Activity Overview

Program Description

The human papillomavirus (HPV) causes more than 99% of all cervical cancers. Exposure to HPV infections occurs in a high proportion of the overall population; however, 2 safe and effective vaccines, HPV2 and HPV4, are approved for the prevention of HPV-16 and HPV-18 infection, the most common causes of cervical cancer. Additionally, HPV4 prevents HPV-6 and HPV-11-related genital warts. While prevention of cervical cancer in women has been the initial aim of vaccination programs, it has now become apparent that HPV causes other types of cancer as well, including vulvar and vaginal cancers in women, penile cancer in men, and anal cancer in both sexes. Furthermore, these viruses have been implicated in head and neck cancers in both men and women as well. It is estimated that HPV-related cancers occur in 10,000 American males annually, suggesting that limiting vaccination programs to females may be underserving a significant proportion of the population. The efficacy of the 2 available vaccines against oncogenic HPV is more than 90% for both cervical and anal intraepithelial neoplasia. For those receiving the HPV4 vaccine, efficacy against genital warts is nearly 90%. Adverse effects are few and include episodes of syncope in the period immediately following vaccination. Benefits of vaccinating males include reduction in disease burden in men and enhanced herd immunity to reduce disease burden in women. This online CME activity is based on slides and lecture content presented by the faculty at the pmiCME Updates Day at the pmiCME Conference & Exhibition event, which took place on June 15, 2011, in New York, NY.

Target Audience

Internal Medicine, Family Medicine, Primary Care

Topics

Vaccines

Learning Objectives

After completing this activity, the participant should be better able to:
  1. Explain the epidemiology and burden of disease associated with HPV viruses
  2. Identify those HPV types most often associated with particular cancers and genital warts
  3. Discuss strategies to reduce the prevalence of these diseases

Faculty

Kenneth Alexander, MD, PhD
Professor of Pediatrics
Chief, Section of Pediatric Infectious Diseases
The University of Chicago
Chicago, Illinois

Kenneth A. Alexander, MD, PhD, is Professor of Pediatrics and Chief of the Section of Pediatric Infectious Diseases at The University of Chicago, Chicago, Illinois. He attended the University of Washington School of Medicine, Seattle, Washington, where he earned his medical and doctoral degrees.  After a Pediatric residency at the Children's Hospital Boston, in Boston, Massachusetts, followed by Pediatric Infectious Diseases fellowship training at Duke University, Durham, North Carolina, Dr Alexander joined the faculty at Duke Medical Center. He has been a member of the medical staff at the University of Chicago since 2005. 

Dr Alexander's research activities include laboratory studies of human papillomavirus replication, and community-based and school-based promotion of adolescent immunization.

Anna R. Giuliano, PhD
Professor, Department of Oncologic Sciences
Chair, Department of Cancer Epidemiology
Program Leader, Cancer Epidemiology Program
H. Lee Moffitt Cancer Center & Research Institute
Tampa, Florida

Anna R. Giuliano, PhD, an oncologic sciences professor and also chair of the Department of Cancer Epidemiology and program leader of the Cancer Epidemiology Program at the H. Lee Moffitt Cancer Center & Research Institute in Tampa, Florida, is a consultant for several National Institutes of Health (NIH)-funded cervical cancer prevention programs, as well as serving as an advisory board member to several large international research consortia. Dr Giuliano received her doctorate from Tufts University, Boston, Massachusetts, continuing her studies at the New England Epidemiology Institute in Boston and at the University of Arizona in Tucson as a National Cancer Prevention and Etiology Fellow. From 1993 to 1998 she was the recipient of an NIH National Cancer Institute Preventive Oncology Career Development Award.

Research interests include human papillomavirus (HPV) infection among women and men—with a specific interest in prevention interventions—and understanding of HPV infection and its association with nonmelanoma skin cancer and other viral-associated cancers.

Author of more than 160 scientific manuscripts, and manuscript reviewer for The Lancet, International Journal of Cancer, and JAMA, among other journals, Dr Giuliano contributed significantly to the 1999 Institute of Medicine report, The Unequal Burden of Cancer, and to the WHO IARC HPV Monograph published in 2007.

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Continuing Education Credit