HJAR Nov/Dec 2019

34 NOV / DEC 2019 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN ORAL HEALTH The human papillomavirus (HPV) is a known cause of 70 percent of oropharyn- geal cancers (OPC), the most common type of HPV-related cancer in men, and second only to cervical cancer in women. According to theAmerican Cancer Society, approximately 53,000 people in the U.S. will be newly diag- nosed with OPC in 2019, and 10,680 will die because of it. Arkansas has one of the highest rates of OPC in the nation, at 5.2 per 100,000, compared to the national average of 4.5. HPV is easily transmitted through direct skin-to-skin contact of vaginal, penile, anal, and oropharyngeal mucosal surfaces. Most infections are asymptomatic and resolve without intervention within 12-20months af- ter contact. However, HPV is believed to have long periods of inactivity or dormancy that can cover years, and during these periods of time, a person will test negative for it. HPV is so common that 80 percent of people will become infected during their lifetimes. The Centers for Disease Control and Prevention (CDC) estimates that there are 6.2 million new infections each year in the U.S. Every day, about 12,000 people ages 15 to 24 are infected with HPV. Although more than 200 types of HPV have been identified, there are only a few that have oncogenic potential. Infection with one of the 13 known oncogenic HPV types is more likely to persist and progress into pre-cancer and cancer. HPV vaccination protects against some cancer-causing strains, especially the most dangerous, 16 and 18, which cause 80 percent of HPV-related cancers. More males than females will develop OPC, and white, non-smoking males age 35 to 55 are most at risk, 4 to 1 over females. There is currently no test available to de- tect oral HPV. Early signs of oral cancer can be detected visually in the oral cavity. These include persistent white or red lesions, ul- cerations that do not heal, unusual bleeding or loose teeth. OPC are detected in the back of the tongue and tonsil area with symptoms including enlarged lymph glands, chronic sore throat, trouble swallowing, hoarseness, and unexplained weight loss. The HPV vaccine licensed by the U.S. Food and Drug Administration (FDA) and recom- mended by the CDC is Gardasil 9, made by Merck. Gardasil 9 protects against cancer and precancerous lesions caused by nine types of HPV, including 6, 11, 16, 18, 31, 33, 45, 52, and 58. Children receiving the vaccine from ages 9-15 receive two shots given over six months. HPV-Related Cancer Prevention: A Dentist’s Perspective Oral health care providers have a unique opportunity to fill a critical gap in cancer prevention and education in Arkansas.

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