It’s important to educate on HPV

Once upon a time, cervical cancer was the No. 1 cancer affecting women’s genital organs. Then Dr. George Nicolas Papanicolaou discovered that he could detect cancer cells in some smears taken from the uterine cervix. He published his findings in 1928, hoping that his new test would be a way to detect early cervical cancer.

As his research evolved, he found that he could detect earlier, non- cancerous changes that could lead to cancer. If these abnormal- ities were treated, the risk of cervical cancer plummeted. The pap smear, as we call it now, became the quintessential screening test. It’s cheap, doesn’t require surgery and finds pre-cancerous lesions that can be treated and eliminated, thus dramatically reducing the risk of cancer.

In developed countries, cervical cancer dropped to third place among female genital cancers. It has not, however, disappeared completely, mainly because of lack of regular screening.

Some women either cannot afford to get to a doctor on a regular basis (close to 60 million people in the United States are without health insurance) – or don’t show up for other reasons. Since cervical cancer develops very slowly in most cases, occasional skipped paps aren’t the end of the world.

In fact, women don’t necessarily have to get a pap smear every year. Frequency of paps depends on age and medical history. So a discussion with your health-care provider is always in order.

That’s the story here in the United States. But in developing countries, according to a World Health Organization paper published in 2002, cervical cancer is the most common cancer in women, surpassing lung and breast cancer, which vie for top honors here in the United States.

Cervical cancer screening can involve three trips to a clinic – first to get the pap smear, next to take biopsies if the smear is abnormal, and finally a visit for treatment. For women who live perhaps hundreds of miles from the nearest clinic, and who often travel on foot, this is impossible.

Since women are still dying throughout the world from an essentially preventable disease, it is no surprise that public health workers are ecstatic about the development of a vaccine for the human papiloma virus (HPV), the virus that causes cervical cancer. As it stands now, the vaccine, still in testing, can prevent at least 70 percent of cervical cancers.

It is no stretch to think that as the vaccine evolves, more subtypes of HPV will be added to the vaccine, thus preventing even more cases of the most common type of cervical cancer.

Vaccines are always more cost effective than treatment. Think about it. One or two shots versus three clinic visits – and that’s only for the women with a pre-cancerous condition. Once a woman has developed cancer, the cost accelerates astronomically.

Yet initial reaction to the new vaccine was not universally positive. Media reports quoted numerous social conservatives expressing reservations at vaccinating girls (and boys) before they become sexually active, because HPV is sexually transmitted and a vaccine might “send the wrong message.”

I’ve searched the Web sites of the Concerned Women for America, the Family Research Council and the Abstinence Clearinghouse, organizations whose representatives have been quoted in several news articles as fearing that such a vaccine would promote promiscuity. I haven’t found any reference to the vaccine.

Does this mean these groups have come to their senses after their initial reactions? I certainly hope so. Because preventing 500,000 deaths per year worldwide is a very good thing.

I have been in the business of women’s health for 27 years now, and I can say with certainty that people have sex. They have sex with some regularity, often inappropriately, and often unprotected. It’s estimated that 50 percent of teenagers have sex by the time they are 17.

Why would we not want to protect our children from a killer like cancer? I am excited about the vaccine.

I don’t think it will promote promiscuity any more than requiring seat belts means there’s an accident immediately ahead. But that’s just my (educated) opinion.