The HPV Vaccine and Pap Results
A dear friend of mine, Sarah Stern, recently had an abnormal Pap test result showing precancerous cells. She submitted to all the requisite follow-up: a colposcopy, or microscopic examination of the cervix; a biopsy of the suspicious-looking area; and treatment with cryosurgery to freeze and destroy the abnormal cells. Plus, she endured plenty of fear and anxiety. Very few women in this country now die of the cancer that killed Eva Perón in the 1950s, but 1 in 3 will, like Sarah, have an abnormal Pap at some point in her life. It appears that you can reduce the odds of being the one, however, by getting vaccinated against the cervical cancer-causing virus known as HPV. The Gardasil vaccine cuts the rate of Pap abnormalities by 43 percent, researchers announced today at the meeting of the Society of Gynecologic Oncologists.
Let's qualify this a bit: The women in the vaccine study were ages 16 to 26, not infected with HPV, and followed for just three to four years—not the two or three decades it can take for precancerous lesions to develop. Still, this certainly adds to the reasons for getting vaccinated. Gardasil, the only vaccine currently available in the United States, protects against four HPV types, two of which cause genital warts and two of which are responsible for 70 percent of cervical cancers. A new vaccine called Cervarix could be approved by the Food and Drug Administration later this year.
"We saw significant reductions in the most severely abnormal Pap smears," says study leader Warner Huh, associate professor of gynecologic oncology at the University of Alabama-Birmingham. The vaccine protection translated into about a 20 percent reduction in colposcopies and a 22 percent drop in cervical biopsies. Considering that $3.6 billion is spent every year on the treatment and evaluation of abnormal Pap smears, Huh adds, vaccination could yield a big cost savings. (The current study was funded by Merck, manufacturer of Gardasil, and Huh also serves as a paid consultant for both Merck and GlaxoSmithKline, manufacturer of Cervarix.)
One reality that gets lost in all the enthusiasm over the HPV vaccine is that it can't completely guarantee a woman won't get cervical cancer. So women still need to go in for regular Pap smears. Moreover, older women like my friend Sarah, 55, usually aren't vaccinated, since Gardasil is currently approved only for women up to age 27; most who wind up with Pap abnormalities were infected with HPV decades ago, well before Gardasil was invented. As the founder of a Mideast think tank called Emet, she's used to getting her message out, and this time she has two. The vaccination might save young women from both cervical cancer and unnecessary torment. And "surgery and early detection saved my life," she tells me. "I want to remind every woman to go for that regular Pap smear."
Tags: human papillomavirus | cervical cancer
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Reader Comments
Thank you!
Deborah,
I just wanted to thank you for your article on HPV & Paps.
I am one of those women like your friend. I was diagnosed with HPV in August 2007, having no idea what it was. My pap was normal, but we still did a colposcopy anyway. All came back clear.
My pap from January 2008 has come back abnormal, and I have another colposcopy scheduled for March 24. I'm alot more worried this time.
Like your friend, Sarah, I have experienced, and continue to experience, much fear and anxiety over this.
I am a vocal New York woman who is also committed to making the message about the HPV vaccine and HPV testing out (because not all doctors do it still…it’s all still so “new”)…especially to young girls. I have tried to find ways to spread the word, but have been told by others that they are already doing a good job of vaccinating young girls, etc. I wish I could find more ways to 'help' or get the word out. Heck, I would go on Good Morning America if it would make the difference in even one woman's life!
I am 42, and I really think it’s women around my age that might need the most education, as I certainly didn’t know what HPV was until I was diagnosed with it. I had always been careful about sex, and was shocked to find out that I had an STD..and one that could potentially cause cancer!!
There is so much to know about the disease…such as:
*There are usually no symptoms. (although genital warts are linked to a few strains)
*There are over 100 strains, 30 of which are genital, and only 13 of which have been linked to cervical cancer.
*80% of people have HPV, but not as many have one of the 13 more dangerous strains…
*A person is only considered 'positive' for HPV if they have one of the 13 strains.
*The body usually cures itself of the virus within a year, but not always.
* And what is scariest to me is that there is no test for it in men. Men have no way of knowing if they have it or not. Fortunately, they do not seem to be affected by the virus in the way women are (although there are a few studies that say it can lead to penile or anal cancer). The scary thing is that they can pass it on to other women..and a condom is not enough protection against HPV.
This virus has been in my body for a minimum of 3 years and who knows how long, as it could be from 20 years ago. That is another one of the problems is that the virus can lay dormant in a person's body for decades..so it is impossible to know where I got it from, or who I might possibly have infected as well.
My body is one of the few that hasn't healed itself. Fortunately today there is HPV testing so that it was caught 'early', and I am grateful to my doctor for that. However, coping with and learning to live with it (and the potential it has to wreak havoc on my body and my sex life) is not always easy. I often wish I had others in the same boat to talk to.
Thank you for your article…it’s a great start to getting the word out!! I do not wish the fear and anxiety Sarah and I have suffered on anyone and hope that by educating more and more people we can prevent this from happening.
Just one more thing... if any of you reading this is a mother of a young girl, please, please get her vaccinated. You don't want your children to suffer from small pox or measles, right? Then you want to put her at less of a risk for a cancer causing virus as well. The vaccine does not protect against all strains, but at least it's more protection than none...and hopefully one day there will be a vaccine against all strains of HPV!
Follow the Money!
For the moment, forget the fact the Gardasil's FDA approval was based upon short-term "junk-science", and forget the fact that Dr. Huh held a significant role in those test, and forget the fact that Dr Huh is a paid consultant for Merck (among many other pharma companies), and forget the fact there is no long-term efficacy study of safety analysis, this vaccine is now suspected of as many as 10 deaths!!!! Deaths! Through the Freedon of information act, Judicial Watch, a governmental watchdog and oversight group obtained a list of reported side effects (judicialwatch.org). I urge anyone considering this vaccine to read their report and consider the dangers associated with this drug and compare the real benefit..is death or paralysis a side effect you accept?? and for what benefit? You still need annual pap and there are still another 100 strains of the HPV virus for which you would not be protected. This is all about making this vaccine as standard and making money.
Re: To Nancy of New York--
Nancy,
Your comment "A person is only considered 'positive' for HPV if they have one of the 13 strains." is untrue.
What do mean "considered positive"? there isn't any consideration about it. Positive means that the test probes for you were tested reacted in adequate amounts of detection above the cutoff level (5,000 HPV DNA copies).
Most people beleive that HPV tests only for high-risk strains--NOT TRUE, don't take my word for it, from Qiagen's website, maker of the Digene Cpature 2: digene HPV hc2 Test For 40 cervical samples (96 tests); Probe Diluent, Low-Risk HPV Probe, High-Risk HPV Probe, Quality Controls, Calibrators, Capture Microplate, Reagents and Buffers Part #5196-1330.
The real problem is that most Dr's (and insurance companies) are not concerned with affiramative testing for low-risk strains.
You're so concerned with promoting this vaccine; maybe you should do a little research before regurgitating what the drive-by media and Merck would have you and everyone else believe.
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