Cervical cancer and Penile cancer are caused by the High Risk HPV viruses, (Human Papilloma virus), this epidemic can be halted with widespread effective HPV vaccination. Almost 3 billion individuals worldwide are infected with one or more HPV viruses, and this includes over 50 million Americans: men, women, and children. There are over 45,000 HPV related cancers in the USA each year. Although we naturally make antibodies that should both neutralize the disease and clear an HPV infection should we get one, persistence is prevalent, leading to an epidemic of the consequences of HPV disease.
1. Prevention is important. Three of 10 individuals will never clear their infection and thus be at risk for HPV diseases.
2. The cause of cervical and penile cancer are the same HPV high risk viruses. HPV virus persistence causes a variety of conditions; the most dramatic is cervical cancer, but it also can cause genital warts, precancerous conditions and cancers of the urogenital tract of men and women, and a disease of the oral cavity and larynx called RRP (recurrent respiratory papillomatosis, which is warty tumors of the larynx), and anal cancers. There are 2,500 new RRP cases in the U.S. each year. Cervical cancer is a worldwide epidemic with 500,000 new cases diagnosed a year; more than 250,000 women die from it annually.
3. Use condoms. Preventing HPV disease also means preventing other co-factor STDs that make a person more likely to progress from HPV infection to cervical or penial cancer disease.
4. Get Screened with either Cervical HPV testing or Cervical Pap Smears with CoTesting when due, and consult your physician individually as to what frequency is best for you. Some women have only had a pap and not the cotest with HPV, so check your last results to see if you need additional testing. Pap smear testing is not a prevention it is detection of HPV disease or sort of a back up plan to the strategy HPV disease eradication. Deaths in the U.S. due to cervical cancer have been greatly reduced in the last 50 years due to wider availability of pap smears, accurate tests to diagnose the primary causative agent, and the high risk types of HPV. But we still have a rate of about 7/100,00 women and about 25,000 cases and 5000 deaths from Cervical Cancer each year in the US. And if diagnosed, most patients are getting appropriate triage from gynecologists and primary care doctors, leading to the effective elimination of most pre-invasive cervical disease. The real tragedy of the disease here is the ever increasing numbers of young women who have contracted precancerous disease and have to deal with the consequences: financial, emotional, physical and mental. There many young women who have had large areas of the cervix permanently removed in an attempt to ward off the cancer. . HPV causes genital warts in men and women. Genital warts are treated in much the same way, removing the affected tissue. Because elimination of the wart is not always accompanied by elimination of the viral infection causing the wart, recurrences are common and resistance to treatment is common, as well. In older women we are currently seeing a dramatic rise in external genital precancerous changes. Other consequences of infection are depression, lower sex drive, lower self-esteem, anxiety, and the issues of “pre-existing,” i.e. “not-covered,” conditions on your next insurance policy, which causes economic burdens for those in treatment.
5. Get vaccinated, HPV vaccines are indicated for up to the age of 45. Prevention of disease acquisition is the only strategy available to eradicate HPV disease. There is no known treatment yet for persistent HPV disease. Even acquisition of one virus doesn’t protect against acquisition of one of the other HPV types, of which there are over 100. The U.S. Centers for Disease Control and Prevention says condoms do not completely prevent HPV disease acquisition, but new statistics show they do significantly lower the risk. To be most effective, they should be used with used with appropriate microbial concentrations of spermicide, but if any skin-to-skin contact occurs in an affected area transmission will occur.
6. Get all your scheduled vaccine boosters, and get completed series with the 9 if you first had dosages with Gardasil 4. There is a vaccine against 9 types of the HPV virus which is approved by the FDA. HPV is a DNA virus that infects skin and mucosal tissues and causes cell changes that lead to what is known as cell proliferation (overgrowth) and conversion to neoplastic changes (premalignant and malignant). These vaccines have the ability to prevent the majority of cervical cancers, a cancer thought to be virtually 100 percent preventable. The Gardasil, is a vaccine that when given the individual develops fairly rapid immunity to one of f9 types HPV virus. They have targeted the HPV 16 and HPV 18 viruses in particular because they together are the responsible for more than 70 percent of cervical cancer cases. This vaccine has also been shown to protect against vaginal, vulvar and anal cancers caused by the HPV virus. Gardasil by Merck included 6 and 11 because they cause genital warts and abnormal pap smears, and the vaccine effectively prevents 90 percent of those cases.
7. Vaccinate your kids. Who will need the vaccine? We know that about 50 percent of adolescent women will contract HPV within three years of becoming sexually active. So it is most likely to help those prior to their debut into sexuality, although there are studies that show as long as you are negative to a particular type of HPV when you get the vaccine you will be protected. Gardasil vaccine is approved for girls and boys, and young men and women ages 9-26, and insurance companies and state and federal plans cover the injections. Everyone should be vaccinated. The HPV vaccines have the ability to prevent disease, save money, and save lives. This is not debatable. The prevention of this epidemic is in our hands, and we must rapidly as a nation move to vaccinate all eligible individuals. Until all HPV virus infections can be prevented we will not truly eradicate the disease, but we will eradicate the epidemic. The last case of wild small pox in North America was October 26, 1977. In my medical career I hope to be able to tell you the last date known for an HPV-induced cervical cancer.