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    Faculty & Disclosures
    Prof. Lynette Denny GCOB (Silver)

    University of Cape Town
    Cape Town, South Africa

    Lynette Denny is a gynaecological oncologist and professor of special projects at the Department of Obstetrics and Gynaecology, Faculty of Health Sciences at the University of Cape Town, South Africa. Prof. Denny has worked in the field of cervical cancer prevention in low-resource settings in collaboration with colleagues from Columbia University, New York, since 1995. read more

    Prof. Denny and her research group pioneered the search for alternative protocols for the prevention of cervical cancer in community-based research sites in the townships just outside Cape Town. Since then, Prof. Denny and her group have had extensive experience in cervical cancer prevention, including three cross-sectional studies comparing different screening tests, a prophylactic human papillomavirus (HPV) vaccine trial in human immunodeficiency virus-positive women and a therapeutic vaccine trial in HPV-negative women. Prof. Denny and her group are currently engaged in a USA National Cancer Institute-funded trial evaluating an HPV screen-and-treat approach.

    Prof. Denny has been the director of the South African Medical Research Council Gynaecological Cancer Research Centre for the past 7 years. She was the chair and professor of obstetrics and gynaecology at Groote Schuur Hospital/University of Cape Town from 2013–2022. In November 2021, she was awarded the Grand Counsellor of the Baobab in silver by the president of South Africa for ‘distinguished service’ to South Africa. In November 2022, she was awarded the Lifetime Achievement Award by the South African Society of Obstetricians and Gynaecologists.

    Prof. Lynette Denny discloses: Advisory board or panel fees from Vaccitech. Other financial or material support (royalties, patent, etc.) from UptoDate. Speaker’s bureau fees from Roche Diagnostics.
    Prof. Eduardo Franco OC

    McGill University
    Montreal, Canada

    Eduardo Franco is a James McGill professor and chairman of the Department of Oncology, and director of the Division of Cancer Epidemiology at McGill University, Montreal, Canada. Since 1985, Prof. Franco has conducted epidemiological research into cancer causes and prevention, and means to improve patient survival. read more

    Prof. Franco is an Officer of the Order of Canada, and a fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences. He is also a foreign member of the Brazilian Academy of Sciences. Prof. Franco has received the Distinguished Service to Cancer Research Award from the Canadian Cancer Research Alliance; lifetime achievement awards from the American Society for Colposcopy and Cervical Pathology, and the International Papillomavirus Society; the Women in US Government’s Leadership Award; the O. Harold Warwick Prize from the Canadian Cancer Society; the Geoffrey R. Howe Outstanding Contribution Award from the Canadian Society for Epidemiology and Biostatistics; the Dr Chew Wei Memorial Prize in Cancer Research from the University of British Columbia; and the McLaughlin-Gallie visiting professorship from the Royal College of Physicians and Surgeons of Canada. Prof. Franco is the editor-in-chief of the Journal of the National Cancer Institute, editor-in-chief emeritus of Preventive Medicine and a senior editor of eLife. He has served on the editorial boards of several top-tier journals in oncology and epidemiology.

    Prof. Eduardo Franco discloses: Advisory board or panel fees from BD Biosciences, Roche, Merck and PathoVax. Grants/research support from Merck. Other financial or material support (royalties, patent, etc.) for a registered patent entitled “DNA methylation markers for early detection of cervical cancer”.
    Prof. Daniel Kelly OBE

    European Cancer Organisation,
    HPV Action Network
    Cardiff, UK

    Daniel Kelly has co-chaired the HPV Action Network of the European Cancer Organisation since 2019, where he was a former board member. Prof. Kelly is also the Royal College of Nursing chair of nursing research at the School of Healthcare Sciences, Cardiff University, UK, a position that he has held since 2011. read more

    Prof. Kelly’s career-long interest has been in cancer care research and education, and cancer prevention, particularly the potential of human papillomavirus (HPV) vaccination and screening to protect young people from cancer. Prof. Kelly was awarded an Officer of the Order of the British Empire from the late Queen Elizabeth II in 2021 for his contribution to research and education in cancer care. Prof. Kelly is a former president of the European Oncology Nursing Society, and is a fellow of the Royal College of Nursing of the UK. He is currently a visiting professor at Edinburgh University, University College London and Oxford Brookes University. Prof. Kelly is also a trustee at St Christopher’s Hospice London and a Public Governor at King’s College London NHS Foundation Trust. Prof. Kelly has published over 250 papers and has contributed to many international conferences, including presenting the case for HPV to be included in the Beating Cancer Plan in the European Parliament.

    Prof. Daniel Kelly has no financial interests/relationships or affiliations in relation to this activity.
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    Gynaecological Cancers, Head and Neck Cancer CE/CME accredited

    touchPANEL DISCUSSION
    A visually engaging discussion designed to emulate a ‘live’ panel experience and provide clinicians with practical expert insights to address their clinical challenges. Useful tips below will show how to navigate the activity. Close

    Preventing HPV-associated cancer by maximizing vaccine uptake

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    • Downloads including slides are available for this activity in the Toolkit
    Learning Objectives

    After watching this activity, participants should be better able to:

    • Illustrate the importance of vaccinating children and adolescents against HPV to prevent cancer in adulthood
    • Describe recent guidelines and best practices for HPV vaccine eligibility and administration
    • Appraise the barriers to HPV vaccine uptake in different populations and how they may be overcome
    Overview

    In this activity, three experts discuss the importance of HPV vaccination in preventing malignancies, and consider the barriers to HPV vaccine uptake and share strategies of how to overcome them. This discussion is guided by pre-canvassed questions provided by healthcare professionals involved in HPV vaccination.

    This activity is jointly provided by USF Health and touchIME. read more

    Target Audience

    This activity has been designed to meet the educational needs of primary care physicians, physician assistants, nurse practitioners, nurses and pharmacists involved in HPV vaccination.

    Disclosures

    USF Health adheres to the Standards for Integrity and Independence in Accredited Continuing Education. All individuals in a position to influence content have disclosed to USF Health any financial relationship with an ineligible organization. USF Health has reviewed and mitigated all relevant financial relationships related to the content of the activity. The relevant relationships are listed below. All individuals not listed have no relevant financial relationships.

    Faculty

    Prof. Lynette Denny discloses: Advisory board or panel fees from Vaccitech. Other financial or material support (royalties, patent, etc.) from UptoDate. Speaker’s bureau fees from Roche Diagnostics.

    Prof. Eduardo Franco discloses: Advisory board or panel fees from BD Biosciences, Roche, Merck and PathoVax. Grants/research support from Merck. Other financial or material support (royalties, patent, etc.) for a registered patent entitled “DNA methylation markers for early detection of cervical cancer”.

    Prof. Daniel Kelly has no financial interests/relationships or affiliations in relation to this activity.

    Content reviewer

    Sally Alrabaa, MD has no relevant financial relationships to disclose.

    Touch Medical Contributors

    Sadaf Kazi discloses: Employee of or independent contractor relationship with AS&K Communications-Remedica (Relationship Terminated).

    Katrina Lester has no financial interests/relationships or affiliations in relation to this activity.

    USF Health Office of Continuing Professional Development and touchIME staff have no financial interests/relationships or affiliations in relation to this activity.

    Requirements for Successful Completion

    In order to receive credit for this activity, participants must review the content and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

    If you have questions regarding credit please contact cpdsupport@usf.edu.

    Accreditations

    Physicians

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through a joint providership of USF Health and touchIME. USF Health is accredited by the ACCME to provide continuing medical education for physicians.

    USF Health designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 CreditTM into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

    Advanced Practice Providers

    Physician Assistants may claim a maximum of 0.75 Category 1 credits for completing this activity. NCCPA accepts AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society.

    The AANPCP accepts certificates of participation for educational activities approved for AMA PRA Category 1 CreditTM by ACCME-accredited providers. APRNs who participate will receive a certificate of completion commensurate with the extent of their participation.

    Date of original release: 31 July 2023. Date credits expire: 31 July 2024.

    If you have any questions regarding credit please contact cpdsupport@usf.edu.

    This activity is CE/CME accredited

    To obtain the CE/CME credit(s) from this activity, please complete this post-activity test.

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    Topics covered in this activity

    Gynaecological Cancers / Head and Neck Cancer
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    This Activity Is Funded By:

    An independent medical education grant from Merck & Co., Inc.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 31 July 2023. Date credits expire: 31 July 2024.

    Claim Credit
    touchPANEL DISCUSSION
    Preventing HPV-associated cancer by maximizing vaccine uptake
    0.75 CE/CME credit
    Question 1/5
    The bivalent, quadrivalent and nonavalent HPV vaccines stimulate an immune response against which of the following HPV genotypes?

    HPV, human papillomavirus.

    There are currently 12 oncogenic HPV genotypes: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59.1 Additionally, types 66 and 68 are considered ‘possibly carcinogenic’ and ‘probably carcinogenic’ according to the IARC classification, respectively.2 Pre-HPV vaccination, types 16 and 18 were the most frequent types worldwide, with HPV-16 the most common in all regions.1 HPV genotypes 16 and 18 are responsible for 71% of cervical cancer cases worldwide, 85% of HPV-related head and neck cancers and 87% of all anal cancers.1

    Abbreviations:

    HPV, human papillomavirus; IARC, World Health Organization International Agency for Research on Cancer.

    References:

    1. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
    2. Schiffman M, et al. Infect Agent Cancer. 2009;4:8.
    Question 2/5
    How would you explain the rationale for the WHO including girls aged 9–14 years in the primary target group for HPV vaccination?

    HPV, human papillomavirus; WHO, World Health Organization.

    Although the HPV vaccine is approved for use in adults up to the age of 45 years, HPV vaccination is not routinely recommended for persons older than 26 years because the benefits of the vaccine decline after exposure to HPV infection.1 Due to the high rate of HPV transmission during sexual contact, the HPV vaccination should be given prior to sexual activity.1–3 Furthermore, studies have shown that the highest immune responses to HPV vaccines were observed in girls aged 9–15 years.3

    Abbreviation:

    HPV, human papillomavirus.

    References:

    1. Kamolratanakul S, Pitisuttithum P. Vaccines (Basel). 2021;9:1413.
    2. Salvadori M. Paediatr Child Health. 2018;23:262–5.
    3. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
    Question 3/5
    A 27-year-old-male with HIV attends your clinic to discuss receiving the HPV vaccine. Assuming availability of the HPV vaccine in your clinic and based on the WHO guidance, what would you do?

    HIV, human immunodeficiency virus; HPV, human papillomavirus; WHO, World Health Organization.

    People living with HIV are at increased risk of HPV infection and HPV-related disease, including certain types of malignancies, compared with HIV-negative persons.1 Vaccination of HIV-positive individuals against HPV is recommended by the WHO regardless of age or antiretroviral status.2 HIV often reduces responsiveness to vaccines.1 Therefore, for immunocompromised and HIV-positive people, the WHO recommends administering at least two doses of the HPV vaccine, at least 6 months apart, and three doses if possible.2 Regional practice may vary from the WHO recommendation.

    Abbreviations:

    HIV, human immunodeficiency virus; HPV, human papillomavirus; WHO, World Health Organization.

    References:

    1. Lacey CJN. Papillomavirus Res. 2019;8:100174.
    2. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
    Question 4/5
    You are discussing HPV vaccination with a 14-year-old girl and her mother. The mother is reluctant to consent to vaccination due to safety concerns of the HPV vaccine. What counsel would you provide?

    HPV, human papillomavirus.

    The safety of the HPV vaccine is regularly reviewed by the Global Advisory Committee for Vaccine Safety,1 with data showing that the vaccine is well tolerated in different age groups.1,2 The most common side effects of HPV vaccination are localized to the injection site and include redness, pain and swelling.2,3 These injection site reactions are mild-to-moderate and usually resolve within a few days.3 Mild systemic side effects such as headache, dizziness or gastrointestinal symptoms can also occur.1 Syncope can occur after HPV vaccination and is most common among adolescents and young adults, but can be prevented by observing the vaccine recipient for 15 minutes post-HPV vaccination.3 As with any vaccine, anaphylaxis post-HPV vaccination can occur, but such cases are rare.1,3

    Abbreviation:

    HPV, human papillomavirus.

    References:

    1. WHO. Wkly Epidemiol Rec. 2022;97:645–72.
    2. Cheng L, et al. Vaccines (Basel). 2020;8:391.
    3. Salvadori M. Paediatr Child Health. 2018;23:262–5.
    Question 5/5
    You are aware that HPV vaccine hesitancy is high among parents/caregivers of adolescents at your clinic. Which of the following approaches could be undertaken to most successfully counter these individual barriers to HPV vaccine uptake?

    HPV, human papillomavirus.

    HPV vaccine hesitancy among individuals may be due to safety concerns, poor awareness of the benefits of HPV vaccination, and stigma and misconceptions associated with the vaccine.1–3 These barriers can potentially be overcome with education. A review article analysing quantitative systematic reviews evaluating interventions to increase HPV vaccine uptake and/or intention showed that face-to-face interventions can lead to an increase in HPV vaccine uptake. Printed information and online information were shown to improve intention for HPV vaccination only.4

    Abbreviation:

    HPV, human papillomavirus.

    References:

    1. Black E, Richmond R. Vaccines (Basel). 2018;6:61.
    2. Oyedeji O, et al. Vaccines (Basel). 2021;9:1360.
    3. Nguyen NY, et al. Ann Glob Health. 2020;86:118.
    4. Bennett C, et al. Sex Transm Infect. 2022;98:599–607.
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    This Activity Is Funded By:

    An independent medical education grant from Merck & Co., Inc.
    This activity is jointly provided by USF Health and touchIME.

    The information provided by this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

    USF is an Equal Opportunity / Affirmative Action / Equal Access Institution.

    USF Health is accredited by the Accreditation Council for Continuing Medical Education, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to healthcare professionals. As an accredited provider, USF Health is required to disclose personal information to relevant accredited bodies that certify CME to process credits/contact hours, comply with reporting requirements, and for internal recordkeeping and regulatory purposes. USF Health does not share or sell any individual’s contact information or unique identifiers to any commercial supporter, advertiser, or third party without the specific permission of the individual.

    Unapproved products or unapproved uses of approved products may be discussed by the faculty; these situations may reflect the approval status in one or more jurisdictions. The presenting faculty have been advised by touchIME and USF Health to ensure that they disclose any such references made to unlabelled or unapproved use. No endorsement by touchIME or USF Health of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchIME or USF Health activities. touchIME and USF Health accept no responsibility for errors or omissions.

    This content is intended for healthcare professionals.

    Date of original release: 31 July 2023. Date credits expire: 31 July 2024.

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