In my last blog I talked about human papillomavirus (HPV), the virus that causes cervical cancer. HPV can cause genital warts, and cancer or pre-cancerous dysplasia of the vulva, vagina and cervix; it is quite common, found in fifty percent of college women.
The HPV vaccine, Gardasil, provides protection from four of the most common types of HPV-the two "high risk" strains that are most likely to cause cervical cancer (16 and 18), and the two most common causes of genital warts (HPV types 6 and 11). The immunity is type-specific-it protects you from infection provided you have not been infected with that viral type before. By preventing infection with these types of HPV, the vaccine should be able to decrease the rate of genital warts by 90 percent, and cervical cancer by as much as 70 percent, provided it is taken before infection occurs. Can you think of any other simple treatment that can diminish a cancer risk like that?
Gardasil is recommended for girls and women ages 9-26. Since the vaccine doesn't work once infection is established, this age range was chosen to try to reach girls before they become sexually active, or at least before they have been exposed to these four viral types.
Worldwide, cervical cancer is a tremendous killer of women: almost five hundred thousand new cases each year, and over two hundred thousand deaths. Cervical cancer isn't that common in developed countries. In the US, almost ten thousand women are diagnosed with cervical cancer each year, and just under four thousand die of the disease. But these numbers are merely the tip of the iceberg of women who are affected by HPV. If you factor in every woman who is distressed because she finds out that she has a sexually transmitted infection, each relationship that is scarred by having passed an infection from person to person, the discomforts of being treated for genital warts, the worry of receiving an abnormal Pap test report, the annoyance and discomfort of having to undergo colposcopy and cancer-prevention treatments, and the financial costs and health effects of these different evaluations and treatments, you can see that the benefits of HPV prevention would touch a tremendous number of women.
Gardasil comes as a three-shot series taken over six months, and costs about $360. Most insurance plans are covering it, with the usual co-pays and deductibles. Low-income families may qualify to receive the HPV vaccine through a federal program called Vaccines for Children. Because the vaccine only protects you before you are exposed to HPV, it works best in girls who have not yet had sex, and those who have not yet been infected with any of the four viral types. Immunization may still be worthwhile after known infection with one strain, to prevent infection with the other types. If you are in this age range, talk to your healthcare practitioner about whether you should be immunized against HPV.
