HPV and cancer

January is Cervical Health Awareness Month.

Following the recommended guidelines for Pap smears is a good way to find and treat cervical cancer early, when it’s basically curable.

A Pap smear is one of the few screening tests for which there is good evidence that it’s effective, plus it’s relatively cheap and painless.

The American Cancer Society, The United States Preventive Services Task Force (USPSTF) and the American College of Obstetricians and Gynecologists all recommend the following:

  • No screening before age 21.
  • Screening every 3 years between ages 21-29 with Pap smear only, no HPV testing. (The rate of incidental HPV infection is high in this age group; add HPV testing only if the Pap smear is abnormal.)
  • Screening every 5 years between ages 30-65 with Pap smear and HPV testing, or every 3 years with just Pap smear.
  • No screening after age 65, unless the most recent Pap smear was abnormal.

HPV or human papillomavirus, the most common sexually-transmitted disease, is known to cause cervical cancer, and that’s why the HPV vaccine is recommended for girls at the age of 11 or 12, before they become sexually active.

Watch Dr. Mike Evan’s excellent YouTube video about the HPV vaccine:

Boys, too, are recommended to get the vaccine at 11 or 12.

HPV doesn’t just cause cervical cancer. It’s also responsible for a large percentage of head and neck cancers (through oral sex).

The incidence of head and neck cancers is increasing in young people, and about 70% of those cancers are related to HPV.

The medical journal JAMA Oncology last week released a study that confirms HPV can cause cancer of the throat, tongue, tonsils, mouth and neck.

For the study, participants who were all cancer-free at the time, provided mouthwash samples. A total of 132 cases of head and neck cancer were identified within a four-year follow-up time period. The study also included a comparison group of 396 controls. After evaluating the overall data, the researchers concluded that the risk for head and neck cancer was significantly higher in those with a past HPV infection of the mouth.

But wait—there’s more!

Because HPV is a sexually-transmitted disease, it can also be linked to other cancers, specifically cancer of the anus, penis, vagina and vulva.

The HPV vaccine has been shown to be safe and effective. There is controversy around all vaccines, unfortunately, but as the Science-Based Medicine blog wrote recently:

The public fight over the human papillomavirus (HPV) vaccine is still raging. The debate partly reflects the underlying logic of health prevention measures, which is essentially a statistical game of risk vs benefit. Unfortunately thrown into the mix are ideological opponents to vaccines who are distorting the facts at every turn.

Notice that I said this was a “public” fight, because it is not a serious scientific dispute. There is sufficient evidence to confidently conclude that the HPV vaccines currently available are safe and effective. All medical interventions will contain some risk, it is never zero, but vaccines in general, and the HPV vaccine specifically, have minimal risks and clearly prevent disease.

One downside to the vaccine is that it’s expensive, but it should be covered under the Preventive Benefits of ACA-compliant health plans.

And it doesn’t prevent every form of cervical or head/neck cancer (there are over 100 types of HPV), but it’s a good start to protecting your child’s future health.

Sláinte,

Frugal Nurse

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