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¡°If we had a vaccine that helped prevent breast cancer, would you hesitate to have your daughter vaccinated?¡± That¡¯s a question often asks. She¡¯s a cancer epidemiology professor and researcher?at the Moffitt Cancer Center in Tampa, Florida.?Giuliano was named the first recipient of the Dorothea Bennett Memorial American Cancer Society Research?Professorship?in July 2018 for her world-leadership on HPV and other infections related to cancer.?

¡°We don¡¯t have a vaccine to prevent breast cancer,¡± says Giuliano. ¡°But we do have a vaccine that can help prevent more than 3 other?cancers that affect women.¡± These are gynecological cancers of the cervix, vagina, and?vulva. The vaccine also protects women and men from cancer of the?anal canal and certain mouth and throat cancers, known as?oropharyngeal?cancer. The vaccine also helps protect men from?penile?cancer, which is also caused by HPV.?

Over time, Giuliano says, we may be able to eliminate these 4 cancers in the United States. That means women would no longer get any of these cancers. The first target is cervical cancer.

At this time, cervical cancer is the only HPV-related gynecological cancer that we can reliably screen for in the US. That means, Giuliano explains, ¡°cervical cancer is the only HPV-related cancer that we can hit with a double whammy¡ªvaccination plus screening. We can be aggressive with both.¡± That¡¯s why cancer experts, including Giuliano, think cervical cancer could become the first cancer to be eliminated.?

Eliminating Cervical Cancer in the U.S.

To meet the goal of eliminating cervical cancer, Giuliano says, we need to reduce the infection rate of HPV to 0 or near 0. That¡¯s why the ´óÏótv Mission HPV Cancer Free campaign,?which Giuliano advised on,?has 2 goals:

• Increase yearly HPV vaccination rates of American preteens to at least 80% by 2026. According to an August 2018 report from the Centers for Disease Control, in 2017, only 49% of boys and girls got both the shots that are needed.
• Reduce the differences in vaccination rates based on gender and geography. We need to ensure that both boys and girls from all?regions of the country are equally vaccinated. This can protect them against HPV infection and the cancers it causes.

Richard C. Wender, MD, chief cancer control officer for the American Cancer Society says, ¡°If we can achieve sustained 80% HPV vaccination in pre-teen boys and girls, combined with continued screening and treatment for cervical pre-cancers, we could see the elimination of cervical cancer in the U.S. within 40 years.¡± Giuliano thinks some states may be able to eliminate it long before then.

Giuliano¡¯s Reminders for Women

Here¡¯s a list of the things Giuliano wants women to remember about gynecologic cancers.

An HPV vaccine is a gift to your child. ¡°Parents don¡¯t always recognize the value of the vaccine because most types of HPV infections don¡¯t cause symptoms, but the vaccine will help prevent up to 6 types of cancer over your child¡¯s lifetime.¡± Those types are cervical, vaginal, and vulvar in females, penile cancer in males, and anal cancer and certain cancers of the mouth and throat (oropharyngeal) for both females and males.

Women can get vaccinated up to age 26 and men up to age 21. If you weren¡¯t vaccinated between the ages of 11 and 12, you have a second chance. ¡°Vaccination is more effective when it is received at a younger age because the immune system responds better then, and it¡¯s before most kids are exposed to the virus,¡± Giuliano says. ¡°But it still offers some protection in older teens and young adults.¡±

Vaccinated women still need Pap tests and HPV tests. ¡°Even women who have received the HPV vaccine are not covered against all the types of HPV that can cause cervical cancer.¡± There are about a dozen high-risk types of HPV that cause cervical cancer. The vaccine protects against the 7 that are responsible for most HPV-caused cancers. That¡¯s why all women, even those who are vaccinated, need to follow guidelines for screening. Screening tests are used to look for a disease in someone who doesn¡¯t have any symptoms.?

Follow-up with your doctor about Pap and HPV test results. Women whose screening test shows precancerous changes in the cervix need prompt follow up with a health care provider and proper treatment.

Be especially vigilant about the vaccine and screening if you¡¯re in a high-risk group. A family history of cervical cancer and HPV infections can increase your risk for cervical cancer.?But women who don¡¯t have health insurance or adequate coverage also have a greater risk of developing and dying from cervical cancer, she says. That¡¯s because high-quality cancer screening is not as easily available to everyone equally. Neither is high-quality follow-up care after abnormal results from screening.?If you need help paying for Pap tests and other preventions, check out these sources:

• This article from the ´óÏótv: Cervical Cancer Prevention and Screening: Financial Issues
• The (NBCCEDP) to see if you qualify for free or low-coast breast and cervical cancer screenings
• The on the website for the National Cervical Cancer Coalition (NCCC) to find free or low-cost Pap tests near you.?

To reach the goal of eliminating cervical cancer, Giuliano says, requires 2 key things. Doctors need to make strong, consistent recommendations for HPV vaccination. And parents need to become educated on HPV. ¡°Vaccination is a gift that keeps on giving,¡± Giuliano says. It helps prevent up to 6 cancers for the rest of your child¡¯s life.

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