Prevalence of Genital Human #Papillomavirus Infection and Human Papillomavirus Vaccination Rates Among US Adult #Men

http://jamanetwork.com/journals/jamaoncology/fullarticle/2598492

Among men aged 18 to 59 years in the United States, the overall prevalence of genital HPV infection was 45.2% (95% CI, 41.3%-49.3%). The overall genital HPV infection prevalence appears to be widespread among all age groups of men, and the HPV vaccination coverage is low.

Outcomes in Women With Cytology Showing #Atypical Squamous Cells of Undetermined Significance With vs Without Human #Papillomavirus Testing
http://jamanetwork.com/journals/jamaoncology/fullarticle/2633183?widget=personalizedcontent&previousarticle=2633179

Little is known about the long-term yield of high-grade cervical intraepithelial neoplasia (CIN) and the influence on biopsy and treatment rates of human papillomavirus (HPV) triage of cytology showing atypical squamous cells of undetermined significance (hereafter ASC-US cytology).

Human papillomavirus testing led to faster and more complete diagnosis of cervical disease, but 55.8% more biopsies and 20.0% more loop electrosurgical excision procedures were performed. In those tested, virtually all high-grade disease occurred in the 43.1% of women who were HPV positive, allowing clinical resources to be focused on women who need them most. These data provide essential information for cervical screening guidelines and public health policy

Final efficacy, immunogenicity, and safety analyses of a nine-valent human #papillomavirus #vaccine in women aged 16–26 years: a randomised, double-blind trial
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31821-4/abstract

Primary analyses of a study in young women aged 16–26 years showed efficacy of the nine-valent human papillomavirus (9vHPV; HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58) vaccine against infections and disease related to HPV 31, 33, 45, 52, and 58, and non-inferior HPV 6, 11, 16, and 18 antibody responses when compared with quadrivalent HPV (qHPV; HPV 6, 11, 16, and 18) vaccine.

Between Sept 26, 2007, and Dec 18, 2009, we recruited and randomly assigned 14 215 participants to receive 9vHPV (n=7106) or qHPV (n=7109) vaccine. In the per-protocol population, the incidence of high-grade cervical, vulvar and vaginal disease related to HPV 31, 33, 45, 52, and 58 was 0·5 cases per 10 000 person-years in the 9vHPV and 19·0 cases per 10 000 person-years in the qHPV groups, representing 97·4% efficacy (95% CI 85·0–99·9). HPV 6, 11, 16, and 18 GMTs were non-inferior in the 9vHPV versus qHPV group from month 1 to 3 years after vaccination. No clinically meaningful differences in serious adverse events were noted between the study groups. 11 participants died during the study follow-up period (six in the 9vHPV vaccine group and five in the qHPV vaccine group); none of the deaths were considered vaccine-related.

Interpretation
The 9vHPV vaccine prevents infection, cytological abnormalities, high-grade lesions, and cervical procedures related to HPV 31, 33, 45, 52, and 58. Both the 9vHPV vaccine and qHPV vaccine had a similar immunogenicity profile with respect to HPV 6, 11, 16, and 18. Vaccine efficacy was sustained for up to 6 years. The 9vHPV vaccine could potentially provide broader coverage and prevent 90% of cervical cancer cases worldwide

Effect of Several Negative Rounds of Human #Papillomavirus and Cytology Co-testing on Safety Against #Cervical Cancer: An Observational Cohort Study
http://annals.org/aim/article-abstract/2664574/effect-several-negative-rounds-human-papillomavirus-cytology-co-testing-safety

Five-year ≥CIN3 risks decreased after each successive negative co-test screening round (0.098%, 0.052%, and 0.035%). Five-year ≥CIN3 risks for an HPV-negative co-test, regardless of the cytology result, nearly matched the performance (reassurance) of a negative co-test for each successive round of screening (0.114%, 0.061%, and 0.041%). By comparison, ≥CIN3 risks for the cytology-negative co-test, regardless of the HPV result, also decreased with each successive round, but 3-year risks were as high as 5-year risks after an HPV-negative co-test (0.199%, 0.065%, and 0.043%). No interval cervical cancer cases were diagnosed after the second negative co-test. Independently, ≥CIN3 risks decreased with age. Length of previous screening interval did not influence future ≥CIN3 risks

Conclusion:
After 1 or more negative cervical co-tests (or HPV tests), longer screening intervals (every 5 years or more) might be feasible and safe

4-Valent Human #Papillomavirus (4vHPV) #Vaccine in Preadolescents and Adolescents After 10 Years
http://pediatrics.aappublications.org/content/140/6/e20163947

For HPV types 6, 11, and 16, 89% to 96% of subjects remained seropositive through 10-years postvaccination. The preadolescents had 38% to 65% higher geometric mean titers at month 7, which remained 16% to 42% higher at 10 years compared with adolescents. No cases of HPV type 6, 11, 16, and 18–related diseases were observed. Ten subjects had a persistent infection of ≥6 months duration with vaccine-type HPV and 2 subjects had persistent infection for ≥12 months. No new serious adverse events were reported through 10 years.

CONCLUSIONS: A 3-dose regimen of the 4vHPV vaccine was immunogenic, clinically effective, and generally well tolerated in preadolescents and adolescents during 10 years of follow-up. These long-term findings support efforts to vaccinate this population against HPV before exposure

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Trends in Human #Papillomavirus–Associated #Cancers — United States, 1999–2015

https://www.cdc.gov/mmwr/volumes/67/wr/mm6733a2.htm?s_cid=mm6733a2_w


HPV-associated cancer rates changed from 1999 to 2015. Rates increased for oropharyngeal SCC, anal SCC and vulvar SCC, decreased for cervical carcinoma and vaginal SCC, and remained stable for penile SCC.

The decline in cervical cancer from 1999 to 2015 represents a continued trend since the 1950s as a result of cancer screening. Rates of cervical carcinoma in this report decreased more among Hispanics, American Indian/Alaska Natives, and blacks than other groups; however, incidence rates were still higher among Hispanics and blacks than among whites in 2015. These persistent disparities in incidence suggest that health care delivery needs of some groups are not fully met.

Several factors could contribute to the increase in oropharyngeal and anal cancers including changing sexual behaviors. Unprotected oral sex and receptive anal sex are risk factors for HPV infection. White men have the highest number of lifetime oral sex partners and report first performing oral sex at a younger age compared with other racial/ethnic groups; these risk factors could be contributing to a higher rate of oropharyngeal SCC among white men than other racial/ethnic groups. Although smoking is a risk factor for oropharyngeal cancers, smoking rates have been declining in the United States, and studies have indicated that the increase in oropharyngeal cancer is attributable to HPV

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Trends in Risks for Second Primary Cancers Associated With Index Human #Papillomavirus –Associated Cancers

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2701740

From 113 272 (73 085 female and 40 187 male) survivors of #HPV -associated cancers, 1397 women and 1098 men developed HPV-SPCs. The SIRs for HPV-SPCs were 6.2 (95% CI, 5.9-6.6) among women and 15.8 (95% CI, 14.9-16.8) among men. The EARs were 18.2 per 10 000 PYR for women and 53.5 per 10 000 PYR for men. Among both women and men, those who had index oropharyngeal cancers had the highest HPV-SPC risk (SIR, 19.8 95% CI, 18.4-21.4 and EAR, 80.6 per 10 000 PYR among women; SIR, 18.0 95% CI, 16.9-19.1 and EAR, 61.5 per 10 000 PYR among men). Women who had index cervical cancers and men who had index anal cancers had the lowest HPV-SPC risk (SIR, 2.4 95% CI, 2.2-2.7 and EAR, 4.5 per 10 000 PYR among women; SIR, 6.5 95% CI, 4.7-8.8 and EAR, 18.5 per 10 000 PYR among men). Both women and men who had index HPV-associated cancers of any kind had a significantly higher risk of oropharyngeal HPV-SPCs. Over the last 4 decades, the risk of developing most types of HPV-SPCs after index cervical, vaginal, and vulvar cancers increased.

Conclusions and Relevance According to this study, the HPV-SPC risk among survivors of HPV-associated cancers is significant, implying that persistent HPV infection at multiple sites may be associated with HPV-SPCs. These findings have the potential to inform surveillance recommendations for survivors of HPV-associated cancers

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Human #Papillomavirus #Vaccination Before 13 and 15 Years of Age: Analysis of National Immunization Survey Teen Data

https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiy682/5265326

Human papillomavirus (HPV) vaccination is suboptimally used in the United States. Vaccination before the 13th birthday is recommended by the Advisory Committee on Immunization Practices and vaccination before the 15th birthday requires only 2 doses. We estimated the proportion of adolescents up to date for HPV vaccine using provider-verified vaccination data from the 2016 National Immunization Survey-Teen.

Only 16% of US adolescents completed HPV vaccination before turning 13, and 35% completed HPV vaccination before turning 15. With sexual activity initiation increasing throughout adolescence and higher immunogenicity for younger vaccinees, vaccination before the 13th birthday can provide better protection against HPV-related cancers.

Prevalence of Human #Papillomavirus Infection by Number of Vaccine Doses Among US Women

..Compared with unvaccinated women (prevalence of 12.5% [95% CI, 9.7%-15.3%]), infection with HPV type 6, 11, 16, or 18 was significantly less prevalent among women who received 1 dose (2.4% [95% CI, 0%-4.9%]), 2 doses (5.1% [95% CI, 0.8%-9.5%]), or 3 doses (3.1% [95% CI, 0.9%-5.3%]) of HPV vaccine (Table 1). There was no significant difference in prevalence for 1 dose vs 2 doses or 1 dose vs 3 doses. Differences were not statistically significant for cross protection (except for 2 doses vs unvaccinated and 1 dose vs 2 doses) and other high-risk HPV types.

In adjusted analysis, the predicted probability of infection with HPV 6, 11, 16, or 18 was higher in unvaccinated women (7.4% [95% CI, 7.1%-7.7%]) compared with women who received 1 dose (2.3% [95% CI, 1.9%-2.8%), 2 doses (5.7 [95% CI, 5.1%-6.2%]), or 3 doses (3.1% [95% CI, 2.9%-3.4%]) (Table 2). Black women had a greater predicted probability (10.8%) of infection with HPV type 6, 11, 16, or 18 compared with white women (6.6%). The predicted probability was also higher for women with more than 5 lifetime male sexual partners (11.6%) than women with 0 to 5 lifetime male partners (3.3%).

https://bit.ly/35a64eJ