Dr. Ault and his colleagues are following 1,911 Colombian women ages 24 to 45 who received the vaccine, and another 1,908 who were given a placebo. None of the study participants had a history of genital warts or cervical disease. (There are more than 100 HPV strains; some cause genital warts, others cause cervical cancer, and others are harmless.) The Lancet study, released this week, is based on about two years of follow-up. The study was funded by Merck, the makers of Gardasil.
Gardasil protects against HPV 6 and 11, which cause most cases of genital warts, and HPV 16 and 18, which cause cervical cancer. However, Gardasil won’t protect women who were infected with HPV before they received the vaccine.
About 3 out of 4 sexually active women become infected with HPV at some point in their lives, but usually the virus goes away on its own without any treatment. The virus, if it persists for a long time, can cause the cell changes that lead to cancer.
Four of the 1,615 women who received the full course of the vaccine developed persistent infection with one of these HPV types, or any disease related to one of the viral strains, compared to 41 of the 1,607 women in the placebo group. The researchers say that the efficacy of the vaccine was “high,” but mostly in terms of protecting against infection—not cervical cancer.
It’s not known if new HPV infections will lead to precancerous cervical changes in older women, says Cosette Wheeler, PhD, a professor of molecular genetics and microbiology at the University of New Mexico School of Medicine, in Albuquerque. “We understand that people get infections, we understand that people develop low-grade abnormalities, but we also understand that the amount of precancer is very low in these populations,” says Wheeler, who has conducted extensive research on HPV infection and cervical cancer.
Also, Wheeler says, the current study is simply too small to show whether the vaccine did indeed reduce precancerous changes in the older women, because this occurs so rarely. “If you have such a low reality of an outcome, it’s probably not a useful or cost-effective application to extend the age of vaccination,” she explains.
Dr. Ault argues that the vaccine makes sense for older women who have new sex partners later in life. “The best argument against getting this vaccine more widely is that it’s expensive,” he says. “The guys aren’t out there getting Pap smears, so who knows what’s going on with them?”
Regardless of whether they have the HPV vaccination, women should still get routine Pap smears. That test looks for cancerous and precancerous changes in the cervix so that they can be caught and treated at an early stage.
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Comments (3)
There is a new book on the HPV vaccine: The HPV Vaccine Controversy- Sex, Cancer, God and Politics which gives an overview of HPV infections and an unbiased opinion of the vaccines. It is authored by Shobha S. Krishnan, M.D, Barnard college, Columbia University. The book is available at amazon.com and Barnes and Noble.com and is written without the influence of any pharmaceutical companies or special interest groups. Link to the book: http://www.greenwood.com/catalog/C35011.aspx
Ladies 30 and over can protect themselves right now from developing Cervical Cancer. Be sure to go for your annual visit and demand from you doctor that you receive your Pap AND a HPV test. Right now if you get the Digene HPV test added to your Pap you will know your risk of developing disease. I have low grade disease right now that was missed by the Pap test alone and was found because my doctor gave me a HPV test also an I am persistently HPV positive. Go check out a great site http://www.thehpvtest.com and decide for yourself but luckily my doctor was smart enough to give me the test. Tell your friends and help eliminate cervical cancer.
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