Jason Harris

Evaluating health-related concerns as part of routine care for elderly patients with advanced cancer significantly improved doctor-patient communication, and patient satisfaction, according to results of a trial recently discussed at the American Society of Clinical Oncology Annual Meeting in Chicago.

Overall, the mean number of patient-oncologist discussions was 6.3. Patients whose physicians conducted geriatric assessment had a mean of 3.5 more discussions about age-related concerns than patients whose physicians did not (7.74 vs 4.24; 95% CI, 2.28-4.72,

In the geriatric assessment group, patient satisfaction with communication was a statistically significant 1.12 points higher than in the control group (95% CI, 0.23-2.03;

= .027). Lead author Supriya Gupta Mohile, MD, MS, the Wehrheim Professor of Medicine at the University of Rochester, said the differences in satisfaction scores persisted for up to 3 months.

“A web-based geriatric assessment summary with recommendations for interventions improved patient-centered outcomes, including direct communication about age-related health concerns and patient satisfaction with communication,” she said.

Adults aged ≥70 years represent the fastest growing patient population in cancer. These patients often want treatment, Mohile said, but only if it does not have a negative effect on other health issues.

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Evaluating health-related concerns as part of routine care for elderly patients with advanced cancer significantly improved doctor-patient communication, and patient satisfaction, according to results of a recent study.

Patient Satisfaction, Communication Improve with Geriatric Assessment

The efficacy of the human papillomavirus (HPV) vaccine continues to be impressive, with newly reported findings showing that it reduced the prevalence of high-risk oral HPV infections by 88% in young adults who had at least 1 dose of the vaccine; however, low vaccine uptake remains a concern.

Results from one of the first large studies to explore the impact of HPV vaccination on oral infections show that their prevalence among vaccinated young adults was 0.11% for HPV types 16, 18, 6, and 11, compared with 1.61% for unvaccinated individuals (

= .008). Prevalence of the 4 HPV types covered by the vaccine was eliminated in men who had been vaccinated compared with those who had not been vaccinated (0.0% vs 2.13%;

= .007). Prevalence of the 33 nonvaccine HPV types was similar between the 2 groups (3.98% vs. 4.74%;

HPV vaccination is currently indicated for the prevention of cervical, vulvar, and vaginal cancers in women, and anal cancers in both women and men. It has not been clear, however, whether the vaccines could reduce incidence of oral cancers related to oral HPV infection.

“Our data indicate that HPV vaccines have tremendous potential to prevent oral infections,” said Maura L. Gillison, MD, PhD, professor of medicine at the University of Texas MD Anderson Cancer Center, who discussed the results during a press conference in advance of the 2017 ASCO Annual Meeting, which was held earlier this week. “While we were encouraged that there was a notable impact of the vaccine on oral HPV infections among vaccinated individuals, that benefit was modest overall and lower than we would hope in men due to low vaccine uptake.”

Gillison and colleagues reviewed data collected from 2011 to 2014 in the National Health and Nutrition Examination Survey (NHANES) of Americans. Investigators compared HPV infection rates for 2627 men and women aged 18 to 33 who reported receiving at least 1 dose of HPV vaccine with a similarly aged cohort who was not vaccinated. HPV infection was detected from oral rinse samples collected by mobile health facilities and then tested for HPV in the laboratory.

Although the vaccine appears to show clear efficacy in preventing HPV infections, uptake in the population at large remains low. The vaccine was approved for young women aged 9 to 26 in 2006 and young men aged 9 to 21 in 2011. However, from 2011 through 2014, only 18.3% of adults received at least 1 dose of the vaccine before age 26. Young men were vaccinated at one-quarter the rate of young women (6.9% vs 29.2%).

Researchers estimate that the vaccine reduced oral HPV infections by 17% overall during the study period, representing nearly 170,000 cancers. As expected, the impact was greater among women compared with men, 25% versus 6.9%.

Because uptake has been poor, the vaccine hasn’t had the full effect that it could. Gillison said that with 100% coverage, the vaccine would have prevented an estimated 927,401 cancers.

“The HPV vaccine is one of the most important advances in cancer prevention in the last several decades. Parents who choose to have their children vaccinated against HPV should realize that the vaccine may provide additional benefits, such as prevention of oral HPV infections linked to oral cancers.”

There is some good news; uptake is higher now than during the study period. “Recent data indicate that in individuals under the age of 18, 60% of girls have received the vaccine and 40% of boys,” she said.

1. Basch EM, Deal AM, Dueck AC, et al. Overall survival results of a randomized trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment.

2. Basch E, Deal AM, Kris MG, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: A randomized controlled trial.

The efficacy of the human papillomavirus vaccine continues to be impressive, with newly reported findings showing that it reduced the prevalence of high-risk oral HPV infections by 88% in young adults who had at least 1 dose of the vaccine; however, low vaccine uptake remains a concern.

Jason Harris

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Patient Satisfaction, Communication Improve with Geriatric Assessment

HPV Vaccine Reduces High-Risk Infections, But Are People Getting Vaccinated?