HPV Vaccine is also for Adults - Islands' Sounder

HPV Vaccine is also for Adults - Islands' Sounder
Can you get rid of HPV once you have it? What to know if a Pap test detects virus - TODAY
Could we say ‘goodbye’ to cervical cancer by 2120? - Medical News Today

Posted: 28 Feb 2020 01:30 AM PST

Submitted by the Island Reproductive Health Initiative

If you were born prior to 1980, you may have missed an important opportunity to receive the first vaccine for Human Papilloma Virus approved by the FDA. That was in 2006, but it only targeted teens aged 11-12 years old as being eligible. Shortly after, the FDA expanded the age range from 9-26 years. In 2018, the FDA expanded the age limit again for HPV vaccine to include adults up to 45 years old.

HPV is a common, sexually transmitted infection often acquired soon after sexual debut. There are over 150 strains of the virus, most of which are transient with no symptoms. However, some strains persist, causing genital warts or, decades later, cancer.

The Centers for Disease Control estimates there are over 33,000 new cases of HPV-related cancers in the U.S. every year. This includes cervical and vaginal cancers in women, penile cancer in men, and oral and throat cancers in both sexes. HPV cancer symptoms can take years to show up. In women, it may make its first appearance as pre-cancerous cells seen on a routine pap smear. The HPV vaccine is the first vaccine that targets the dangerous, cancer-causing strains of the virus as well as HPV-associated diseases.

The vaccination program has resulted in significant declines in rates of HPV infections, anogenital warts and cervical precancers. But what about the women and men who missed the age cut-off for the vaccine? Aren't they still vulnerable?

Definitely. Some adults could still be at risk for new HPV infection and would benefit from the vaccine. Therefore, the CDC now recommends "shared decision making" between adults up to age 45 and their clinicians, to discuss the benefits of immunization. Clinicians and patients should be aware that HPV vaccination for adults might not be covered by insurance providers or other payers, and this may affect the decision to vaccinate.

What does all this mean? Put simply, if you are an adult less than 46 years old, you're eligible to receive HPV vaccine. If you never received it before, or if you were not fully immunized in your youth, talk to your doctor. Even if you were exposed to HPV in the past, the vaccine may still provide further protection against other strains of the virus in the future.

The Island Reproductive Health Initiative encourages all Islanders to be mindful of their reproductive health. See our website at rhiorcas.weebly.com.

Can you get rid of HPV once you have it? What to know if a Pap test detects virus - TODAY

Posted: 04 Feb 2020 12:00 AM PST

If you have worries about HPV, you are not alone. Every year, millions of young women get the stomach-dropping notification that human papillomavirus was detected on a routine Pap.

Recently, I got this question from a reader:

I am 31 years old and I just got e-mail from my OB-GYN saying I have HPV on my Pap. They said not to worry and that I should just have a repeat Pap in a year. Not to worry? A year? Doesn't HPV cause cancer? What can I do to get rid of it?

It has been estimated that at least 80% of sexually active women and men will be exposed to HPV in their lifetime. Some say the numbers are closer to 100%. HPV is responsible not only for cervical cancer but also for vulvar, vaginal, anal and oral cancers.

This all sounds terrifying, but the reality is that your HPV will most likely cause no problems — and the advice you were given was correct.

Here's why:

HPV on your Pap is upsetting, but not serious.

Most Pap tests check not only for the presence of the HPV virus, but also inspect individual cervical cells to make sure they look healthy. HPV on your Pap simply means that the virus was detected. If your cervical cells look normal, there's no damage done other than having a viral guest you would rather not have.

Jan. 13, 202004:30

If HPV continues to hang out, as opposed to clearing out or becoming latent — which means it's there, but it's inactive and undetectable — there is a potential for problems down the road. In other words, it is the persistence of HPV — defined as consecutively positive HPV results at least 12 months apart — rather than the presence of HPV that is concerning.

Over time — and we are talking years, not months — HPV can impact normal cell growth patterns. If untreated, those abnormal cells can progress to pre-cancer (dysplasia) and, in some cases, cancer. Since no abnormal cells are present now, it is perfectly reasonable to repeat your Pap in one year because ...

HPV almost always goes away and the likelihood of progressing to cancer is very, very small.

Cervical HPV is almost always a transient infection, which means it is cleared by a healthy immune system without treatment. Some 90% of first-time HPV results will revert to a negative result within six to 12 months. More important, less than 1% of all women infected with HPV go on to get cervical cancer.

The most likely HPV infections to progress to cancer are in women who smoke, have a compromised immune system (due to conditions such as HIV/AIDS), or simply don't follow-up on recommended testing.

HPV will not impact your ability to have a healthy pregnancy.

The cervix, which is located at the top of the vagina, is the opening to the uterus. It lets menstrual blood out and sperm in. The cervix is a thick-walled tubular structure about 3-4 inches long; it shortens and thins out in labor to allow the baby to exit the uterus. A healthy cervix is critical to getting and staying pregnant, but even if there is persistent HPV that causes pre-cancerous cells and requires treatment down the road, it is extremely rare that the treatment compromises the function of the cervix.

In addition, HPV does not enter the uterus, so there is no possibility of infecting the baby during a pregnancy.

Sept. 17, 201904:13

Note: There is a very rare possibility of the baby getting HPV in the mouth and throat during delivery, but this is unlikely.

Action steps to protect your cervix:

If you smoke, stop. Breakdown products of cigarette smoke are concentrated in cervical mucus, where they promote the growth of abnormal cells, pre-cancer, and over time, cancer.
If you haven't had the HPV vaccine, it's not too late to get it. It will not make your HPV go away, but it will prevent you from getting infected with other sub-types. Gardasil 9 is the newest version of the vaccine; it protects against the seven viral types that are most associated with cervical and other genital cancers, and the two types of HPV that are most likely to cause genital warts. A vaccine to make HPV go away is in development, so stay tuned.
Be sure to follow up with your next Pap and HPV test. In developing countries, where Pap tests are not done, cervical cancer is still the leading cause of death among women aged 35 to 45. In the U.S., the rate has been extremely low since the 1960s, when routine Pap tests were introduced.

If you keep up with your recommended testing, nothing bad will happen. It's the women who ignore follow-up testing that get into trouble down the road.

Do you have a question about women's health? Ask your question in the form below and it may be featured on TODAY. (We'll need to know your name but we can keep your details private.) No topic is taboo!

Dr. Lauren Streicher is a clinical professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University and medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. Dr. Streicher is a regular contributor to TODAY.

Lauren Streicher. M.D.

Dr. Lauren F. Streicher is a contributor to TODAY.com. She is clinical professor of obstetrics and gynecology at Feinberg School of Medicine, Northwestern University, and medical director of Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago.

Could we say ‘goodbye’ to cervical cancer by 2120? - Medical News Today

Posted: 31 Jan 2020 12:00 AM PST

Hundreds of thousands of people worldwide have cervical cancer, which currently has a high mortality rate. However, specialists and the World Health Organization (WHO) argue that within the next 100 years, we may be able to eradicate this form of cancer altogether.

Doctor speaking with patient — Researchers affiliated with the WHO argue that if the world's countries put in place the right preventive measures, they could eradicate cervical cancer.

According to the WHO, in 2018 — the latest year for which data are available — there were an estimated 570,000 new cases of cervical cancer globally.

They also note that this form of cancer has a high mortality rate, particularly in low- and middle-income countries. However, applying the right preventive measures could significantly lower this rate.

Now, two separate studies that appear in The Lancet argue that cervical cancer could become a distant memory within the next 100 years.

The studies — conducted by researchers affiliated with The WHO Cervical Cancer Elimination Modelling Consortium — outline the measures that they advise different countries to apply when it comes to preventing cervical cancer.

The consortium was co-led by Prof. Marc Brisson from Université Laval's Faculty of Medicine in Québec, Canada.

In one study, the researchers predict that vaccinating girls from low- and middle-income countries against the human papillomavirus (HPV) could lead to an 89.4% reduction in cervical cancer cases over the next century.

HPV is a widespread virus and most people who are sexually active experience an HPV infection during their lifetime.

Usually, HPV infections pass on their own, without any significant effects on a person's health. However, in more severe cases, the virus can cause genital warts and cancer — and it is the top risk factor for cervical cancer.

However, getting vaccinated against HPV can prevent these possibilities. Currently, the National Cancer Institute (NCI) recommend that children get vaccinated against HPV when they are around age 11–12. They also note that people can receive the vaccination as early as age 9.

However, the NCI note that most — though not all — people may receive the vaccine up to age 45.

In the first study, Prof. Brisson and his colleagues also argue that with adequate vaccination, low- and middle-income countries could avert an estimated 61 million cases of cervical cancer up to 2120.

They also say that getting screened for this type of cancer twice in one's lifetime can reduce its incidence by 96.7%, and avert 2.1 million new cases.

The team also predicts that in countries that successfully put into effect an HPV vaccination policy, it may be possible to achieve the full elimination of cervical cancer at some point between 2055–2102.

Furthermore, "introducing twice-lifetime screening" into the mix could hasten the eradication of cervical cancer by as much as 11–31 years.

"For the first time, we've estimated how many cases of cervical cancer could be averted if WHO's strategy is rolled out and when elimination might occur," says Prof. Brisson.

"Our results suggest that to eliminate cervical cancer, it will be necessary to achieve both high vaccination coverage and high uptake of screening and treatment, especially in countries with the highest burden of the disease."

– Prof. Marc Brisson

In their second study, the WHO consortium researchers estimate that in low- and middle-income countries — the regions whose populations are most affected by cervical cancer — the mortality rate for cervical cancer will be 13.2 per 100,000 women in 2020.

Yet, they say, if those countries implement effective twice-lifetime screening policies, as well as deliver appropriate treatment where needed, this action could lower the mortality rate by 34.2% by 2030.

This would mean averting as many as 400,000 deaths related to cervical cancer within just 10 years. Even getting people to undergo once-lifetime cervical cancer screenings could achieve similar results, they note.

Prof. Brisson and his colleagues also predict that improving vaccination rates could lower mortality rates by 61.7% by 2070. He also notes that adding better screening and cervical cancer treatment practices into the mix could reduce death rates by 88.9%.

In 100 years from now, the researchers argue that appropriate HPV vaccination could lower death rates by 89.5%, preventing 45.8 million deaths related to cervical cancer.

And applying better screening practices and cancer treatment on top of that could lead to a 97.9% lower mortality rate by 2120. Once-lifetime screening could prevent 60.8 million deaths in this timeframe, while twice-lifetime screening could avert 62.6 million deaths related to cervical cancer.

The researchers have used the findings of their two studies to put together WHO's cervical cancer elimination strategy, which they will present at the 73rd World Health Assembly to be held in Geneva, Switzerland, in May 2020.

"If the strategy is adopted and applied by member states, cervical cancer could be eliminated in high income countries by 2040 and across the globe within the next century, which would be a phenomenal victory for women's health," argues Prof. Brisson.

"However," he cautions, "this can only be achieved with considerable international financial and political commitment, in order to scale up prevention and treatment."

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