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HPV Vaccination Uptake Also Linked to Benefits in the Unvaccinated

Since the first human papillomavirus (HPV) vaccine became available in 2006, the rate of HPV infections, which can cause several cancers, including cervical, anal and throat cancer, has declined among women and men in the U.S. A recent analysis published in JAMA Pediatrics, suggests the HPV vaccination has also reduced infection rates in unvaccinated girls and women. For the study, researchers assessed the vaccination status and infection rates of 2,335 adolescent girls and young women ages 13 to 26 who had some history of sexual activity and took part in regional surveillance studies between 2006 and 2023. The study looked at infections by HPV type, including the most carcinogenic types: HPV-16 and HPV-18. The earliest versions of the vaccine addressed these strains. Over the course of the study, the proportion of vaccinated girls and women who tested positive for HPV-16 or HPV-18 dropped 98.4%, MedPage Today reported. In addition, infection rates of unvaccinated girls and women for these same HPV types fell 75.7% in the same time period. “High HPV vaccination rates achieved during adolescence may have the capability to decrease infection, precancers, and new cancer diagnoses for a much larger group of beneficiaries,” wrote physician Rachel Katzenellenbogen, and epidemiologist Teresa Imburgia, both of Indiana University in Indianapolis, in an editorial published in JAMA Pediatrics. However, disruptions to people’s ability to get health care and vaccine hesitancy could undermine this progress, study author Jessica Kahn, director of the Block Institute for Clinical and Translational Research at Albert Einstein College of Medicine in New York City, told MedPage Today. “We do have that potential to actually eliminate cervical cancer in our lifetimes,” Kahn said. “It depends on vaccine access and uptake being high.”

Radiation Lowers Recurrence in Locally Advanced Bladder Cancer

Radiation therapy reduced the risk of local recurrence when added to treatment for muscle-invasive bladder cancer, according to a study presented at the American Society for Radiation Oncology (ASTRO) meeting. The study included 153 people with high-risk muscle-invasive bladder cancer who had surgery to remove their bladder and chemotherapy. Half the patients in the trial received radiation therapy while the rest were observed without getting radiation. In the study, 87.1% of patients who received radiation were alive without local or regional recurrence compared with 76% in the observation group, Oncology News Central reported. “The use of adjuvant radiotherapy for localized bladder cancer is an age-old question that does not have an answer,” said Chad Tang, a radiation oncologist at the University of Texas MD Anderson Cancer Center in Houston, who discussed the findings at an ASTRO media briefing. “Overall, BART [Bladder Adjuvant Radiotherapy] is an important beginning to the integration of radiation in a setting where we had very little clear data until now,” Tang said. The addition of radiation came with increased reports of moderate diarrhea and inflammation of the small intestine or rectum, but rates of severe toxicities were similar between the two groups, according to principal investigator Vedang Murthy, a radiation oncologist at Tata Memorial Hospital in Mumbai, India, who presented the findings at the conference. The study was conducted in India and did not include people treated with immunotherapy. Tang said he was curious to see data on how radiation affects outcomes in people receiving immunotherapy as part of their bladder cancer treatment, MedPage Today reported.

Some Increases in Early-onset Cancer May Be Due to Better Detection

Recent reports about rising cancer rates in younger adults has raised speculation about potential modern causes, including diets and environmental changes. A recent study questions whether the increases are more a reflection of the improved ability to find cancer. The study, published in JAMA Internal Medicine, examined eight cancer types with the fastest growth in early-onset diagnoses. Rates of thyroid, anal, kidney, small intestine, colorectal, pancreas and endometrial cancer, and multiple myeloma have doubled in people under the age of 50 between 1992 and 2022. The mortality rate across those cancers remained consistent throughout, at 5.9 deaths per 100,000 people, indicating that the rise in cases may not reflect a change in biology but a change in our ability to detect cancers, according to the researchers. “There really isn’t much more cancer out there,” study author H. Gilbert Welch, a physician and researcher at the Center for Surgery and Public Health at Mass General Brigham hospital, told NBC News. “We’re just finding stuff that’s always been there.” The researchers contended that mortality rates among different cancer types would change if there were a true increase in cases. Meanwhile, greater awareness, expanded screening in younger people and better tests may be turning up cases that would have been missed in the past. Ahmed Jemal, senior vice president for surveillance, prevention and health services research at the American Cancer Society, rebutted the idea that rising incidence rates can be dismissed as a product of more screening. But Jemal said that treating cancers that aren’t dangerous creates expenses, anxieties and other burdens for people who are diagnosed. The study authors argued that raising alarms about cancer in young adults could lead to more tests in otherwise healthy people. “The epidemic narrative not only exaggerates the problem, but it may also exacerbate it,” the authors wrote. “While more testing is often seen as the solution to an epidemic, it can just as easily be the cause.”