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Dr. Jon LaPook

Dr. Jon LaPook

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HPV Affects Half Of U.S. Men

Posted: 03/ 1/11 07:02 AM ET

A study out yesterday in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital infection with human papillomavirus, or HPV. HPV is the virus that causes cervical cancer in women. It also causes warts and cancer of the genitals and anus in both men and women. Over the past several years, researchers have realized that the virus can also cause cancer of the head and neck.

Aimee R. Kreimer, Ph.D., of the National Cancer Institute, estimates that about 65 percent of the approximately 8,000 cancers of the oropharynx (tonsils and base of the tongue) seen in the U.S. in 2010 were from HPV infection; 80 percent of these are in men. The rates for HPV-associated cancers like these are increasing; for sites like the mouth and larynx that are associated with tobacco and alcohol use, the rates are decreasing (though still too high since too many people still smoke and abuse alcohol).

An infection rate of 50 percent for a virus that can cause cancer sounds scary. But knowing a few more facts about HPV helps put the risk in perspective. About 90 percent of men and women infected with HPV virus get rid of it on their own within about two years. There are many different strains of HPV -- some that cause cancer and some that don't. Only about 6 percent of men have genital infection with HPV 16 -- the strain linked to more than 90 percent of cancers of the head and neck. And only about 0.6 percent of men have HPV 16 in specimens taken from their mouths; what percentage of those men go on to develop head and neck cancer is unknown.

Right now, there are many more questions than answers. How exactly does HPV get from the genitals to the mouth? Oral sex is one obvious answer but the virus may also be spread by the fingers, kissing, or some other unsuspected route. Why does the infection persist in 10 percent of people?

What's urgently needed is some way of detecting the virus early -- the oral equivalent of a Pap smear. Researchers are trying to develop such a test at centers like Johns Hopkins, where earlier this month I interviewed a 64-year-old man whose HPV-linked tongue cancer was picked up only incidentally because he happened to go to an ear, nose, and throat doctor to get ear wax removed. There's got to be a better way of picking up asymptomatic HPV infection of the head and neck - before it progresses to cancer.

Finally, today's study is sure to provoke discussion about whether an HPV vaccine like Gardasil should be routinely recommended by public health officials for males as it is for females. The vaccine covers four strains of HPV, including strain 16, the one most commonly linked to head and neck cancer. Right now, the CDC supports "permissive use" of the vaccine in males 9-26 but stops short of actually recommending its use.


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A study out yesterday in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital...
A study out yesterday in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital...
 
 
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08:58 PM on 03/29/2011
HPV is not the only STD that affects MILLIONS. HERPES DOES - BOTH 1 AND 2. Why doesn't it receive the attention? It has been linked to an increase in:

HIV
Alzheimers
Blindness
Prostate Cancer
It's own set of problems (sores, social alienation, etc)

One drug in 30 years - what a joke?

Please check out these petitions. They have links to the stuff I quote above:

http://www.petition2congress.com/3986/fund-peregrine-pharmaceutical-to-test-bavi-herpes/
http://www.petition2congress.com/3875/decrease-us-unemployment-find-cure-herpes/
http://www.petition2congress.com/3738/increase-herpes-research-funding/
http://www.change.org/petitions/please-increase-herpes-research-funding#?opt_new=t&opt_fb=f

These petitions speak for themselves. They are free and anonymous.
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HUFFPOST SUPER USER
TWeissMA
http://www.disabilitymessage.com
01:16 PM on 03/09/2011
Human Papillomaviruses (HPV) Information
http://disabilitymessage.com/disability/content/human-papillomaviruses-hpv-information
Syllogizer
Barely Left of Pobedonostsev
01:44 PM on 03/03/2011
I have to disagree with the good doctor. It is far too early to make good use of a Pap-smear like test for HPV. If we had such a thing right now, the only 'benefit' we would get out of it would be that insurance companies would use the info to deny more people coverage.

We need to know more about the variety of strains and their pathogenic potential before we release a test on the world.
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Ezzy666
12:09 AM on 03/03/2011
There are over 100 types of HPV and they can cause anything from a simple hand wart to cancer. The virus is quite common and I'm sure we all come in contact with one type or the other more often than we think.
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Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
03:09 AM on 03/03/2011
True. That's why the vaccines are so useful.
05:59 PM on 03/02/2011
Given the current state of, well, nearly everything related to males these days, I'm hoping my daughter grows up to be a lesbian. Seems she would likely live longer and healthier.
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JWW33
If we cannot dig ourselves out, we must go deeper
10:42 AM on 03/03/2011
lol if only it was that simple.
08:24 AM on 03/02/2011
Half of all men in the US carry the HPV virus. The good news seems to be that 90% of men get rid of the virus within 2 years.

The disturbing conclusion of these two facts must be that men keep being re-infected with the HPV virus over and over again.
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StevenKeirstead
Photographer and Biologist who happens to be gay.
01:57 PM on 03/02/2011
It may be that some men are infected once, but their immune system does not control their HPV infection. They can become reservoirs of the virus, infecting other people unknowingly, and are at higher risk of cancer.
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JWW33
If we cannot dig ourselves out, we must go deeper
10:43 AM on 03/03/2011
Most women can fight off the virus themselves too. Once you have the virus and have fought it off, your immune system will not be affected by it again. Think of chicken pox, you typically get it once. That is the way viruses work.
Syllogizer
Barely Left of Pobedonostsev
01:46 PM on 03/03/2011
You are making too sweeping a generalization. Only a few viruses can work like chicken pox, where you get it once, and then it comes back as shingles later. It is, after all, a retrovirus.
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Sonic hedgehog
A true word needs no oath
07:11 PM on 03/03/2011
That's the way some viruses work, not all.
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farmilyman
everything is illusion
05:10 AM on 03/02/2011
Here's some research:
http://www.vaccinationcouncil.org/

I'm sure this article is about getting the vaccine.
This comment has been removed due to violations of our [Guidelines]
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Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
12:59 PM on 03/03/2011
That is hardly a website where one could describe what is posted there as research.
OverseasVet
stuck in a 3rd world country called texas
10:04 AM on 03/07/2011
Thats like going to HP for health advice.
03:45 AM on 03/02/2011
interesting this focuses on head and neck cancer while cervical cancer, caused by same virus', causes many more deaths.
I always think its so unfair...women are more likely to catch SDS from hetersexual sex than men are, and have to deal with getting pregnant. Let alone sex without a condom with half of the me or more out there can give you cancer!
FYI...they say 90% of women clear HPV in two years. Women over forty do not clear it as easily...I don't know the percentage but it's significantly lower. The longer highrisk HPV sits around in you the longer it has to cause cancer. If your over forty you have a really high chance of catching a burdensome condition--to say the least--if you sleep with ANY man without a condom.
drag. Men get warts, women get cancer and could die.
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JaxReader
Hear reason, or she'll make you feel her.
12:57 PM on 03/02/2011
Shouldn't have eaten that apple, Eve. ;-)
03:47 PM on 03/02/2011
Your facts are wrong. 3700 women in the US will die from cervical cancer this year and more than 8,000 will die from oral cancers. As % of people who are diagnosed oral cancers, the numbers are particularly devastating, with a survival rate of only about 57% after diagnosis at five years. Cervical cancers have much greater survival rates. www.oralcancer.org

Men get much more than warts, and they dominate the HPV16 caused oral cancer population.
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The Cause Endures
12:37 AM on 03/02/2011
Um. Yikes.

This really killed the mood.
03:48 AM on 03/02/2011
agreed, see my post above. sex without a condom for a woman with American men...50% chance she'd be risking catching virus that could give her cancer.While man risks warts!! (I bet less than fifty percent of women carry it tho so his risk is less). If she catches it, she has to get painful burdensome expensive testing every 3 months sometimes (colposcopy) or risk worse.
Men think of this next time you dont' wanna where a condom...50% chance you have somethign that can cause your woman to get cancer.
If I were a guy that would bother me alot.
11:04 PM on 03/01/2011
I feel that this could have something to do with the certain usage of socks!
09:50 PM on 03/01/2011
Thanks for this article. They are even associating HPV with onset of many chronic diseases like Crohn's disease. http://www.journey-with-crohns-disease.com/
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Mark128
09:03 AM on 03/02/2011
seems they will go to many lengths to sell a vaccine. Chrons is caused by NUMEROUS issues that affect the digestive tract. Pharmaceuticals for one as well as an unhealthy diet.
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dugmaze
Any man's death diminishes me
08:50 PM on 03/01/2011
What do people think of this?

HPV at any age:

"Children may become infected with HPV at any time and via various modes of transmissi­on. Given these realities and possible viral latency, evaluation of the mode of transmissi­on is extremely challengin­g. In this study, all infants under age 1 year had innocent transmissi­on. In this small sample, children older than 6 had a high rate of suspected or proven sexual abuse, and most abused children were girls. However, there are no reliable rules. There is no substitute for careful examinatio­n and interview. Clinicians must use their judgment, not necessaril­y to establish sexual abuse, but to determine whether referral to child protective services is indicated.­"
http://dermatology.jwatch.org/cgi/content/full/2006/818/1
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Dyson
debunking pseudoscience, one fallacy at a time.
06:10 AM on 03/02/2011
Cases of HPV infection in childhood, either through transmission from the mother to baby during birth, or due to sexual abuse, comprise a tiny minority compared to the prevalence of HPV that is sexually transmitted in adults.
Same for things like HSV, gonnorhea and other similarly transmitted diseases really.
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dugmaze
Any man's death diminishes me
06:34 PM on 03/02/2011
"either through transmissi­on from the mother to baby during birth, or due to sexual abuse"

Please read the study. It's not either birth or sex. Children at different ages have HPV even though sexual abuse is ruled out.

The whole HPV argument is based on teenage sex. This study proves HPV can be present in all people at any age.
07:38 PM on 03/01/2011
What shocked me about this vaccine when it first came out in 2006 or 2007, was the fact that they wanted it to be a required vaccine (for girls only) in order to be allowed in school. Now, I'm not surprised that vaccines for measles, etc. are required, but this one? The cancer it "prevented" - cervical - doesn't usually appear until much later in adulthood. So why make it a requirement to attend school? That made me very suspicious. The flu virus kills 5,000 to 30,000 Americans a year.
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Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
09:16 PM on 03/01/2011
The basics:

A high percentage of men and women get infected with various strains of HPV. Some through intercourse, some in other ways, so a condom isn't enough. Some of the strains cause all the strains of cervical cancer.The same cancer causing strains can cause oral and anal cancer. Different strains can cause genital warts. And other strains don't seem to do any harm.

Almost all those infected with the cancer causing strains get over the infection completely. A small percentage of those persistently infected develop abnormal cells in the cervic, throat or anus. A very small percentage of those get pre-cancerous lesions. A percentage of those develop cancer. This process most often takes decades. In the US, that amounts to 4000 cervical cancer deaths a year.

I don't know the percentages of oral and anal cancer, but for cervical cancer -- unless you are infected wth specific strains of HPV then you simply can't get cervical cancer.

Gardasil protects against infections with the strains causing 70% of cervical cancer and high percentage of genital warts. Cervarix protects against strains causing 80% of cancer, but does not prevent genital warts.

A new version of Gardasil on the market in 2011 or 2012 protects against strains causing 90?% of cancer.
11:18 PM on 03/01/2011
Sheldon101, there are egregious inaccuracies in your above post.

While it is correct that many HPV infections are cleared by the immune system within two years, it is now being reported that males do not clear the infection the same as females do and it appears that an infection in males can persist indefinitely. This would be another reason male HPV vaccination would make sense. Further, until one's immune system has cleared the virus, the infected person can infect others.

It is also entirely incorrect to say as you did that "unless you are infected with specific strains of HPV then you simply can't get cervical cancer." Wrong, wrong, wrong. At this point, 14 strains of HPV have been identified as associated with cervical cancer. And while it looks like HPV causes the majority of cases of cervical cancer, there are other agents that can cause cervical cancer --- such as radiation exposure, chemical exposure in agriculture or manufacturing, the drug DES (diethylstilberstrol) and it looks like HIV compounds the effects of HPV.

While it appears that Gardasil will protect against cervical cancers caused by the involved strains of HPV, we may not know its full effectiveness until the vaccinated population reaches the ages of 40-55 when most cervical cancer is diagnosed. Whether or not a woman has been vaccinated, an annual pelvic examination with a Pap test is needed --- not only for early detection of cervical neoplasma, but for detection of vulvar carcinoma and other gynecologic neoplasms.
03:53 PM on 03/02/2011
The current % of oral cancer patients that are coming from HPV16 vs. the historic tobacco risk factor, is now at about 63% of cases -reported at the American Association for the Advancement of Sciences by Maura Gillison MD, a long term HPV/oral cancer researcher, whose work is routinely published in peer reviewed scientific journals.
06:44 PM on 03/01/2011
I know a bit about this...I'm a nurse practitioner in family practice. For one, the vaccine is not "required" for anybody, it's simply recommended. I urge all teen girls to get it. People DIE of cervical cancer, even today. Even if you don't die from it, having all the surgical procedures involved in treating it is no picnic. I do agree the pharmaceutical maker of it is having a field day and I'm not giving it to boys (including my own son) until more research done that it's really necessary. I've prescribed hundreds of Gardisil shots to girls and have never had an adverse effect.
07:43 PM on 03/01/2011
The only reason it isn't "required" is because of the outrage of parents. Merck campaigned to make it a requirement for all pre-teen girls. In fact, Texas Gov. Rick Perry (keep government out of our lives, except for stuff involving female reproductive systems) signed such a requirement into law, but it was overturned by the legislature. If it were up to Merck, it most certainly would be a requirement for girls (and now boys I guess) to get this vaccine.

http://en.wikipedia.org/wiki/Gardasil
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10:26 AM on 03/02/2011
My mother begs to differ on that. She works at a major research hospital and has seen girls come in with serious problems meant for adults and not girls, and the biggest link between them all is that they all got the Gardisil shots. I don't remember what they specifically had (she told me this a while ago), but there could be adverse effects. Of course, the fact that they all had the shots could be coincidental, but after years of my mother pushing me to get them, she finally told me it might be a good thing I never did.
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Sheldon101
sheldon101blog.blogspot.com Wakefield transcripts
05:06 PM on 03/02/2011
VAERS, VSD and Coincidence
--------------------------------------------.

"Of course, the fact that they all had the shots could be coincidental,"

Clinical trial before approval showed the same rate of bad events happening to those given the vaccine and those given the placebo. The active US monitoring system, VSD, didn't find ANYevents that happened more often in those vaccinated than those who did not.

I admit I don't understand the math. But, unlike VSD, the passive reporting system VAERS did not have higher reports for any adverse except for fainting (so make sure they sit down for 15 minutes) and blood clots. The reports of blood clots did not show up in VSD and seem related to risk factors. See http://www.cdc.gov/vaccinesafety/vaccines/hpv/gardasil.html

What your mother thinks is happening is not --- but your getting all the possible results of HPV is real. So get vaccinated.
08:16 PM on 03/03/2011
Be sure and use condoms very time or abstinence is even better. You won't need the vaccine
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Bushido08
Spirit of a Warrior
06:39 PM on 03/01/2011
I would like just one serious journalist to compile all of these studies into one article and tell me the percentages of all the diseases that people probably have. Most people don't even believe half of these studies anymore because they make such outlandish statements.