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South Florida Dr. Ellen Daley Publishes HPV Related Articles in Two Major Journals

University of South Florida College of Public Health’s Dr. Ellen Daley, professor and associate dean of research and practice, is getting the word out on human papillomavirus (HPV). She had an article published in the Journal of the American Dental Association (JADA) in January and is having commentary published in the Journal of the American Medical Association Pediatrics (JAMA) this fall.

Dr. Ellen Daley (Photo courtesy of USF Health).

For their January cover article JADA featured Daley and her team’s article, “Assessing Dentists’ Human Papillomavirus-Related Health Literacy for Oropharyngeal Cancer Prevention.” Their research involved conducting focus groups with dental professionals to assess their health literacy regarding the connection of HPV and oropharyngeal cancer.

The Journal of the American Dental Association’s January 2018 cover featuring Dr. Ellen Daley and her team’s article, “Dentists’ Health Literacy Regarding Human Papillomavirus, Oropharyngeal Cancer (Photo courtesy of JADA).

HPV is the most common sexually transmitted infection and can cause a variety of cancers including cervical, anal and oropharyngeal.

More than 30,000 cases of HPV-related cancer are diagnosed each year in the U.S., according to the U.S. Centers for Disease Control and Prevention (CDC). While there is currently no treatment for HPV, there is a vaccine that can prevent the majority of those cancers.

In 2017, the CDC stated that roughly half of adolescents were up to date on the HPV vaccine and 66 percent of adolescents ages 13-17 years received the first dose to start the vaccine series. These rates are low compared to other developed countries, such as Scotland and Australia, who have vaccination rates between 80-90 percent.

The United States implements the HPV vaccine through provider recommendation, such as pediatricians, family practice doctors and obstetrics/gynecologists.

Daley and her team are hoping to start including dentists and dental hygienists as the next group of providers to recommend the vaccine. They believe that with more providers recommending or providing the vaccine, vaccination rates will increase.

The team was funded by the National Institutes of Health (NIH) for the two-year study. They talked to dentists and dental hygienists about their health literacy with HPV and the vaccine, what they understand about HPV, where do they get their information, how do they apply that information with their patients and would they be willing to talk to their patients about HPV and recommend the vaccine.

“Just about every dentist and dental hygienist said that informing patients of the vaccine is absolutely their role. This is their opportunity to help prevent oropharyngeal cancers and they’re the right ones to do it,” Daley said. “Almost 70 percent of Americans see dentists every year, including children, which creates a great opportunity for parents to hear about the vaccine for their kids.”

A child receiving the HPV vaccine (Photo courtesy of Google Images).

After Daley’s research on dentist’s health literacy was published, her next focus was on the commentary that will be featured in JAMA.

The commentary is focused on adding the HPV vaccine to the list of vaccines required of children before they are allowed to enter middle school.

The CDC recommends the HPV vaccine for children ages 11 and 12, when their immune response is stronger than that of teenagers and when most states require vaccinations for tetanus, diphtheria and pertussis.

Widespread HPV vaccination has the potential to reduce cervical cancer incidence around the world by as much as 90 percent according to the NIH. While there are no formal screening programs for the non-cervical cancers, researchers estimate that vaccination could have an important public health benefit.

“One of the things that we’ve been working on is trying to add the vaccine to school entry programs and promote the idea that this should be added to the list of required vaccines within adolescent immunization schedules” Daley said. “The vaccine is very controversial in the United States, though. Because HPV is a sexually transmitted infection, parents don’t want to connect that with their children, so they don’t have them vaccinated.”

The HPV vaccine has already been implemented into the school entry program in Rhode Island, where vaccination rates have greatly increased.

“To have these two HPV articles featured in two major journals within a few months of each other is great, they complement each other so well!” Daley said. “With increasing the number of providers recommending the vaccine and requiring it for school entry I think we are going to reach the rates that we need. My intention is to do whatever that takes to increase the vaccine rates.”

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Vázquez-Otero, C., Vamos, C. A., Thompson, E. L., Merrell, L. K., Griner, S. B., Kline, N. S., Catalanotto, F. A., Giuliano, A. R., Daley, E. M. (2018). Assessing dentists’ human papillomavirus–related health literacy for oropharyngeal cancer prevention. The Journal of the American Dental Association,149(1), 9-17. doi:10.1016/j.adaj.2017.08.021

Story by Caitlin Keough, USF College of Public Health