A DNA test for the human papillomavirus (HPV), the leading risk factor for cervical cancer, is better than the Pap smear and other screening methods at preventing cervical cancer according to a new study.

The multi-year study of 131,746 women in India, published in last week's New England Journal of Medicine, showed that a single round of HPV DNA testing was more effective than other screening methods at preventing cervical cancer and related deaths. 

Health experts believe that the widespread introduction of the DNA test for HPV could result in the elimination or reduction of use of the Pap smear, the gold standard for cervical cancer detection in the United States. With the Pap smear, cells from the cervix are collected by a clinician and sent to a laboratory where they are examined for cellular abnormalities. In contrast, the DNA screening test also uses cervical cells but results are read by a machine and not as prone to subjective assessment.

HPV is the most common STD in the United States with more than half of all sexually active women and men becoming infected at some point in their lives. Although most women with cervical cancer are infected with HPV, not all women with HPV will develop cervical cancer as only certain types of HPV cause abnormal cells to develop.

A spokesman for the National Cancer Institute has urged medical professionals to adopt HPV DNA testing. Hurdles to adoption of the DNA test include hesitation by gynecologists and other primary care doctors to do away with Pap smears, which have been credited with dramatically reducing the rate of cervical cancer deaths in the United States.

The American College of Obstetricians and Gynecologists currently does not recommend the HPV DNA test for women younger than 30.  For women over 30, the organization suggests that women get an HPV DNA test at the same time as a Pap smear.

Read more about HPV and cervical cancer screening or submit a question to our medical students or health professionals.


_{Photo: euthman, Flickr, Creative Commons}

The HPV vaccine known as Gardasil may not be just for females anymore. A recent study shows that the vaccine, currently approved to prevent genital warts and cervical cancer in females, also prevents genital warts in males.

The phase III study involved nearly 4000 males aged 16 to 26 from several countries. The researchers report that Gardasil was about 89% effective in preventing genital warts and that it also appeared to prevent a precancerous condition called penile/perineal/perianal intraepithelial neoplasia or PIN.

The vaccine targets four types of the Human Papillomavirus, two that cause most cases of genital warts in both males and females, and two that are responsible for about 70 percent of cervical cancers. One of the major arguments for vaccinating males against HPV is that it could prevent the spread of the virus, potentially eliminating many of the nearly 12,000 cases of cervical cancer diagnosed in U.S. women each year. However, since the vaccine is not cheap – about $375 for three doses given over six months – many males might not want to be immunized if the only benefit to them is genital wart prevention.

But the vaccine might also have a direct cancer benefit for males. Even though cervical cancer makes up nearly 80% of cancers caused by HPV, the virus also causes penile and anal cancers in men. Additionally, recent studies suggest that HPV now causes as many cases of oral and throat cancer as tobacco and alcohol do. Making Gardasil available to boys and young men might also prevent many cases of these cancers in men.

The FDA is awaiting further information from Merck, the makers of Gardasil, before approving the vaccine for use in males. To find out more, see our earlier blog post Gardasil: an overwiev or stop by the Healia Health Community for HPV or the Healia Health Community on Cervical Cancer.

 

_{Photo: NathanF, Flickr, Creative Commons}

August is National Immunization Awareness Month, and news of a recently-developed vaccine has hit the headlines. Gardasil is the commercial name for a vaccine for young girls designed to protect against cervical cancer. Cervical cancer is caused by the highly communicable STD Human Papillomavirus (HPV). There are many different strains of HPV, and the CDC estimates that 80% of women at age 50 will have had an HPV infection at some point in their life. Fortunately, infection with HPV is most often asymptomatic, and clears itself up in a few weeks. However, a few strains of HPV are responsible for diseases and conditions like cervical cancer and genital warts.

Controversy has surrounded Gardasil for many reasons, including high costs ($120 for each dose), and the fact that it is recommended for girls aged 11 to 12 who are not sexually active.

In Texas, Governor Rick Perry was the first state governor to recommend that the vaccine be mandatory for all school children by 2008. His recommendation was not confirmed by the Texas legislature. Other states have legislation in committee stating that it will be required for schoolchildren in the near future, though it will be an “opt out” type of vaccine, as are all the other required school vaccines (MMR, DPT, hepatitis).

Whether or not the vaccine passes through legislation, safe sex practices and early detection through annual Pap smear tests should continue to be encouraged.

NIAM Gardasil HPV vaccine immunization cervical cancer