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Sentists show support for gender-neutral HPV vaccinations

28 April 2017

Sentists show support for gender-neutral HPV vaccinations

The overwhelming majority of dentists and GPs are backing calls for the Human Papillomavirus (HPV) vaccination programme to be expanded to school aged boys, according to a new survey.

In the new poll published by the campaign coalition HPV Action for World Immunisation Week (24th-28th April), 97% of dentists backed expansion of the programme, with the same proportion saying if they had a son they would want them to receive the vaccination. 94% of GPs said they would support both positions.

The survey was sent to members of the Faculty of General Dental Practice (UK), the British Dental Association and the British Medical Association. Findings come as the Government’s vaccination advisory committee (JCVI) moves towards a decision on whether boys should be given the HPV vaccination.

Up to 80% of sexually active people will be infected by HPV at some point in their lives. 5% of all cancers are caused by HPV and some of these, notably oral cancers, are now rising sharply in incidence. HPV-related cancers such as anal cancer are also among the hardest to diagnose and treat.

Parliamentarians from all parties have signed an open letter to the Health Secretary, Jeremy Hunt MP, urging him to ensure that the UK doesn’t miss this opportunity to eradicate some of the fastest-rising cancers in the developed world.

Mick Horton, Dean of FGDP(UK) said: “The incidence of oral cancer has increased dramatically over the last decade, and over two-thirds of diagnoses are in men. HPV is a main causative agent, and the introduction of the NHS vaccination programme for girls has led to a significant reduction in the prevalence of the virus among women. Yet with over 2,000 men a year in the UK diagnosed with an HPV-related cancer - of whom almost half will die from the condition within five years – it is clear that current measures are not working for everyone. The view of oral health professionals is resounding - many of these lives could and should be saved by also vaccinating boys against HPV.”

Mick Armstrong, Chair of the BDA's Principal Executive Committee, said: “HPV is the leading cause of oro-pharyngeal cancers and men are just as likely to develop it as women so where is the logic – or fairness – in targeting protection to one section of the population? It is morally indefensible to allow people to contract cancer when prevention – the new NHS mantra – could be so cheap and easy. Cancers affecting the mouth and throat have a huge impact on the quality of people’s lives, so it’s frustrating for dentists, who are often the first to detect them, knowing how easily they could have been prevented."

Dr Andrew Green, a member of the BMA’s General Practitioners Committee (GPC), said: “If we want to see an end to some of the most aggressive and hard to treat cancers such as throat, head, neck and anal cancer, boys as well as girls must be given the HPV vaccination. It is ridiculous that people are still dying from these cancers when their life could have easily been saved by a simple injection.”

Peter Baker, HPV Action Campaign Director, said: “HPV affects men and women equally and both sexes therefore deserve equal protection though a national vaccination programme. It is now time for the Government’s vaccination advisory committee to look up from its financial spreadsheets and act to end the suffering of those men and women affected by easily-preventable diseases caused by HPV.”

HPV Action is asking members of the public, especially the parents of boys, to sign an online petitiondemanding gender-neutral vaccination: and will be calling on all political parties to commit themselves to gender-neutral HPV vaccination during the forthcoming General Election campaign.

Plain tobacco packaging 'may cut smokers by 300,000 in UK'

Plain cigarette packaging could lead to 300,000 fewer smokers in the UK over the next year, a major review suggests.

Standardised packs could also reduce the appeal of tobacco and increase calls to quit helplines, experts behind the Cochrane Review said.

UK law, which comes into full effect in May, states that all cigarette packs must feature health warnings and have a standard colour, shape and font.

But a smokers' group said the estimates were "wishful thinking".

The Cochrane Review team, led by researchers from London and Oxford, estimated that the number of people who smoked in the UK could go down by 0.5% by May 2018, although they said the current evidence was limited.

The findings were backed up by a report from the Australian government, which showed a similar drop in smoking prevalence - 0.55% - following the introduction of plain packaging there in 2012.

Currently, about 17% of the UK adult population are smokers.

The review looked at new evidence from 51 studies, involving 800,000 people, on the impact of standardised packaging on smokers' attitudes and behaviour.

It is also the first review to include research on smoking in Australia after packaging rules were changed.

They said the following changes could occur over the next year in the UK:

  • no change in the number of cigarettes smoked by those continuing to smoke
  • a 6% increase in people trying to give up smoking
  • an increase in calls to quit smoking helplines

Prof Ann McNeill, lead review author from King's College London, said there was evidence that standardised packaging made people less likely to be motivated to smoke and reduced cravings for tobacco.

The health warnings, which have to cover 65% of the front and back of packs, were prominently in people's eye lines, she said.

But there was room for further changes to cigarette packs.

"It would appear that the impact of standardised packaging may be affected by the detail of the regulations such as whether they ban descriptors, such as 'smooth' or 'gold' and control the shape of the tobacco pack," she said.

However, there were no studies showing whether changing the packaging affected the number of young people taking up smoking.

Giles Roca, director general of the Tobacco Manufacturers' Association said: "This report destroys the rationale for the introduction of plain packaging by finding no evidence that it actually acts a deterrent to young people in taking up smoking - this was at the core of the government's and health campaigners' argument for its introduction."

Simon Clark, director of the smokers' group Forest, said the estimates were "wishful thinking, based on hope and anecdotal evidence, not facts".

"Since plain packaging was introduced in Australia, smoking rates have fallen, but only in line with historical trends," he said.

From May 2017, all packs of tobacco sold in the UK must meet these standards:

  • Picture and text health warnings must cover 65% of the front and back of cigarette and roll-your-own tobacco packages
  • No branding other than the product name and brand variant in a standard font, size and colour
  • All other trademarks, logos, colour schemes and graphics are banned
  • The only colour permitted on the external pack is olive green with a matt finish
  • Cigarette packets must be cuboid in shape and contain a minimum of 20 cigarettes
  • Misleading information on tar, nicotine and carbon monoxide emissions must be removed
  • Any promotional descriptors such as references to flavours must be removed

What is happening in other countries?

Australia was the first country in the world to require cigarettes to be sold in plain, standardised packaging, in December 2012.

The UK became the second country to pass similar legislation. Ireland and France have followed suit.

Several other countries, including Hungary, Slovenia and Norway, are now in the process of introducing plain packaging laws.

Uruguay introduced large health warnings on cigarette packs in 2005.

'Exciting' blood test spots cancer a year early

Doctors have spotted cancer coming back up to a year before normal scans in an "exciting" discovery.

The UK team was able to scour the blood for signs of cancer while it was just a tiny cluster of cells invisible to X-ray or CT scans.

It should allow doctors to hit the tumour earlier and increase the chances of a cure.

They also have new ideas for drugs after finding how unstable DNA fuels rampant cancer development.

The research project was on lung cancer, but the processes studied are so fundamental that they should apply across all cancer types.

Lung cancer kills more people than any other type of tumour and the point of the study is to track how it can "evolve" into a killer that spreads through the body.

In order to test for cancer coming back, doctors need to know what to look for.

In the trial, funded by Cancer Research UK, samples were taken from the lung tumour when it was removed during surgery.

A team at the Francis Crick Institute, in London, then analysed the tumour's defective DNA to build up a genetic fingerprint of each patient's cancer.

Then blood tests were taken every three months after the surgery to see if tiny traces of cancer DNA re-emerged.

The results, outlined in the journal Nature, showed cancer recurrence could be detected up to a year before any other method available to medicine.

The tumours are thought to have a volume of just 0.3 cubic millimetres when the blood test catches them.

Dr Christopher Abbosh, from the UCL Cancer Institute, said: "We can identify patients to treat even if they have no clinical signs of disease, and also monitor how well therapies are working.

"This represents new hope for combating lung cancer relapse following surgery, which occurs in up to half of all patients."

So far, it has been an early warning system for 13 out of 14 patients whose illness recurred, as well as giving others an all-clear.

In theory, it should be easier to kill the cancer while it is still tiny rather than after it has grown and become visible again.

However, this needs testing.

Prof Charles Swanton, from the Francis Crick Institute, told the BBC: "We can now set up clinical trials to ask the fundamental question - if you treat people's disease when there's no evidence of cancer on a CT scan or a chest X-ray can we increase the cure rate?

"We hope that by treating the disease when there are very few cells in the body that we'll be able to increase the chance of curing a patient."

Janet Maitland, 65, from London, is one of the patients taking part in the trial.

She has watched lung cancer take the life of her husband and was diagnosed herself last year.

She told the BBC: "It was my worst nightmare getting lung cancer, and it was like my worse nightmare came true, so I was devastated and terrified."

But she had the cancer removed and now doctors say she has a 75% chance of being cancer-free in five years.

"It's like going from terror to joy, from thinking that I was never going to get better to feeling like a miracle's been acted," she said.

And taking part in a trial that should improve the chances for patients in the future is a huge comfort for her.

"I feel very privileged," she added.

The blood test is actually the second breakthrough in the massive project to deepen understanding of lung cancer.

A bigger analysis, published in the New England Journal of Medicine, showed the key factor - genetic instability - that predicted whether the cancer would return.

Multiple samples from 100 patients containing 4.5 trillion base pairs of DNA were analysed.

DNA is packaged up into sets of chromosomes containing thousands of genetic instructions.

The team at the Francis Crick Institute showed tumours with more "chromosomal chaos" - the ability to readily reshuffle large amounts of their DNA to alter thousands of genetic instructions - were those most likely to come back.

Prof Charles Swanton, one of the researchers, told the BBC News website: "You've got a system in place where a cancer cell can alter its behaviour very rapidly by gaining or losing whole chromosomes or parts of chromosomes.

"It is evolution on steroids."

That allows the tumour to develop resistance to drugs, the ability to hide from the immune system or the skills to move to other tissues in the body.

The first implication of the research is for drug development - by understanding the key role of chromosomal instability, scientists can find ways to stop it.

Prof Swanton told me: "I hope we'll be able to generate new approaches to limit it and bring evolution back from the brink, perhaps reduce the evolutionary capacity of tumours and hopefully stop them adapting.

"It's exciting on multiple levels."

The scientists say they are only scratching the surface of what can be achieved by analysing the DNA of cancers.


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