| Cervical cancer used to be the number one cancer killer
of
US women. Today, thanks to the Pap test, it does not have the
domestic impact it once did, but cervical cancer remains on
the global public health agenda. Worldwide, more than 250,000
women die from cervical cancer every year.
Although scientists were able to connect cervical cancer
with sexual activity centuries ago, it wasn’t until just a few
decades ago that human papillomavirus (HPV) was discovered
to be the actual link.
HPV is the most common sexually transmitted disease in the world, infecting
an estimated 80 percent of sexually active women at some point in their
lives, and probably as many men. For the majority of women who contract
HPV, the body’s natural defenses are enough to beat the virus. But
we now know that persistent infection with certain high-risk types of
HPV actually causes cervical cancer.
This knowledge brings cervical cancer firmly into the category
of preventable diseases. We should be able to lower
rates of cervical cancer even further. In lieu of the traditional
Pap smear, liquid-based Pap technology shows promise as
a more sensitive means of testing for abnormal cell growth.
And HPV DNA testing allows clinicians to screen for the
high-risk HPV types that can cause cervical cancer and
assess those abnormal Pap test results that are not related to
high-risk HPV.
Yet technology alone will not prevent disease. We need to increase access
to screening and find those women who haven’t been screened. The
first step is to educate clinicians, patients, and the general public
about cervical cancer screening and prevention. Informed, shared decision
making about increasing choices in care and management is the next step.
For this reason, we timed this issue of Health & Sexuality
to coincide with National Cervical Cancer Awareness Month.
This is an exciting time in the field of cervical cancer
screening and prevention. For the past decade, two major
pharmaceutical companies have been vying to develop a
vaccine against HPV, and now they are nearing that goal. In
addition to injections, an oral vaccine is in development, an
HPV vaccine is being tested in men, and new ways to detect
HPV are being perfected. There is even a revolutionary gel
in development that would destroy cervical cancer cells.
HPV vaccines could have special impact in the developing
world, where cancer screening is not widely available or
accessible and more than 80 percent of deaths from cervical
cancer occur. In the United States, such vaccines may be a
harder sell because they may be initiated in girls as young as
10, to ensure they are protected before the onset of sexual
activity. Convincing society of the need to vaccinate young
girls against what is essentially a sexually transmitted disease
will be a hurdle. We look forward to adding cervical cancer
vaccines to our future reproductive health agenda.
Wayne C. Shields
ARHP President and CEO
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