediatric settings across the country.
The published call to action was a major recommendation resulting from discussions at that summit, with the goal of sending a powerful message to parents, adolescents and health care providers about the importance of HPV vaccination for cancer prevention.
Fred Hutch and other National Cancer Institute-designated cancer centers joined in this effort in the spirit of President Barack Obama's recent State of the Union call for a national "moonshot" to cure cancer, a collaborative effort led by Vice President Joe Biden.
"We are on the threshold of incredible advances, such as harnessing the power of the immune system to fight cancer," Gilliland said. "At Fred Hutch, our mantra is 'Cures Start Here.' This is fitting, because the goal here is not merely to treat but to cure - and, ultimately, prevent - cancer. The HPV vaccine is a prime example of the power of prevention to save lives."
source: Fred Hutchinson Cancer Research Center