HPV linked to growing number of young adults with oropharyngeal cancer

Sep. 24, 2013 — The human papillomavirus (HPV) may be to blame for the alarming increase of young adults with oropharyngeal cancer, according to researchers from Henry Ford Hospital in Detroit.

The study reveals an overall 60 percent increase from 1973 and 2009 in cancers of the base of tongue, tonsils, soft palate and pharynx in people younger than age 45.

Among Caucasians, there was a 113 percent increase, while among African-Americans the rate of these cancers declined by 52 percent during that period of time.

But compared to Caucasians and other races, the five-year survival rate remains worse for African Americans.

“The growing incidence in oropharyngeal cancer has been largely attributed to the sexual revolution of the 1960s and 1970s, which led to an increased transmission of high-risk HPV,” says study lead author Farzan Siddiqui, M.D., Ph.D., director of the Head & Neck Radiation Therapy Program in the Department of Radiation Oncology at Henry Ford Hospital.

“We were interested in looking at people born during that time period and incidence of oropharyngeal cancer. Not only were we surprised to find a substantial increase in young adults with cancer of the tonsils and base of tongue, but also a wide deviation among Caucasians and African Americans with this cancer.”

The study – which examined the trends in cancers of the base of tongue, tonsils, soft palate and pharynx among people 45 years-old and younger – was presented at the 55th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Atlanta.

The American Cancer Society estimates about 36,000 people in the U.S. will get oral cavity and oropharyngeal cancers in 2013; an estimated 6,850 people will die of these cancers. Oropharyngeal cancers are more than twice as common in men as in women, and about equally common in African Americans and Caucasians.

Recent medical research has shown that HPV exposure and infection increases the risk of oropharyngeal squamous cell cancer independently of tobacco and alcohol use, two other important risk factors for the disease, according to the National Cancer Institute.

The incidence of oropharyngeal cancer has been growing in recent years due to increasing rates of HPV infection. This has been largely attributed to changes in sexual practices. Studies have shown, however, patients with HPV related head and neck cancer do have a better prognosis and survival.

For the Henry Ford study, Dr. Siddiqui and his colleagues used the SEER (Surveillance Epidemiology and End Results) database to gather information about adults younger than age 45 who had been diagnosed with invasive squamous cell oropharyngeal cancer between1973 and 2009.

Since SEER does not record HPV information, the researchers used tumor grade as a surrogate indicator of HPV infection.

Among the study group of more than 1,600 patients, 90 percent were ages 36-44 and the majority (73 percent) was Caucasian.

During the 36-year period, the majority of patients (50-65 percent) underwent surgical resection for their tumors. Patients who had both surgery and radiation therapy had the highest five-year survival rate.

“These patients have a favorable prognosis and are likely to live longer while dealing with treatment related side-effects that may impact their quality of life,” notes Dr. Siddiqui.

The five-year survival for the study group was 54 percent. There was no difference in survival based on gender. African Americans, however, had significantly poor survival compared to other races.

“The predominance of oropharyngeal cancer in this age group suggests either non-sexual modes of HPV transfer at a younger age or a shortened latency period between infection and development of cancer,” says Dr. Siddiqui.

View the original article here

6.6 Million Young Adults Joined Parents' Health Plans in 2011: Report

AppId is over the quota
AppId is over the quota

FRIDAY, June 8 (HealthDay News) -- About 6.6 million young American adults who would likely not have been able to be covered by their parents' health plans before the Affordable Care Act took effect joined such plans in 2011, a new report finds.

The new study from the Commonwealth Fund found that, in total, 13.7 million young American adults, aged 19 to 25, either stayed on or joined their parents' health plans last year.

But not all young adults can join their parents' health plans and many still have gaps in coverage and are burdened with medical bill problems and medical debt, the report found.

Nearly two in five young adults (39 percent) aged 19 to 29 went without health insurance at some time in 2011 and more than one-third (36 percent) had medical bill problems or were paying off medical debt. Of those who were dealing with medical bills or debt, many faced serious financial consequences such as using all of their savings (43 percent), being unable to make student loan or tuition payments (32 percent), delaying education or career plans (31 percent), or being unable to pay for necessities such as food, heat or rent (28 percent), the researchers said.

One-quarter of young adults with medical debt owed $4,000 or more, and 15 percent owed $8,000 or more, the report noted.

"While the Affordable Care Act has already provided a new source of coverage for millions of young adults at risk of being uninsured, more help is needed for those left behind," lead author and Commonwealth Fund Vice President Sara Collins said in a Commonwealth Fund news release.

Young adults in low-income households were most likely to be uninsured, the report said. Seventy percent of young adults with incomes below 133 percent of poverty ($14,484 for a single person) had a gap in coverage in 2011. That's more than three times the rate of those with incomes over 400 percent of poverty ($43,560 for a single person).

The study also found that only 17 percent of young adults aged 19 to 25 in low-income families stayed on or joined their parents' health plans, compared with 69 percent of those in the highest income households. Young adults older than 25 are not eligible.

Young adults who did not have insurance or had a gap in coverage were more likely than those with continuous coverage to skip or delay getting needed health care because of cost -- 60 percent, 56 percent and 29 percent, respectively.

However, Collins noted that "the law's major insurance provisions slated for 2014, including expanded Medicaid and subsidized private plans through state insurance exchanges, will provide nearly all young adults across the income spectrum with affordable and comprehensive health plans."

The findings are based on an online survey of 1,863 respondents, aged 19 to 29, that was conducted in November 2011.

More information

The U.S. Centers for Medicare and Medicaid Services has more about young adults and the Affordable Care Act.

Copyright c 2012?HealthDay. All rights reserved.

Fear of Dark Keeps Some Adults Awake at Night: Study

AppId is over the quota
AppId is over the quota

MONDAY, June 11 (HealthDay News) -- Some adults who have problems sleeping may actually be afraid of the dark, a small new study suggests.

Researchers at the Ryerson University Sleep and Depression Lab in Toronto used loud noises to measure blink responses among a group of college students in both light and dark settings. They found good sleepers got used to the noises while the students with trouble sleeping anticipated the outbursts when the lights were out.

"The poor sleepers were more easily startled in the dark compared with the good sleepers," study author Taryn Moss said in a news release from the American Academy of Sleep Medicine. "As treatment providers, we assume that poor sleepers become tense when the lights go out because they associate the bed with being unable to sleep. Now we're wondering how many people actually have an active and untreated phobia."

The study is scheduled for presentation Monday at the Associated Professional Sleep Societies annual meeting in Boston.

The researchers suggested new treatments may be needed to help adults with sleeping problems who are afraid of the dark.

"We may need to add treatment components for these patients and adapt existing treatment components in light of the phobia," principal investigator Colleen Carney, an associate professor at Ryerson, said in the news release. "A lot more research is needed, but we believe we have stumbled across an unmet treatment need for some poor sleepers."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institutes of Health has more about sleeping difficulty.

Copyright c 2012?HealthDay. All rights reserved.