Adolescent sexual activity and cancer risk: physicians’ duty to inform?

Abstract

Yearly, 33,000 cancer diagnoses in the US are attributed to human papillomavirus (HPV), with cervical cancer the most common. HPV is transmitted through sexual contact; HPV types 16 and 18 cause the majority of ano-genital cancers in men and women. HPV causes ∼100% of cervical cancers, ∼90% of anal cancers, and ∼50% of vaginal, vulvar, and penile cancers. HPV is also involved in ∼70% of oropharyngeal cancers (OPCs) in the US. The CDC recommends routine administration to all female (bivalent or quadrivalent vaccine) and male (quadrivalent vaccine) patients at 11-12 years of age; the series may be started as early as 9 years of age. Recent evidence suggests physicians do not universally recommend the vaccine to all adolescents. Additionally, parents may refuse the vaccine due to safety concerns as well as religious and moral beliefs related to onset of sexual debut. It has been suggested physicians should consider discussing HPV vaccine as a cancer prevention tool only, with less focus on the fact that transmission is caused by sexual activity. In this commentary we suggest physicians have a duty to warn parents and adolescents that OPCs may be transmitted through oral sex, which is often perceived as not constituting sexual activity.

Poly-substance use and sexual risk behaviours: a cross-sectional comparison of adolescents in mainstream and alternative education settings

“…These behaviours, which include smoking, heavy alcohol consumption and drug use, have all been shown to contribute to excess morbidity and mortality during adulthood [7]. Furthermore, it has been identified that tobacco, alcohol and drug use [8, 9] and sexual risk taking behaviour [9, 10] are two of the major causes of death and illness among adolescents and young adults. It is thus important to understand trends in health inequalities and the underlying social determinants of these in order to develop interventions and policies to reduce the effects of these upon population health [11, 12].…”

Health risk behaviours amongst school adolescents: protocol for a mixed methods study

“…Some of these behaviours contribute to the leading causes of mortality and morbidity among adolescents, such as suicide attempts, injuries and the various risks associated with unprotected sexual behaviour, conditions related to tobacco or alcohol use and overweight or obesity [3–5]. The majority of adolescent death and illness are caused by risk behaviours that can be grouped into four categories: tobacco, alcohol and drug use; dietary behaviours; physical activity; and sexual behaviours [6, 7]. These key health-risk behaviours are often the focus of prevention strategies for non-communicable diseases and some sexual conditions [8, 9].…”

Creating a Strategic Partnership for Educating Nurse Practitioner Students about Sexual Health

“…These missed opportunities have also been implicated in the slow uptake of the human papilloma virus (HPV) vaccine among those who could most benefit from it. Clinicians who do not feel competent or comfortable discussing sexual matters often find it difficult to bring up the importance of the HPV vaccine and it is, therefore, neither discussed nor provided (Centers for Disease Control and Prevention, 2013;Quinn, Vadaparampil, Johns, Alexander, & Giuliano, 2014).…”