Ann Arbor, U.S.A. – Most U.S. adults support laws that allow teens to get medical care for sexually transmitted infections without parental consent. But when asked about the vaccine against the human papilloma virus (HPV), most adults want parents to have the final say on whether their teen or pre-teen gets the shots.

The University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health recently asked a national sample of adults about allowing adolescents age 12 to 17 years old to receive the HPV vaccinations without parental consent.

Only 45 percent of those polled would support state laws allowing the HPV vaccination without parental consent.

“But in contrast, 57 percent say they support teens being able to get medical care for prevention of sexually transmitted infections and 55 percent for treatment, all without parental consent,” says Sarah Clark, M.P.H., Associate Director of the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan and Associate Director of the National Poll on Children’s Health.

In the short term, the HPV vaccine protects against genital warts, one of the most common types of sexually transmitted infection. In the long term, the vaccine prevents development of cervical cancer in females and some head and neck cancers in men.

Routine HPV vaccination is recommended for males and females at 11-12 years of age. The vaccine is most effective if administered before the onset of sexual activity.

“That presents a challenge. Parents aren’t thinking their 11 or 12 year-old child is ready for sexual activity at that age,” Clark says. “Many parents ask to delay the vaccine until their child is a little older. But older teens go to the doctor much less than younger adolescents, and often they go without a parent.”

Public health officials have considered pushing laws that would drop the need for parental consent, in order to boost HPV vaccination rates.

“But in this poll, most agreed they are reluctant to support dropping parental consent, even though 74 percent agreed that getting vaccines is a good way to protect adolescents from disease,” Clark says.

Those who did not support dropping parental consent were asked about their reasons. The most common reason, cited by 86 percent, was that HPV should be a parent’s decision; 43 percent cited the risk of side effects of the vaccine. About 40 percent said they have moral or ethical concerns about the vaccine.

The support for state laws that would allow HPV vaccination without parental consent was not different between parents and non-parents.

“These poll results show the majority of adults view HPV vaccination as distinct from sexually transmitted infection prevention and are reluctant to support taking away parental consent,” Clark says.

“Policymakers and public health officials interested in changing parental consent rules should consider this data and provide education to ensure adults understand the importance of HPV vaccination as a form of prevention against sexually transmitted infections.”

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Andover, England  – A survey of 11,785 British adults has found that 70% say they are unaware of any of the symptoms of mouth cancer. Simplyhealth’s Annual Dental Survey 2012 also found that only 3% of individuals think kissing can increase your chances of developing mouth cancer. The healthcare provider’s findings highlight the need to educate the population on the main risks and symptoms of a cancer that’s on the increase^[1].

James Glover, spokesperson for Simplyhealth says: “While 85% of people surveyed recognise that smoking tobacco can increase their chances of developing mouth cancer, there is a lack of awareness about other potential risks.

Our findings follow recent news from Cancer Research UK that high risk strains of human papillomavirus (HPV) infections which are spread through bodily contact could be the key reason for the increase in mouth cancer, particularly among younger people^[2]. Although this risk cannot be avoided in the same way as not smoking, it’s important for people to know what makes us all susceptible to this type of cancer.”

Michael Thomas, a practicing dentist says: “As well as knowing the risks, individuals should be educated in identifying the symptoms. As with all cancers, the sooner it is identified, the better. Worryingly, only 28% of those surveyed by Simplyhealth would consider consulting or have consulted with their dentist about concerns or queries over mouth cancer.

Dentists are integral to addressing any worries individuals may have about the health of their mouth. I’d encourage everyone to utilise their time in the dentist’s chair and speak up should they have any questions about the risks or symptoms of mouth cancer.”

Michael Thomas has put together the below ‘cut out and keep’ guide to the main risks and most common symptoms of mouth cancer:

The main risk factors:

• Smoking
• Alcohol
• Poor diet and nutrition
• Sun exposure (lips)
• Human papilloma virus (HPV) which affects the immune system and can be spread by kissing and bodily contact (most strains of HPV are harmless but a few are high risk)
• Previous cancer diagnosis

Most common symptoms:

• A mouth sore or ulcer that fails to heal or bleeds easily
• All red or red and white patches in the mouth that will not go away
• A lump or thickening in the mouth, tongue or throat
• Difficulty in chewing or swallowing food
• New persistent pain

With a Simply Cash Plan or Simply Dental Plan you can claim back money towards the cost of check-ups, treatment and emergencies. Our plans entitle you to claim for as many treatments as you want up to your annual limit. You simply pay a monthly premium and once you’ve attended your appointment you can claim the money back, by completing a claim form and sending off the receipt.

The Simply Dental Plan also includes a one off payment, in the unfortunate event that a person develops mouth cancer. For further information please visit http://www.simplyhealth.co.uk.

1. In the last ten years, cases have risen from around six cases per 100,000, to eight cases. Cancer Research UK – http://www.cancerresearchuk.org 

2. Cancer Research UK – http://info.cancerresearchuk.org/news/archive/pressrelease/2012-03-16-hpv-push-oral-cancer-cases-past-6000-a-year?rss=true 

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Researchers at the University of Michigan Health System have found a new indicator that may predict which patients with a common type of throat cancer are most likely have the cancer spread to other parts of their bodies.

Patients with oropharyngeal squamous cell carcinoma who had “matted” lymph nodes – nodes that are connected together – had a 69 percent survival rate over three years, compared to 94 percent for patients without matted nodes, according to a study published online ahead of print publication in Head & Neck.

The oropharynx is an area that includes the back of the tongue, soft palate, throat and tonsils. ”The spread of cancer throughout the body accounts for about 45 percent of the deaths from oropharyngeal carcinoma,” says the study’s senior author, Douglas B. Chepeha, M.D., M.S.P.H., an associate professor of otolaryngology head and neck surgery at the U-M Medical School.

“Our findings may help doctors identify patients who are at higher risk for having their cancer metastasize and who would benefit from additional systemic therapy. Conversely, some patients without matted nodes may benefit from a reduction of the current standard treatment, which would cut down on uncomfortable side effects.”

Notably, the findings indicate an increased risk independent of other established prognostic factors, such as the patient’s history of smoking or whether they have the Human papillomavirus (HPV), the study found. Smoking (tobacco and marijuana), heavy alcohol use and HPV infection have each been linked to the development of oropharyngeal squamous cell carcinoma.

Matted nodes appear to be an especially strong indicator of increased risk among patients who are HPV-positive, even though HPV-positive patients had better overall outcomes than their HPV-negative peers. The patients with the best outcomes were HPV-positive non-smokers.

“It’s not clear why we’re finding these survival differences for patients who have matted nodes,” says study lead author Matthew E. Spector, M.D., a head and neck surgery resident at U-M who won a national award from the American Head and Neck Society for this work. “It is possible that there are biological and molecular differences in these types of tumors, which can be explored in future research.”

The results affirm the value of having a team of doctors and researchers from different specialties, radiology, oncology, biostatistics and surgery, working together to find advances that can directly benefit patients, Chepeha says. “This was a collaborative effort and all of the authors made important contributions,” he adds.

The study tracked 78 cancer patients who were part of a clinical trial evaluating two cancer drugs in combination with intensity-modulated radiation therapy. All the patients had stage III or IV squamous cell carcinoma of the oropharynx and had not had any previous treatment. Sixteen of the 78 patients had matted nodes.

“It’s significant that we’ve identified this new marker that can help us predict which patients have worse survival odds,” Chepeha says. “Now we need to go one step further and figure out what mechanisms are at work and how we can use this knowledge to improve survival rates.”

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Rick Perry’s decision to mandate HPV vaccines for sixth-grade girls back in 2007 has become a bone of contention on the campaign trail. Under the terms of Perry’s executive order, 12 year old girls in Texas were supposed to receive the Gardasil vaccine, which inoculates them against the human papillomavirus (HPV).

HPV is quite widespread, with approximately 50% of sexually-active adults acquiring it during their lifetime. However, according to the Center for Disease Control, in 90% of cases, the body’s immune system eliminates the virus without any adverse effects. But in the remaining 10% of cases, the virus can have serious side effects, including genital warts or cervical cancer.

It is because of the risk of sexually-transmitted diseases that many medical authorities recommend administering the HPV vaccine to all girls before they become sexually active. Even though the executive order was ultimately overturned by the Texas legislature, Perry’s attempt to impose the HPV vaccine by executive fiat is hard to reconcile with his promise to reduce the government’s role in people’s lives.

Fellow GOP presidential hopeful Michele Bachmann criticized Perry’s decision, saying that “to have innocent little 12-year-old girls be forced to have a government injection through an executive order is just flat out wrong.” Even Democrats have joined in the criticism. During the 2010 election, they ran attack ads featuring menacing images of a needle poised to strike a young girl’s arm.

Perry’s decision also vexes social conservatives because inoculating girls against sexually-transmitted disease flies in the face of their support for abstinence-only sex education. Conservative Christian leaders were vocal in their opposition to the executive order, and their opposition was instrumental in convincing the legislature to overturn it.

Another issue with Perry’s support for the HPV vaccine is that Merck, the company that makes Gardasil, donated $30,000 to Perry’s campaign. The company also employs Perry’s former chief-of-staff as a lobbyist. Naturally, these close connections have given rise to claims that the Texas governor was acting more for the benefit of a major donor than the general public.

Although Michele Bachmann accused Perry of “crony capitalism,” he claimed that there was nothing untoward about the situation. “”If you’re saying that I can be bought for $5,000, I’m offended,” he replied. However, as noted above, Merck’s contribution was actually much greater than the $5,000 quoted by Perry.

Furthermore, Merck and its subsidiaries also contributed $380,000 to the Republican Governors Association once Perry took the helm of that organization in 2006. Now that Perry is coming under fire for his decision, he seems intent on distancing himself from it. During a recent debate, he admitted that, if he had to do it all over again, he would have approached the matter differently.

Meanwhile, his spokesman Mark Milner, accused Bachmann and others of staging histrionics in order to draw attention to themselves. “You have candidates out there that are trying to get attention and will throw outlandish accusations out there just to get their name in the paper,” Milner said. “What drove the governor on this issue was protecting life.”

Despite the Sturm und Drang that this has generated, Perry is still the candidate most likely to appeal to the right wing of the GOP. His social conservative credentials are still stronger than those of Mitt Romney, who is still struggling to overcome grassroots Republican opposition to Massachusetts’ healthcare law.

Image Courtesy of  http://www.flickr.com/photos/gageskidmore/

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