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The facts about HPV

Many people now know about the link between the human papilloma virus (HPV) and cervical cancer, but did you know that HPV can play a role in penile, vaginal, urethral, anal, and head and neck cancers? In addition, an infected mother can pass HPV to her baby during birth, resulting in recurring tumors in the child’s larynx that cause respiratory obstruction and require laser removal.

 

In 2006, HPV was responsible for about 15,000 newly diagnosed cases of cervical, anal, or vulvar cancers in the United States, and about 450,000 cases of genital warts, according to a peer-reviewed paper from researchers at the American Cancer Society (ACS). Cervical cancer is the second most common cause of cancer death in women worldwide, killing 288,000 women annually, primarily from resource-poor populations. In the United States, Texas is among the states with the highest death rates from cervical cancer. Studies suggest that 80% of women who ever have sex become infected with HPV by age 50, and 50% of college-age women acquire an infection within 4 years of first having sex.

 

 “The incidence of HPV is very high, but most people clear it pretty rapidly,” said Allison Blazek, M.D., assistant professor of Clinical Cancer Prevention at M.D. Anderson Cancer Center in Houston. “A woman who develops cervical cancer will have a high-risk type of HPV that has been with her for 10 or 20 years and may also have a cofactor, like immunosuppression or smoking,” Blazek said. Immunosuppression can occur with disorders that affect the immune system, such as lupus.

 

Yet, with screening and/or a preventive vaccine, the cancer is almost 100% preventable. Screening involves regular Pap smears to identify cellular changes caused by an HPV infection. Early on, cells may have an “atypical” appearance, and removing these cells usually removes the virus. In a persistent infection, the virus hijacks and disrupts the cellular DNA, leading to more profound changes called “dysplasia” (abnormal growth and appearance). Unchecked, dysplasia can progress to cancer. The health and economic burden of HPV infection is thus not limited to cancer treatment. “It is important to remember that it is not just cervical cancer, but it is the precancerous lesions that have to be monitored and treated,” Blazek said. “About 2 million women a year have an abnormal Pap result that must be repeated.”

 

Studies show that 50% of cervical cancer cases occur in women who have never had a Pap smear, yet even these cases could be averted if the HPV infection were prevented in the first place. As the second round in the arsenal against this cancer, the ACS recommends routine administration of the HPV vaccine to girls ages 11 and 12 to meet the goal of vaccination before sexual activity. “If we can achieve pretty universal vaccination among the girls, there will be ‘herd immunity,’” Blazek said. “There won’t be a need to vaccinate the boys.” Gardasil® is the vaccine that currently has FDA approval, and it targets the HPV strains responsible for most cases of cervical cancer and the strains responsible for genital warts. The ACS reports that it was tested for five years and causes minimal side effects of soreness at the injection site and fever.

 

This piece appeared in the Round Rock Leader.

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