professor and so I am used to having a
podium and a monitor so I feel very
exposed and he’s hiding behind things
but that’s okay because this topic needs
to be exposed I’m going to talk about
human papillomavirus and what we have
failed to even talk about today is that
we have a cancer prevention vaccine and
this is a gift that we can give our
children and this gift is easier than
genetic testing it’s easier than finding
a friend for your child when they’re
going through cancer treatment to help
them get through cancer treatment this
gift can prevent cancer better than
early detection of cancer through PAP
testing or colorectal cancer screening
or mammography all of those cancer
screening tests detect pre-cancer the
HPV vaccine prevents HPV infection which
causes cancer it’s truly a cancer
prevention vaccine we have a vaccine
that prevents cancer that is horribly
underused in the United States and it is
terrifically underused in the Mountain
West and Utah especially so I’m going to
talk to you a little bit about how we
need to turn this around so how many
cancers are caused by HPV in the United
States we can fill the entire rice
Eccles Stadium with people who have been
impacted by an HPV related cancer in one
year this is not just cervical cancer
these are cancers that affect the Ino
genital region of the human body so
that’s the penile male cancers too anal
vaginal region and the oral pharyngeal
region which is the back of your throat
and your tonsil area so HPV cancers
don’t just affect women
they affect men and women the highest
incidence HPV cancers are cervical but
then oral pharyngeal is the next highest
incidence it doesn’t just cause cervical
and HPV oral pharyngeal and anal genital
it also causes genital warts you ask any
teenager if they could get a vaccine to
prevent general warts
what do you think they’ll say this could
be preventing 200,000 cases of general
warts times 2 each year you in the u.s.
that would be to Salt Lake City’s each
year in the u.s. general Ward’s general
warts are not going to cause someone to
die but they can have lifelong morbidity
they can affect the quality of someone’s
life they can cause a condition called
jorpe which is requires repeated
surgeries of a child in teenagers throat
to remove paplu mitosis which are warts
that the mom has passed from her womb to
the child through the cervical canal in
birth of the HPV virus 6 and 11 so we
can prevent that with the vaccine so
it’s a bonus not only preventing cancer
causing a treeview toys for also
preventing 6 and 11 which causes genital
warts and this other condition called
jorpe even more than that many of us
women know that when we have Pap tests
we um when we have our pap exams we are
detecting the existence of HPV related
pre-cancers we have not been informed of
this human papilloma virus causes
abnormal pap tests so if you get the
vaccine you will prevent abnormal pap
tests so how common are abnormal pap
tests one in 10 women have had an
abnormal pap test that’s 1.4 million
women each year have a pre cancer a
low-grade pre cancer
that’s 330 thousand more women have a
high-grade pre cancer what’s the result
of an abnormal pap test
there’s leap procedures there’s cone
procedures that’s where they freeze off
a portion of your cervix that has been
has demonstrates precancerous tissue or
they surgically remove a portion of your
cervix why is this bad
well it’s emotionally stressful it
results in difficult conversations with
your sexual partner it could result in
miscarriage it can even result in
hysterectomy if you have a more advanced
stage women who have abnormal pap tests
and have pre cancers and cervical cancer
tend to be in their reproductive years
so this HPV affects women’s fertility
what could be more devastating to a
woman than to talk then for her to be
told she doesn’t have the option to have
a child and we could prevent this with
the HPV vaccine but yet there is all the
stigma around the HPV vaccine in Utah
and in the whole United States so who
has HPV infection I’ve been doing this
work in Utah for almost six years I’ve
been doing this work in the United
States for ten years people love to say
it’s those people it’s those kids it’s
not my kids it’s those other kids it’s
those other folks who has human
papillomavirus infection I do I have HPV
infection you do you have HPV infection
we all have HPV infection we have all
had HPV infection nearly all of us have
had it at one point in our lives or
we’ll have it at one point in our lives
it is the most common sexually
transmitted infection in the world but I
would like to say as the cancer
prevention scientist it is the least
talked about even today in our
presentations today by top oncologists
least talked about one in four of us
here today have HPV infection one in
four of us who are sexually active
individuals have HPV infection how do
you know if you have it most often it
has absolutely no symptoms you don’t
know you have it
so you pass it along without even
knowing you were infected most of us
with healthy immune systems clear it
within six months to two years without
even knowing that we had it well what
can we do to prevent HPV infection what
can you do for your children you can
give them two doses of the HPV vaccine
many of you may remember this was a
three dose vaccine
well this vaccine is so effective you
only need to give two doses two doses
that’s it so two doses for kids under
the age of 15 within a one-year time
frame perfect’ take a minute age 11 go
back at age 12 to doses your doctor or
your nurse practitioner should be
strongly recommending this vaccine with
the other vaccines that are given to
your child at this age
at this time in their lives which are
Tdap the menara or meningococcal how are
other countries in the world doing with
this vaccine
well Australia just this month had lots
of news just hitting the scientific
press they are going to be the first
country in the world to eradicate a
cancer eradicated cancer why because
they have integrated HPV vaccination
into their primary care delivery system
within their school-based immunization
healthcare practices we on the other
hand because we’re conservative
Americans have puritanical values are
very questioned science are not going to
be able to say that we can eradicate a
cancer as soon as Australia unless we
turn this around furthermore Utah’s
gonna even be further behind if you look
at so in the United States we have about
half of our girls completing the vaccine
vaccine series we have less than half of
our boys and if you look at the Mountain
West you look at Utah Wyoming Idaho
Montana we’re in the lowest quintile of
the country less than 40
some of our kids are completing the
recommended doses for this vaccine we
are denying our kids the opportunity to
prevent genital warts abnormal pap tests
and all of those HPV related cancers
because we are not integrating this into
our healthcare system we are state
number 49 for boys 49 we have a
phenomenom ”’l universities here
state-of-the-art scientific education
and yet we are not accepting this cancer
prevention vaccine for our boys and
state number forty for girls forty we
can do better we truly can do better
wait why why are we so slow about this
some people say oh it’s a new vaccine no
this vaccine has been recommended for
more than ten years
for girls since 2006 it prevents
infection with nine HPV types that’s 90%
of the HPV types that cause cervical
cancer and 99% of the types that cause
genital warts and it has been shown to
be more safe and effective than the
other vaccines that we give to our kids
at the exact same age which are called
Tdap meningococcal the vaccine safety
registry at the Centers for Disease
Control has better outcomes for HPV than
the other immunizations that we’re
giving to our kids at the same age this
is a safe and effective cancer
prevention vaccine that is not talked
about and is not being integrated into
our primary care delivery system the way
it should be
let’s turn these numbers around if your
primary care provider does not ask for
does not recommend this vaccine when
your child is in for their well-child
visit demand it when you bring in your
child for a strep throat visit ask for
it an ear infection visit ask for it it
needs to be delivered at any time when
you’re in that physician’s office if you
come in and you’re at that point of care
and you walk out then that was a missed
opportunity for the vaccine you just
denied your child the
gift of cancer prevention you had the
opportunity for it and you did not get
it for your child
insurance is not a barrier undocumented
status is not a barrier because in the
United States we have a program called
the vaccines for children program and
that means if the Centers for Disease
Control recommend this vaccine by the
Advisory Committee on Immunization
Practices up through age 18 the health
department through the vaccines for
children program cannot deny a child
that HPV vaccine if it’s part of that
aesop recommended vaccines regardless of
ability to pay
so regardless of ability to pay if it’s
recommended by the CDC the Centers for
Disease Control you can get this vaccine
for your child at federally qualified
community health centers or at health
departments and this vaccine is so
effective the data have been so
promising that we have dropped one dose
from the immunization series from three
doses to do two doses and that’s why
it’s even better to get the vaccine at a
younger age if you wait until age 15 up
through 26 for women or 21 for men then
you’ll need three doses in a much
tighter time frame is this vaccine just
for girls no even though apparently in
Utah we seem to think that way this
vaccine needs to be as strongly
recommended for girls as it is for boys
and even more so now than ever before
because HPV oral pharyngeal cancer which
is the cancer that affects the back of
the throat and the tonsil area has now
surpassed incidence in men than in than
cervical cancer in women which means the
most common each year related cancer is
now a male cancer not a female cancer
and if you look at those dark blue bars
those are HPV 16 and 18 cancers so I was
trying to think of an analogy for this
and so I would call those the tzunami
HPV types they caused the most HD
related cancers and then the other the
lighter blue are like the hurricane
types and then the even lightest blue or
the tropical storm so if you need to
protect against those darkest blue types
those are the ones that are covered in
the vaccine and that’s why the vaccine
is so important
but then you can’t just ignore the
lighter blue types and that’s why PAP
testing or HPV ko testing and then soon
we’ll be moving into HPV testing alone
are so important to make sure that your
body is clearing those other HPV types
or that your healthcare provider is
monitoring infection with the other HPV
types for the vaginal cervical region
but the trick is with men and with women
who have oral HPV we don’t have an HPV
test for oral HPV so women we have the
Pap test and we have HPV test for the
cervix we don’t have that for the oral
region that’s why the vaccine is even
more important we don’t have a face safe
we don’t have another stage of detection
for this upper region what are we doing
in Utah what are we doing at Huntsman
Cancer Institute we received a grant
from the National Cancer Institute to
work on working together so primary care
organizations physicians nurses health
department’s at the state level at the
county level parent groups churches
let’s get to know what’s going on with
the barriers around this vaccine in Utah
and the nearby states let’s learn about
how we can improve attitudes around it
how we can improve awareness how we can
integrate this and every single talk
about how to prevent cancer we need to
do that we need to turn this around so
we built this coalition where our vision
is working together across disciplines
listening to each other keeping each
other up to date on the state of the
science and on the evidence around how
this vaccine works and how we can work
with doctors and nurses and healthcare
delivery teams to make strong
recommendations for the vaccine if you
go into your doctor’s office and the
nurses on board your doctors on board
but if the receptionist said oh I didn’t
get that vaccine for my daughter are you
going to get the vaccine no you need to
have everyone at the health clinic on
board everyone needs to be on board with
this cancer prevention vaccine so that’s
what we’re working to do training entire
healthcare clinic practices
so we have spread out we start off with
just a couple states and now we’re in
the entire Mountain West region we have
participation from across the whole
United States learning about how we’re
working together learning about how
we’re staying informed with the hottest
topics in the state of the science
around HPV vaccinations the field has
changed so much just in the time that
I’ve been involved we were learning
about how this vaccine is working we’re
learning about how the evidence around
its effectiveness which is allowed us to
drop down from a three dose series to a
two dose series and we’re also learning
about how countries that are integrating
the vaccine into their platform they are
reducing cervical cancer they’re
reducing genital warts and we are also
reducing those things where you’re
juicing general warts and pre cancers
but not as a quick as quick of a pace as
we could be so we need to try and
improve that so we have monthly
activities if you want to join our
coalition feel free to email me or
anyone on my team stay up to date these
activities are done via webinar so you
could participate from anywhere in the
world and then we also have in-person
meetings and we are hosting a national
meeting coming up in June where we’re
hosting experts from all around the
country from the Centers for Disease
Control and from the National Cancer
Institute to talk about the state of the
science and how cancer centers like
Huntsman Cancer Institute can do a
better job in their region as
oncologists as the experts in cancer
treatment how we can not only work in
cancer treatment but we can also be seen
as the experts in cancer prevention
education and outreach and intervention
development so thank you so much for
your time these are the most important
steps is working with providers
strengthening that recommendation
demanding that recommendation and making
sure your child completes the series my
son just turned nine years old and I’m
looking forward to giving him that gift
of cancer prevention as soon as I
thank you
[Applause] [Music]