Study Highlights Risk to US Vets

A study published in the Journal of the American Medical Association (JAMA) Oncology highlights a major risk to US veterans. University of Pittsburgh Department of Otolaryngology Chair José Zevallos is the senior and corresponding author on the study.

The study was on human papillomavirus vaccination prevalence and disproportionate cancer burden among US veterans – the first of its kind. As the JAMA article states at the outset, “In the US, over 45,000 cases of HPC-associated malignant neoplasms are diagnosed annually.” Active-duty military service members and veterans are twice as likely as the general population to develop oncogenic HPV infections, resulting in a higher risk of HPV-associated cancers and mortality. Also, HPV-associated oropharyngeal cancer – which occurs predominantly in males – is rising more rapidly among veterans than civilians. One long-term effect of all of this is added costs to the VA system.

The study also found that among eligible US veterans, the rate of HPV vaccination was about half of what it was in civilians – in both males and females.

“The degree to which under vaccination is occurring in the VA surprised us,” said Dr. Zevallos. “Additionally, we found that under vaccination was not limited to one particular group or region, but was widespread across the entire VA.”

Where to go from here? Dr. Zevallos said they want to get word out to the military community that this is a major problem. The results of this study should be a call to action to the Department of Defense as well as the VA. The most effective place for prevention, he said, would be among active-duty military recruits. Currently, HPV vaccination is not among the required vaccinations to enter the military.

“Short of a requirement, there should be more efforts to inform our military recruits about the risk associated with HPV-associated cancers and the benefit of vaccination,” said Dr. Zevallos. “Additionally, we need to better educate our primary care providers on new guidelines calling for vaccination in both males and females up to age 26 (up to age 45 in some cases). We have found that many physicians continue to believe that this vaccine is only for females and only given in adolescence.”

The group is designing interventions that would effectively address these issues and hopes to partner with the DOD and VA to improve HPV vaccination rates in the military community and avoid unnecessary suffering among veterans.