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HPV
HPV, CERVICAL CANCER AND THE HPV VACCINE
HPV and Cervical Cancer
Infection with human papillomavirus (HPV) is currently the most common sexually transmitted infection in the United States. According to the Centers for Disease Control and Prevention (CDC), approximately 20 million Americans ages 15 to 49 are currently infected. About half of those who are infected are sexually active adolescents and young adults ages 15 to 24, and more than half of sexually active men and women are infected with HPV at some point in their lives.
HPV is most easily transmitted through direct genital contact. Because HPV infections usually have no symptoms, the virus is most often transmitted unknowingly. The virus can also remain in the body for months or even years after infection before any symptoms appear. This is why newly diagnosed cases are sometimes found in older people who have been in long-term mutually monogamous relationships.
For the most part, infections with HPV are not serious, as most people become infected with strains of HPV that do not have symptoms and that can be cleared by the immune system. However, in some cases, people become infected with strains of HPV that result in genital warts, cervical cell abnormalities, or cervical cancer. Every year in the U.S., 10,000 women are diagnosed with cervical cancer and 4,000 die of the disease. In Texas in 2006, 1,169 women were diagnosed with cervical cancer and nearly 400 women died.
Early detection of precancerous cervical cells is important to help prevent the disease. Annual Pap smears are crucial to the discovery and removal of precancerous cervical cells—PPNT provided North Texas women with over 50,000 Pap smears last year alone, and we provide treatment for abnormal cervical cells in our clinics. Even though women who have had the new HPV vaccine will still need yearly Pap smears, the HPV vaccine is a breakthrough in the prevention of cervical cancer.
The HPV Vaccine
In June 2006, the Food and Drug Administration (FDA) approved a vaccine against HPV by the drug company Merck. In clinical trials, the vaccine, Gardasil, was shown to be 99.8% effective in preventing infection with the HPV strains that are responsible for over 70% of cervical cancer and genital warts cases. According to the CDC, in studies of more than 11,000 females ages 9 to 26, the vaccine was found to be safe and to cause no serious side effects. Side effects were mainly mild injection-site pain.
The vaccine is a series of 3 shots over a 6-month period for girls and women ages 9 to 26. Ideally, the vaccine should be administered before onset of sexual activity. However, females who are already sexually active can still benefit from vaccination, since they may not as yet have acquired the HPV strains that can cause cancer, and so could still be protected.
According to the CDC, duration of vaccine protection is unclear. Current studies of five years duration indicate that the vaccine is effective for at least five years and have not shown evidence that the effects are waning.
The vaccine is available at PPNT clinics. Call 1-800-230-PLAN for more information.
The HPV Vaccine and School Immunization
On February 2, Governor Rick Perry signed an executive order requiring all Texas girls entering the sixth grade beginning in September 2008 to receive Merck's HPV vaccine, Gardasil. The HPV vaccine is a major breakthrough in the fight to prevent cervical cancer, and lawmakers around the country are currently considering legislation relating to HPV immunization for students.
Two HPV related bills were introduced in the Texas House following the Governor's executive order. The first, HB 1098 by Representative Bonnen (R-Angleton), would rescind the executive order and prohibit future immunization for HPV as a condition for admission to public school. The second bill, HB 1379 by Representative Deshotel (D-Port Arthur), would direct the Texas Department of State Health Services to create and distribute materials about the HPV vaccine in order to increase awareness and education among the public. On May 8, Governor Perry let HB 1098 become law without his signature and signed HB 1379 into law.
While the Governor's executive order is a positive step in women's preventive care, it is important that such a requirement not create a financial burden on families, since the vaccine is expensive, and any such requirement must reflect appropriate federal health agency guidelines and recommendations. While the Governor's order does include the same opt-out policies for parents as for other vaccines – for religious or philosophical reasons – it is important to first educate and adequately finance the vaccine for it to be an effective health care initiative in the prevention of cancer.
For additional information, please see the following sources:
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