STIEF News July 2019
In this issue:
In order to continue to meet the demand of our audience, it is important that STIEF keeps up with contemporary online behaviour and trends. We have noted that over 80% of our website visitors are doing so via a smartphone. To this end, we have maximised our online user experience by going ‘mobile first’ with our www.justthefacts.co.nz and www.herpes.org.nz sites. This means that the websites have been re-designed from the mobile end and then the features expanded to create the desktop version. The upgrade includes a fresh new look for the Just The Facts database with easy one-click links to contact sexual health providers/clinics. If your service details have changed please let us know so that we can update the database accordingly. Take a look at the upgraded sites!
“Back in the day, when you actually had to talk to people, like face to face, most sex ed was learnt through your ‘village’ – at school, at home or through the kids in your neighbourhood. But nowadays, most young people learn more about sex from porn than anywhere else. So with giant porn companies stepping in and taking over as sex ed teacher, it’s probably time we actually started talking about it and asking some important questions…”
Our friends at The Light Project have put together a new Just The Facts page for us - Just the Facts on Porn - which addresses:
- So what’s the big deal with porn?
- But isn’t porn normal?
- So what’s the difference between great sex and porn sex?
- Can porn affect us?
- Need help?
The Light Project is a charitable trust founded in 2017 by a small team of sexual and public health experts. The project is a pilot project that aims to help youth, their whānau, schools and wider communities to positively navigate the new porn landscape in Aotearoa.
Their website is a result of their project ‘Porn and Young People – What do we Know?, which was undertaken in 2017 with 622 New Zealand youth stakeholders/stakeholder groups including schools, sexual health services, youth organisations, child protection services, faith-based youth organisations and whānau and caregivers.
A big thank you to The Light Project for this resource!
Two STIEF HPV pamphlets have been updated and reprinted:
There are now available to order - either online, or via email.
Human papillomavirus (HPV) is a very common sexually transmitted virus, which is most widely recognized as the cause of cervical cancer. HPV can cause cancer at other body sites including the vagina, vulva, anus, penis, and oropharynx (including the tonsils and base of tongue).
The incidence of HPV positive oropharyngeal cancer (OPC) has increased in many developed countries, including New Zealand. Here, rates increased from 35 cases in 1996 to 126 cases in 2012, however the role of HPV was uncertain. This research was undertaken as a PhD research project and aimed to establish the burden of HPV positive OPC in New Zealand, investigate diagnostic methods, early detection, and risk factors in a pre-vaccine population.
Our research tested 267 oropharyngeal cancer cases and found the proportion caused by HPV increased from 62% in 1996-98, to 88% in 2010-12. This means in New Zealand we now have approximately the same number of cervical cancers and HPV positive oropharyngeal cancers each year.
We also found that all but two HPV positive cases were caused by HPV type 16. This is a very important finding in terms of the role of vaccination in HPV positive oropharyngeal cancer, and suggests that almost all future cases will be preventable with vaccination. However, although vaccination will likely lead to dramatic reductions in oropharyngeal cancer, this benefit will take decades to become apparent, until those who are vaccinated reach their forties, the age when oropharyngeal cancers most commonly develop.
Once we had established the burden of HPV positive oropharyngeal cancer in New Zealand, we began to explore what might be possible in terms of early detection. We looked at a similar technique to a cervical smear, but taken from the tonsils of those with oropharyngeal cancer. We found that when the tonsil appeared abnormal we could reliably pick up DNA from the HPV virus, but this was not so reliable when the tonsils appeared normal. At this point it doesn’t look like we can screen for oropharyngeal cancer like we do for cervical cancer, but tonsillar tumour brushings may be useful for getting the patient to a specialist sooner. This is an area we feel warrants further investigation.
Other work in this study aimed to look at risk factors for HPV positive oropharyngeal cancer. We found that oral sex was a major risk factor with an odds ratio of 15.8. This means a person was almost 16 times more likely to have an HPV positive tumour if they had ever given oral sex, compared to someone who hadn’t given oral sex.
Another factor that came up in this study was industrial exposures to hazardous substances. Compared to the New Zealand working survey (a study of 3,003 working New Zealanders aged 20-64), oropharyngeal cancer patients in our study were more exposed to hazardous substances, in particular asbestos and formalin. These results should be looked at with caution as there were differences in the populations, such as the New Zealand working survey population being younger and having an even number of males and females. However, there is some evidence for a role of hazardous substances in other head and neck cancers, so this is another area that needs further research.
Some of this work has been published (article reference: Lucas-Roxburgh R, Benschop J, Lockett B, van den Heever U, Williams R, et al. (2017) The prevalence of human papillomavirus in oropharyngeal cancer in a New Zealand population. PLoS ONE 12: 1-13). Additional publications are currently being submitted, if you wold like access to these once they are published, please contact [email protected].
Dr Rebecca Lucas-Roxburgh, Massey University PhD graduate
In May 2019, ESR published the Sexually Transmitted Infections in New Zealand Annual Surveillance Report 2016, now available on the ESR website.
Three key presentations delivered by Dr Jill Sherwood, ESR Public Health Physician, at the IUSTI Asia Pacific Sexual Health Congress 2018, are also available on the ESR website: