HPV vaccine and cervical cancer: Vaccination is it worth?

In the past two years, the One Less campaign for Gardasil, the new HPV vaccine to protect against cervical cancer, has set the discussion of the human papilloma virus brought to the fore, it seems a new light not only on the vaccine itself but also to the issues that surround them.

HPV is ubiquitous. Nearly 50% of sexually active people will have HPV at some point in their lives. There are around 20 million people with HPV infections in the United States, with 6 2 million new cases per year. The most serious consequence of HPV infection is cervical cancer, yet public knowledge about HPV is poor – less than 50% of women have heard about HPV and its link to cervical cancer.

It is critical that the public gains more knowledge about HPV and cervical cancer, have tarnished especially in the current climate in which the benefits of the vaccine was assessed by a political rhetoric. Information about the link between HPV and cervical cancer, how widespread the disease is and who gets it, detection methods have to be other effects of disease and the role and effectiveness of the vaccine started. The analysis of these issues serves as a guideline for deciding to help physicians to recommend this vaccination to a whole generation of 11-12 year old girls and boys, perhaps in the future.

The relationship between HPV and cervical cancer: There are over 100 types of HPV. Over 15 of them are “causing high-risk types that cause cervical cancer. HPV infections are more common in the younger population with almost 75% of the occurring 15-25 age group. Most HPV infections are “silent” – people who do not know carry the virus, they have released him and sent them to their sexual partners. The good news is that most of these infections are self-limiting, which means that almost 90% of them to solve on its own within 24 months without any problems. In a minority of people, but infections remain, either as a result of high risk sexual behavior (eg, multiple partners and unprotected sex) or weakened immunity because smoking, stress, and long-term use of certain medications such as steroids. These factors can HPV infection and precancerous driving causing precancerous lesions of the cervix. About 99% of all cervical cancers are caused by HPV. HPV infections are necessary but not sufficient cause on its own to cervical cancer.

Pap tests and cervical cancer: A Pap test detects early changes in the cells of the cervix caused by HPV or other effects to be appropriately treated if they can progress to cervical cancer. Fortunately, due to a well-organized Pap test program in the United States, the incidence of cervical cancer by 75% in the last 50 years, declined. Therefore, for women who get regular Pap smear, is the low incidence of cervical cancer. Currently in the United States to develop about 11,000 new cases of cervical cancer each year and about 4,000 deaths from it. Even if one would wish that it expected no cases of cervical cancer, when the number of HPV infections is low in comparison with that come every year, the relationship between HPV infection to cervical cancer. According to the American Cancer Society, four out of five women who have died of cervical cancer do not have a Pap test within the last five years. These figures show that the Pap smear has been very successful in limiting the incidence of cervical cancer in this country.

The role of HPV vaccines in preventing cervical cancer: There are now two HPV vaccines available to the world against two major types of cancer-causing HPV to protect. Gardasil, manufactured by Merck, was in the U.S. since June 2006. Cervarix, manufactured by GlaxoSmithKline, is expected to be in the U. S late 2008 or early 2009 introduced. Both vaccines target HPV types cause 16 and 18, the majority of cases of cervical cancer. HPV type 16 caused nearly 50% of all cases of cervical cancer and HPV type 18 cause about 20% of all cases of cervical cancer. Clinical studies have shown that both vaccines, 70% of all cervical cancers prevented, with almost 100% effectiveness. However, this only if the person were vaccinated prior to exposure to the virus types 16 and 18. The effectiveness of the vaccine drops once these types of virus access to the body. Therefore, the CDC use of the vaccine for young girls between the ages of 11-12 is recommended to achieve before their first sexual experience the full benefits.

Pap test versus HPV Vaccine: Both Pap tests and HPV vaccine prevents cervical cancer, but they do so in different ways. The vaccines produce antibodies against the HPV virus to fight long before it can penetrate the cervix. Therefore, vaccination has prevented the development of HPV pathology of the cervix. On the other hand, the Pap test detects abnormal changes in the cervix due to HPV, many of which require follow-up visits and procedures to these abnormalities from progressing to prevent cancer. Most people would agree that prevention is better than detection or treatment. Managing abnormal Pap smear alone cost $ 2-3 billion per year in this country. But because the vaccine only protects against 70% of all cervical cancers, Pap tests should be pursued to identify the remaining 30% of all cervical cancers, which are not covered by the vaccine. It is important to note that apart from cervical cancer prevention, the vaccine has also been found to be against many other HPV-related diseases of use, and it could also in reducing the medical and emotional toll that these diseases on human to help.

most from cervical cancer in the United States, such groups of people who are not denied access to the Pap smear, or because of inadequate access, either as a result of poor socioeconomic status, poor knowledge and cultural differences. These groups are mostly together of women from ethnic minorities and whites in the Appalachian region. Therefore, education at the public should not only be comprehensive cervical cancer prevention programs included in layman’s terms, but should also be culturally sensitive to meet the needs of people from different fields. The HPV vaccine has the potential to save millions of young lives and families, but if it achieves the same group of women who can not get their Pap smear today, it missed retaining its “one less” promise both here at home and around the world.

© 2008 Shobha S. Krishnan, MD Author Bio

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Shobha S. Krishnan, MD, is a board certified gynecologist and family practice physician, at Barnard College, Columbia University. Her new book, The HPV Vaccine Controversy: Sex, Cancer, God and Politics: A guide for parents, women, men and youths on 30 August 2008 published by Greenwood Publications. The book presents the latest information about the vaccine without the influence of pharmaceutical companies or other stakeholders.