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Archives for January 2017

Study Says Cervical Cancer Death Rates Are Far Higher Than We Thought

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New research finds that women in the U.S. are dying from cervical cancer at rates far higher than we realized, especially with black women.

Researchers from Johns Hopkins University examined the mortality rate (or death rate) with cervical cancer and say the statistics are skewed because they include women who have had a total hysterectomy and no longer have a cervix (and no risk for cervical cancer). When looking only at women whose cervix is intact, the investigators found the corrected mortality rate for black women with cervical cancer is actually 10.1 per 100,000 compared to 5.7 per 100,000 with the uncorrected data that includes women who have had a total hysterectomy.  For white women, the corrected rate is 4.7 per 100,000 versus an uncorrected rate of 3.2.

Without the corrected figures, the authors say we’re underestimating the true disparity between black and white women by a whopping 44%.

The authors say the racial differences likely stem from a variety of factors: compared to white women, black women have more barriers to health care and tend to be diagnosed with cervical cancer at a more advanced stage of disease (when the outcomes are poorer). They also note that differences in treatment may have a role, as black women with cervical cancer are at greater risk of inadequate care.

The American Cancer Society estimates there are approximately 13,000 total new cases of cervical cancer in the U.S. each year and about 4,000 deaths. ASHA president and CEO Lynn Barclay says the racial disparities are unacceptable and needless. “We have the tools to prevent cervical cancer and let me be clear: not one single woman need die from this disease,” she says. “It is heartbreaking that black women continue to suffer an unfair burden of cervical cancer mortality, and a national embarrassment that we’re not developing and funding programs to make sure the most vulnerable communities get the care they need.”

For more on preventing cervical cancer, including how to raise your voice and get involved, visit NCCC online.

Reference:

Beavis, A. L., Gravitt, P. E. and Rositch, A. F. (2017), Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Cancer. doi: 10.1002/cncr.30507.

Study Finds Nearly Half of Men have HPV

shutterstock_259994795Nearly half of males in the United States have genital human papillomavirus (HPV), according to a study published January 19 in JAMA Oncology.

HPV is the most common sexually transmitted infection, and experts believe most sexually active individuals have an HPV infection at some point. CDC estimates there are 79 million total cases of HPV in the U.S. (with 14 million new cases each year). Of the HPV types associated with sexual transmission, some are low-risk types linked with genital warts while others are high-risk types associated with cancers of the cervix, vagina, vulva, penis, and anus (along with a number of head and neck cancers). Most cases of HPV are harmless, however, and are cleared naturally by the immune system in a year or two.

The study by Jasmine Han, MD, and her colleagues was done with nearly 1,900 men ages 18-59 as part of the National Health and Nutrition Examination Survey (NHANES) 2013-2014. NHANES is a series of continuing studies assessing the health of adults and children in the U.S. Overall, HPV was detected in 45% of males in the study (25% of subjects were found to have a high-risk type). Unlike HPV infections in females which decline after peaking in mid-20s (click here for data on females), the results from this study found high rates of HPV in males across all age groups.
The researchers also found only 11% of the study subjects eligible for HPV vaccination had received the shots. HPV vaccines are approved for males and females ages 9-26 and are nearly 100% effective in blocking infections and diseases related to the HPV types covered, and the authors write “Our study indicates that male HPV vaccination may have a greater effect on HPV infection transmission and cancer prevention in men and women than previously estimated.”

ASHA’s HPV Resource Center has information for men, women, and healthcare providers.

Reference: Han JJ, et al. Prevalence of Genital Human Papillomavirus Infection and Human Papillomavirus Vaccination Rates Among US Adult Men. JAMA Oncol, published online January 19, 2017.

 

Page created January 20, 2017

Page last updated January 20, 2017

A Cure for HPV? Evaluating HPV Treatment Options

A cure for HPV!
Satisfaction guaranteed!
No more outbreaks!

If you’ve had an HPV diagnosis, you may have seen claims like this in your search for information on the Internet and elsewhere, often written in large bold type. In smaller type are the disclaimers:

“Individual results may vary.”
“This information is not intended to replace medical advice. Seek appropriate medical attention if your condition persists.”
“These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

The promises are bold, but the disclaimers are clear: these are not reliable, approved treatments for HPV.

Claims such as these can be found selling products that treat genital warts. Well, not actually treat warts, as the disclaimers state, since such products are have not been approved as a treatment by the Food and Drug Administration (FDA). The language used to market these products, though, seems to be carefully crafted to obscure that fact. An ad will tout “FDA-approved ingredients” or mention that the product is “FDA-registered.” Impressive sounding, perhaps, but neither of these indicate that the product in question has been through the necessary research to ensure that it is safe and effective.

The Drug Approval Process

The FDA is in charge of overseeing the safety and effectiveness of the drugs we use. The approval process for a new drug can be a long one—from 8 to 12 years in total—with many steps along the way. Drugs are tested in animal studies, then through a series of human clinical trials, with steps along the way to determine safety and dosage, evaluate and verify the effectiveness of the drug, discover side effects. Even after a drug is approved, its safety is monitored, to track any adverse events that may not have been discovered in the clinical trial process.

Does that mean that these non-prescription treatments are not safe? Not effective? If they haven’t gone through a rigorous testing and approval process, there’s no way for you, as a consumer and a patient, to know. And if they haven’t been tested for the claims they make, such as “killing HPV infections” and “curing genital warts”, how can they market them in this way? As the fine print of the disclaimers detail, such products are registered with the FDA as dietary supplements or cosmetics—not drugs. “Not intended to diagnose, treat, cure or prevent any disease” as the label states.

There are treatments available for genital warts that can be applied at home, but these are available by prescription only—no over-the-counter wart treatment should be used to treat genital warts. In addition, a healthcare provider can offer other options. While there is no one treatment is best for all cases, it is important to consult with a healthcare provider to find something safe, effective and right for you.

Vaccines: Prevention, not a Cure

While the type of HPV that causes genital warts is consider “low risk,” there are other HPV types referred to as “high-risk,” as infection with these types can lead to the development of cervical cancer. There are currently vaccines available that can prevent infection both low-risk and high-risk types of HPV, but no vaccine is currently available to treat or “cure” HPV. While there is research underway for what are called “therapeutic” HPV vaccines—vaccines that can treat precancerous or cancerous lesions caused by HPV—these are in the early stages, testing safety and effectiveness.

Yet just as there are unapproved treatments for genital warts advertised as a “cure,” there is also a vaccine that claims to cure cervical cancer. The vaccine is not currently available in the U.S., but is being administered to patients in Mexico, where the researchers studying the vaccine are located. And that is important—the vaccine is still being studied and is considered to be in its experimental stages. Most experts believe it has not been sufficiently evaluated to support claims that it cures HPV or prevents outcomes like cancer.

To be approved in the U.S., vaccines must also undergo a series of clinical trials to test the products safety and effectiveness, as the current preventive HPV vaccines have been. The vaccine offered in Mexico has not. ASHA advisors recommend against treatment with this or any other experimental vaccine intended to cure HPV, unless and until it is offered in a controlled clinical trial by a reputable research center under government oversight.

Given the variety of HPV vaccine research being conducted – and the fact some of the different projects have similarities- it’s easy to be confused. Until a vaccine to treat HPV is evaluated and approved by the FDA it’s best to follow the old adage of buyer beware. ASHA/NCCC advisors recommend against treatment with this or any other experimental vaccine intended to cure HPV, unless and until it’s given in a clinical trial by a well-known research center with the government keeping an eye on things

Get Rid of HPV, Naturally!

Now that sounds like a claim made by some dubious treatment, doesn’t it? But this actually a selling point for your own immune system. The fact is, most HPV infections are harmless and are cleared by your body in a short period of time—no treatment needed. For example, the average length of new cervical HPV infections (as measured by HPV DNA) is about 8 months. About 70% of new infections clear within 1 year, while a full 90% of new infections clear within 2 years.

Even in people with longstanding persistent or recurrent HPV infections, active infection usually is cleared—although viral DNA may persist indefinitely in everyone. This is why experts say there is no “cure” for HPV, as the virus may still be present even though there are no signs of infection, like pre-cancerous lesions or genital warts.

Some websites tout nutritional or herbal supplements that are claimed to either cure the virus or speed natural clearance. The jury is out here: no combination of vitamins, minerals, or herbs is proven effective in clearing HPV infections (despite the claims to the contrary) so consult your health care provider or pharmacist before ordering such products online.

So while there is no cure for HPV, there are treatments that have been shown to be effective at treating genital warts and precancerous cervical lesions caused by HPV. Even more important though, there are also vaccines that can prevent infection in the first place.

Listen to Learn More

In this episode of ASHA’s Sex+Health podcast, H. Hunter Handsfield, MD, Professor Emeritus of Medicine, University of Washington Center for AIDS and STD, breaks down the more common HPV “miracle cures” and also answers the most common questions about legitimate, approved HPV vaccines.

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