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Bernard F. Fuemmeler, Ph.D., M.P.H., associate director for population science and the Gordon D. Ginder, M.D., chair in Cancer Research at VCU Massey Cancer Center, says there is one question he and other cancer researchers, clinicians and advocates often hear: “What can I do to prevent cancer?”

To provide answers to that question, Fuemmeler, who is also a professor in the Department of Health Behavior and Policy at the VCU School of Medicine, moderated a community conversation about youth health and human papillomavirus (HPV) vaccination on April 20 at the Brunswick County Conference Center in Lawrenceville, Virginia, home to one of Massey’s Research and Resource Centers (CRRC).

Shillpa Naavaal, B.D.S., M.S., M.P.H., assistant professor of Dental Public Health and Policy and member of the Oral Health Services Research Core at the Philips Institute for Oral Health Research at the VCU School of Dentistry, developed the program to disseminate her recent HPV study findings and spread awareness about HPV, the HPV vaccine and Massey’s community work and outreach to prevent cancer and improve cancer outcomes.

Speakers included Naavaal and Fuemmeler, along with Jose Trevino, M.D., FACS, surgeon-in-chief at Massey and chair of the Division of Surgical Oncology at the VCU School of Medicine; and Iain M. Morgan, Ph.D., chair of Oral and Craniofacial Molecular Biology, director of the Philips Institute for Oral Health Research and associate dean for research at the VCU School of Dentistry, as well as a member of the Cancer Biology research program at Massey.

“We can’t continue to just do the science and do the research and understand the biology without also talking to people in the community where we can make the most difference,” Fuemmeler said.

Trevino spoke about the importance of holding community conversations around science, like the one about HPV. He said the dialogue with community members enhances the work he and others do each day at Massey.

“This is a team effort, without you there is no us,” Trevino told the in-person and virtual audience. “And to some degree, the care we provide really provides a benefit to the community.”

Morgan presented on the prevalence of HPV, noting that this group of viruses causes 5% of all cancers. He said HPV is behind the recent spike of oropharyngeal cancers, which are detected in the base of the tongue, the soft palate, the side and back walls of the throat and tonsillar region of the mouth.

“Oral cancers are the only cancers in the Western world that are not decreasing because of smoking cessation. We are winning the battle with smoking, but we can’t win this battle with HPV without increasing vaccination rates that prevent the majority of HPV infections that cause cancer,” Morgan stressed. “Currently, HPV-positive orpharyngeal cancers represent an ongoing epidemic.”

In addition to moderating the program, Fuemmeler discussed national surveys about HPV and HPV vaccination versus localized research conducted at Massey.

For one study, Fuemmeler’s team used 2019 data from the Virginia Department of Health (VDH) immunization registry. They found 28.9% of girls and 23.8% of boys aged 9-14 between 2010 to 2018 had completed the HPV vaccination series across Virginia, with some of the lowest rates being in and around Brunswick County.

“We want to make sure we get the word out about the importance of both boys and girls getting the vaccine and the need for getting it before they have exposure to the HPV virus,” Fuemmeler explained. “If the vaccine is given at the right age at the right time, then we can prevent nearly 30-40,000 HPV-related cancers a year as these young people move into adulthood.”

Naavaal released findings of her research looking at knowledge, perceptions and hesitancy in regions with low HPV vaccination rates. Starting in March 2021, she and her team launched an effort in the counties of Brunswick, Dinwiddie and Greensville that included surveys, focus groups and interviews. The research included 362 people, the majority of whom had children between the ages of 11 and 14.

Among the findings, Naavaal and her team identified gaps in the understanding that HPV does not always show signs or symptoms, and the vaccine is preventative and does not cure infections. Despite 76% of parents reporting the belief that overall vaccination helps, their concern and uncertainty about the HPV vaccine was 51 and 58% respectively.

“It is available, but there is more hesitancy to take the HPV vaccine,” Naavaal said, adding that Greensville County has the lowest initiation rate for all of Virginia at 21% and a 10% HPV vaccination completion rate.

Also participating in the program was Janaye Oliver, M.P.H., adolescent immunization coordinator at VDH. Among several topics, she discussed how families can obtain HPV vaccination.

Paula Tomko, CEO at Central Virginia Health Services, Inc (CVHS) and Linda Branson, CVHS practice manager, shared information about community resources and their partnership with Massey’s Project COALESCE, the program launched in January 2021 to increase colon and cervical cancer screenings by 5-10% and improve diagnostic follow-up processes.

The HPV community conversation was supported by the NCI P30 HPV supplement (Supplement PI: Naavaal, P30 PI - Winn).

Written by: Amy Lacey