CDA Essentials 2017 • Volume 3 • Issue 5

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23 Volume 3 Issue 5 |
Issues and People
Can HPV Vaccines Prevent
Oropharyngeal Cancer?
Dr. Anna R. Giuliano is a professor and director of the Center for Infection Research in Cancer at the Moffitt Cancer Center in
Tampa, Florida. Her research focuses on HPV-related carcinogenesis, including head and neck cancers. She gave a presentation
at a Pan-American Health Organization (PAHO) consultation meeting on HPV-associated oropharyngeal cancer in July 2015.
CDA talked to Dr. Giuliano to learn more about the current state of knowledge regarding the efficacy of vaccines in preventing
HPV-related oropharyngeal cancer.
Given how
important this
vaccine is in
preventing so
many of the other
HPV-related
diseases, I think it’s
quite appropriate
to give a strong
recommendation for
vaccination of the
target population.
Can you talk about your lecture at the
PAHO consultation meeting?
I was asked to do a summary of the studies
that have shown the efficacy of HPV
vaccines for preventing related diseases
in both females and males. I was able to
show that there is a very strong prevention
efficacy against cervical, vulvar and vaginal
cancers in females. The one HPV vaccine
trial conducted among males showed very
strong efficacy against the infection as well
as the lesions that HPV causes at the genitals
and anal canal in young men.
How effective are vaccines in preventing
HPV-associated oropharyngeal cancer?
Let’s start with the data we do have.
Among males and females, the prevention
of anal-genital infections and related
cancers is nearly 100% if we vaccinate at a
young age among individuals who have
never been exposed to the virus. So it’s
incredibly effective in preventing HPV-
related diseases in both men and women.
However, the vaccine has never been tested
in a trial designed to evaluate whether the
vaccine will prevent oral HPV infections or
oropharyngeal cancer. So this remains an
unanswered question.
Is there a message that dentists should
be giving to their at-risk patients?
The vaccines are approved for use in the
United States and in Canada the same way:
for vaccination of young adolescents, 11 and
12 years of age, with a catch-up depending
on where you are in the Americas of up to
age 26 for both males and females.
I think the message dentists can give to
families, as well as to young adults, is how
effective the vaccine is in preventing HPV
infection. We don’t have the evidence
to make a statement directly about the
prevention of oropharyngeal cancer, but
given how important this vaccine is in
preventing so many of the other HPV-related
diseases, I think it’s quite appropriate to give
a strong recommendation for vaccination of
the target population.
What were the recommendations that
came out of the consultation meeting?
The oral health providers who attended
the meeting felt very strongly that without
definitive evidence, they could not draft a
policy statement or recommendation to
vaccinate to prevent oropharyngeal cancer.
They felt that there is a tremendous need
for a trial to be conducted to definitely
provide the evidence, in which case
recommendations and policy statements
could be made by the various health
authorities.
Any final thoughts for dentists?
I feel very positive that if we can conduct this
phase-3 trial to test the efficacy against these
oropharyngeal lesions, we will likely see that
the vaccines work. But until we conduct the
trial, we’re in a standstill. So research must
continue. I’d say that within a decade we’ll
have the information we need to cover all of
these cancers. a
Watch the
full interview with
Dr. Anna Giuliano at