A Texas-sized problem: Texas has among the highest rate of hepatitis C, lowest HPV vaccination numbers in the U.S.

Tags: HPV, immunizations, hepatitis B

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By Carolyn Aldigé and Erich M. Sturgis, MD, MPH

As a family physician, your patients rely on you — not just for annual check-ups, diagnoses, prescriptions, and treatments, but also to inform them of what they need to know to enjoy long, healthy lives. But a growing number of patients say they are not getting much-needed guidance from their primary care physicians on a major public health problem: certain viruses that can lead to cancer.

This is why the Prevent Cancer Foundation launched Think About the Link, an education campaign to increase awareness of the connection between these viruses and cancer. The campaign targets three viruses: human papillomavirus, hepatitis B, and hepatitis C, and urges health care providers to talk to their patients in an effort to increase screenings, vaccinations, and treatments for these viruses.

Texas especially needs greater awareness; the state has the fifth lowest three-dose HPV vaccination rate for girls and tenth lowest three-dose HPV vaccination rate for boys in the country. San Antonio is an unfortunate case-in-point: though the Centers for Disease Control and Prevention recommend that all girls and boys get the HPV vaccine at age 11 or 12, currently only about 15 percent of boys and 31 percent of girls in San Antonio received all three doses.

While reported rates of acute hepatitis B in Texas decreased by 71 percent between 2009 and 2013, the National Viral Hepatitis Roundtable reports that Texas has the second highest hepatitis C rate in the United States, with an estimated 300,000 Texans currently infected with the virus.

These rates put many Texans at risk for cancers caused by these viruses. As a family physician, you likely know that HPV is responsible for more than 90 percent of all cervical cancers and a majority of five other types of cancer, including vulvar, vaginal, penile, anal, and oropharyngeal, can be attributed to HPV. You also know that most liver cancers are caused by the hepatitis B or hepatitis C virus. However, most patients do not know either of these facts.

The Prevent Cancer Foundation conducted a survey of more than 650 health care professionals and 1,000 adults across the U.S. to understand the familiarity, perceptions and behavior as they relate to the three viruses, including vaccinations and treatments.

The survey found that 53 percent of adults are unaware HPV can lead to cancer if left untreated and 67 percent of adults are unaware hepatitis B increases the risk of liver cancer. Just as alarming, 57 percent are unaware the HPV vaccine can significantly reduce the risk of certain types of cancer, 76 percent of adults are unaware the hepatitis B vaccine can lower the risk of liver cancer, and 73 percent are unaware treatment for hepatitis C can cure the virus infection and prevent subsequent liver cancers.

While science has proven the HPV and hepatitis B vaccines aid in cancer prevention, 93 percent of adults say their physicians have not recommended one or more vaccines specifically to reduce their cancer risk. However, increased physician communication could potentially increase compliance. More than 92 percent of adults believe more education about the dangers of HPV is needed. In addition, 81 percent of adults would more seriously consider vaccinations they have never received if their physician discussed the benefits and 78 percent would be more likely to get vaccinations if their physician provided more detailed information.

This survey sends an important message: Patients want to hear from their family physicians. Do not assume that a patient is uninterested in the HPV and/or hepatitis B vaccines — research debunks this myth. Family physicians have a critical role in helping to educate patients, and cancer prevention is a key message to use in recommending vaccinations. Talk to parents and other adults about the cancer prevention benefits of screenings, vaccinations, and/or treatments. We can stop cancer before it starts and save more lives when the link between these viruses and cancer is elevated in Texas and the rest of the country.

To learn more about Think About the Link and the link between certain viruses and cancer visit www.preventcancer.org/Think-About-The-Link.

 

Carolyn R. (“Bo”) Aldigé is founder and president of the Prevent Cancer Foundation. Ms. Aldigé is a member of the board of the National Coalition for Cancer Research, having served for eight years as its president.

Erich M. Sturgis, MD, MPH, is a professor in the Department of Head and Neck Surgery, Division of Surgery at The University of Texas MD Anderson Cancer Center. He leads a major research effort in molecular epidemiology of head and neck malignancies.

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