1. EVAC Education and Vaccination Against Cancer Beth Miloro HPA430 July 7, 2013

2. HPV Oropharyngeal Cancers Oropharyngeal cancers caused by Human Papillomavirus (HPV) have now exceeded those caused by smoking. HPV-oropharyngeal cancers affect the tonsils and base of tongue and arise decades after acquiring HPV. By the year 2020, the number of oropharyngeal cancers as a result of HPV infection will exceed the number of cervical cancers due to HPV. HPV is the most common sexually transmitted disease, and while most HPV infections will go away on their own, certain strains are associated with a high risk of cancer 10-20 years later in life.

3. HPV Oropharyngeal Cancer  Approximately 14 million people in the USA become infected with HPV annually.  HPV positive cancers account for 63 percent of all oropharyngeal cancers.  A 225 percent increase in HPV positive oropharyngeal cancers occurred from 1998-2004 (from 16% to 63%)  Men have a 4 times higher incidence of HPV-positive oropharyngeal cancers than women.  Ninety percent of HPV-positive oropharyngeal cancers are caused by HPV strains 16 and 18.  There are vaccines against HPV strains 16 and 18 which have been proven to decrease cervical cancer rates and may reduce oropharyngeal cancer rates.

4. EVAC Education and Vaccination Against Cancer Dentists are a first line of defense against oral cancer when providing oral cancer exams at routine visits. A thorough oral cancer exam allows them a unique opportunity to educate their patients about HPV, its relation to oral cancer, especially in men, as well as HPV prevention. EVAC is an initiative to encourage patient education by dentists about HPV-oropharyngeal cancer and HPV prevention and reduce the rate of this type of cancer.

5. Methods To Prevent HPV Vaccines exist that target high risk strains but only one-third of girls and one percent of boys have received it. Increasing awareness about HPV cancers and HPV vaccinations can help decrease the number of oropharyngeal cancers.

6. Safe Sex Use of condoms lowers the risk of developing HPV diseases (warts, cancers) but since HPV can infect areas not covered by a condom, condoms are not 100% effective. Abstinence The only sure way to avoid HPV. Methods To Prevent HPV

7. Current Illinois Policy on HPV There is currently no legislation regarding HPV education or vaccination. In 2006-2007, legislation was introduced to require schools and the Department of Health to provide/promote information about HPV and the HPV vaccine, but was not passed into law. That legislation also mandated vaccination for girls only.

8. Proposed Policy Increase awareness and reduce the incidence of HPV-oropharyngeal cancer by having dentists provide patient education about HPV- oropharyngeal cancer and ways to prevent HPV infection.

9. Policy Action Plan Provide dentists in the state of Illinois with HPV educational brochures, fact sheets, website in order for them to properly educate their patients on HPV oropharyngeal cancer. Provide patients fact sheets/website information on HPV prevention options: 1.HPV vaccine for boys and girls age 11 and older, 2.using appropriate protection, 3.abstinence. A marketing campaign sponsored by the Illinois State Dental Society consisting of radio and internet ads to increase HPV oropharyngeal cancer awareness.

10. Policy-Making Process A resolution to be adopted by the Illinois State Dental Society to encourage patient education and vaccination against cancer (EVAC) by dentists for HPV-oropharyngeal cancer and HPV prevention.

11. Stakeholders GovernmentalNonGovernmental Oral Cancer Foundation Chicago Dental Society Illinois State DentalSociety Oral Cancer Society of Northern Illinois Merck and Co. Oropharyngeal cancer survivors/families Illinois Department of Health The University of Illinois College of Dentistry IFLOSS Centers for Disease Control Association of State & Territorial Dental Directors

12. Stakeholders Against Anti-vaccine Groups Religious groups that believe the HPV vaccine encourages promiscuity

13. Marketing Approach  Internet and radio advertisements sponsored by the Illinois State Dental Society to increase awareness of HPV oropharyngeal cancer.  Facebook page  Oral Cancer Awareness month (April).  Oral Cancer ribbon (red and white).  Endorsements by celebrities who have been affected by HPV oropharyngeal cancer (Michael Douglas, Gwenyth Paltrow).

14. Senator Kirk Dillard, Licensed Activities & Pensions Committee Member Representative Patricia Bellock, Regulations Committee Member Representative Michael Zalewski, Chairperson of the Healthcare and Licenses Committee David Milller, DDS, Chief, Division of Oral Health,IDPH Former Representative Policy Paramours

15. EVAC “ This is an anti-cancer vaccine” - Thomas Frieden Director Centers for Disease Control and Prevention

16. Works Cited 1. http://www.zila.com/assets/file/650200VLPEBroc%20Rev%202%20v9.pdf http://www.zila.com/assets/file/650200VLPEBroc%20Rev%202%20v9.pdf 2. ADA Statement on HPV and Squamous Cells or the Oropharynx http://www.ada.org/1749.aspx ADA Statement on HPV and Squamous Cells or the Oropharynx http://www.ada.org/1749.aspx 3. HPV Shot ot Not? http://www.courierpostonline.com/article/20130705/NEWS01/307050019/HPV-shot-not-http://www.courierpostonline.com/article/20130705/NEWS01/307050019/HPV-shot-not- 4. HPV Prevention- CDC http://www.cdc.gov/hpv/prevention.htmlhttp://www.cdc.gov/hpv/prevention.html 5. http://www.usatoday.com/story/news/nation/2013/06/19/hpv-vaccine-cancer-rates-down-56/2438137 http://www.usatoday.com/story/news/nation/2013/06/19/hpv-vaccine-cancer-rates-down-56/2438137 6. http://www.gardasil.com http://www.gardasil.com 7. http://www.ncsl.org/issues-research/health/hpv-vaccine-state-legislation-and-statutes.aspx#2006 http://www.ncsl.org/issues-research/health/hpv-vaccine-state-legislation-and-statutes.aspx#2006 8. http://www.ilga.gov/ http://www.ilga.gov/ 9. http://www.isds.org/lawslegislation/licenseandpermits/landp-ilpractact.asp http://www.isds.org/lawslegislation/licenseandpermits/landp-ilpractact.asp 10. http://oralcancerfoundation.org/