How can you tell if you have genital warts?
Genital warts can be extremely hard to diagnose many times. Genital warts are small, bumpy, fleshy colored objects that can be so tiny that they cannot be seen by the naked eye. Often times they are confused with skin tags. If you are worried that you may have genital warts, you have a few options. It is always recommended that you visit a doctor so that they can be properly diagnosed, though due to the type of affliction, many people are embarrassed to go to the doctor because of their genital warts.
If you would rather diagnose the problem yourself, there is an effective way of diagnosing genital warts without going to the doctor. It is an old trick that makes use of some simple items found around the house. To self diagnose genital warts, you will need vinegar and a paper towel or napkin.
Here is how to find out if you have genital warts without having to see a physician:
- Pull off a few sheets of paper towel and fold them up so that they can be used as an absorbent pad.
- Pour enough vinegar on the paper towel pad to soak it, but not so much that vinegar is dripping everywhere.
- Apply the pad to the part of the body that is in question, whether it be penis or vagina
- Hold the pad firmly against the body part in question for 10 minutes and remove the pad
Any white spots that appear are determined to be genital warts.
To remove genital warts, you can either go see a physician who will freeze them off for you - otherwise there are safe and natural methods of wart removal that you can do at home without having to see a doctor.
More throat, mouth cancers linked to HPV
By Jill Coley
Many young nonsmokers get disease as result of contracting virus from oral sexual contact
About once a week, Dr. Boyd Gillespie shocks a young nonsmoker with the diagnosis that he has cancer in the back of his mouth.
Most oral cancers are related to a lifetime of tobacco or alcohol abuse, but that profile is changing.
Gillespie, a head and neck cancer surgeon at the Medical University of South Carolina’s Hollings Cancer Center, is seeing an increasing number of patients who are young, have little if any smoking history and have cancers predominantly of the tonsil and the back of the tongue.
The culprit is human papillomavirus, or HPV, the same sexually transmitted virus that causes cervical cancer. The oral cancer does not discriminate between sexes, striking men and women at equal rates, Gillespie said.
About 25 percent of the 40,000 head and neck cancers annually in the United States, or about 10,000 cases, might be attributable to HPV, Gillespie said. A decade ago, the number of mouth cancers related to the virus was nearly zero.
It’s a trend that other head and neck practitioners around the country also have witnessed, he said. Boyd and virologist Natalie Sutkowski have studied and confirmed that factors such as age, smoking history and tumor location and appearance are highly predictive of which tumors are caused by HPV.
Risk factors are similar to those for cervical cancer: younger age of first sexual intercourse and multiple sexual partners. With throat and mouth cancers, oral sexual contact also is a factor.
“Oral sex is probably a bigger part of first sexual contact than maybe it was in the past,” Gillespie said. A 2005 national study reported that more than half of U.S. teenagers from 15 to 19 had engaged in oral sex. That percentage jumped to 70 percent by ages 18 and 19.
But the complete story of the virus’s transmission is not known. “It’s unclear if it’s only passed through sexual contact,” Sutkowski said. “It would not be impossible in my mind that it could be passed through kissing.” A recent study in Nature Clinical Practice Oncology reported that “direct mouth-to-mouth contact or other means could not be excluded.”
Another factor contributing to the rise in HPV-related oral cancers could be that doctors 10 years ago didn’t necessarily look for the virus, Sutkowski said, and methods of testing have improved.
Also, more people smoked 10 years ago, so it was easier to blame tobacco.
But as more patients in their 20s and 30s appeared who didn’t smoke or abuse alcohol, the medical community took note.
Symptoms of HPV-related oral cancer include a visible growth or lesion on the tonsils or the base of the tongue that might affect speech or swallowing.
The ulcer might be sore, might bleed and could cause hoarseness. Gillespie recommends patients seek medical attention if they’ve had symptoms for a month or longer.
Some positive news is that HPV-related oral cancers have a good prognosis. But early intervention is key, Gillespie said, as survival rates fall from 90 percent to 50 percent when the cancer spreads to the lymph nodes.
To help people get medical attention early, the Hollings Cancer Center will open the Oral Lesion Clinic this month. The clinic will be staffed by a head and neck surgeon and an oral pathologist who will evaluate sores, ulcers and growths in the mouth or throat. A majority of patients will be referred by doctors or dentists.
The increased attention could lead to a push in boys receiving the HPV vaccine, marketed as Gardasil by Merck.
There are more than 100 strains of HPV, about 13 of which are considered high-risk.
The vaccine protects against four types: HPV-16, which is responsible for half of cervical cancers and the majority of virus-related mouth and throat cancers, HPV-18, which is also responsible for cervical cancers, and strains 11 and 6, which are associated with genital warts.
Whether the vaccine protects against oral cancer remains to be seen but seems logical, Boyd said.
“Our hope is that by reducing the number of people incubating HPV-16 in the community, we will also see a dropoff of throat cancer.”
From virus to tumor
How a virus interacts with tissue and becomes a tumor is complicated. Virologist Natalie Sutkowski might have unlocked one process that contributes to human papillomavirus’s transformation to cancer.
Sutkowski has discovered an ancient viral conversation that takes place when HPV meets human DNA.
About 8 percent of human DNA is derived from virus particles that have worked their way into the human genome over millions of years, Sutkowski said.
Normally, these viral particles do nothing. But when HPV is introduced, the viral particles are activated and cause inflammation. The increased blood flow, in turn, nourishes tumors.
“It’s known that inflammation helps tumors grow,” Sutkowski said. “And these viral particles turn on inflammation. So maybe it’s just as simple as that — the inflammation may be helping tumors grow.”
Sutkowski, working closely with head and neck cancer surgeon Boyd Gillespie, is now turning her attention to searching for drugs to inhibit these ancient genes, stop the inflammation and interrupt the tumors’ growth.
Cancer Vaccine For Girls At Private Hospital
A cervical cancer vaccine for young girls, that has yet to be made available under the NHS, can be accessed at Spire Gatwick Park Hospital – part of independent hospital provider Spire Healthcare.
The vaccine is administered in three doses and protects against the human papilloma virus (HPV). It is believed to reduce the incidence of genital warts by 90%, cervical cancer by 75%, other cancers of the genital tract and also of the oesophagus and some oropharyngeal cancers, the hospital claims.
Every year 3,000 new cases of cervical cancer are diagnosed in Britain and three women under 44 die every day from the disease.
Dr Tina Peers, consultant in contraception and sexual health, has set up a new clinic at Spire Gatwick Park Hospital to administer the vaccine and provide advice to women and the parents of girls aged 12 and over.
“The benefits of this vaccine will be felt by women and their families for a long time,” she said. “Although the government has recommended that the vaccine is available on the NHS for 11-12 year olds from next September there has been no announcement of a catch up programme so those girls aged between 13 and 24, who are most at risk will not receive treatment on the NHS.”
Spire Gatwick Park Hospital
0845 6035511
Surgical Cure For Genital Warts
A surgical cure for genital warts involves the use of one of these four methods: surgical excision, cryosurgery, laser treatment or electrocautery.
The laser surgery consists on the use of laser on the warts to kill them and to stop the bleeding. This procedure may require the use of anesthesia.
Electrocautery is similar to laser surgery except that it uses electricity instead of laser. Electricity runs through a special instrument to produce the necessary heat to burn the warts off. Generally, this procedure is performed under local anesthesia.
The other method is called cryosurgery. It involves the freezing of the warts using liquid nitrogen at -196°C to damage their tissues. This procedure is not as painful as electrocautery, and it can be carried out without the use of anesthesia.
There are also cases when the doctor would chose to perform a surgical excision on the genital warts using scissors or a scalpel. In this case anesthesia can be local or general depending on the size of the warts an their location.
From Virus To Vaccine
The back story of the new cervical-cancer vaccine includes, among its many twists: Warts, Italian nuns, a virus old as humanity, a German scientist who shared DNA samples even with those who’d spurned him, numerous naysayers and red herrings, thousands of University of Washington student volunteers, a mended friendship — and a Peace Corps returnee who launched her pivotal career in sexually transmitted diseases (STD) through a chance encounter at the Northgate Mall.
“It didn’t seem to be a linear pathway to how I got here,” laughs UW epidemiology professor Laura Koutsky. She’s credited with developing the world’s first human papillomavirus (HPV) vaccine along with Dr. Kathrin Jansen, a yeast expert then at Merck Research Laboratories.
Human papillomaviruses are responsible for virtually all cervical cancers. Cervical cancer strikes 493,000 women every year and kills 274,000 of them, usually in their most productive years. After breast cancer, it is the second most common cancer among women. In poor countries, it is the leading cause of cancer-related death because Pap tests to screen for pre-malignant cells are not routine.
Talk about contagious! Within a year of first intercourse, a young woman has a 30 percent chance of becoming infected with HPV even if she has only one partner. Within three years, 60 percent of women are infected. By the time women are in their 40s, the infection rate is 70 to 80 percent.
Koutsky calls HPV “an equal-opportunity infection,” unlike other sexually transmitted diseases that tend to hover around people who have many sexual partners. You can get HPV your first time. You can even get it through genital contact without having intercourse.
Those were the startling results of Koutsky’s ground-breaking research that enlisted 900 women volunteers on the UW campus starting in the late-1980s for three years of pelvic exams, shots and detailed questions about their sex lives.
The dogma, back then, was that to learn about any sexually transmitted disease, you had to study high-risk populations at STD clinics. But Koutsky suspected that by the time people sought help at an STD clinic, they’d have already been long infected. It would be too late to figure out how and when they got the virus and how long it would take for the bug to damage cells.
So Koutsky also recruited at UW’s Hall Health outpatient clinic and focused on women who’d had fewer than four sexual partners in their lives. Her important early studies, published in the New England Journal of Medicine and the American Journal of Epidemiology, examined the disease’s natural history — what causes cervical cancer and HPV, who gets it and when.
Without knowing those basics, it would have been impossible to make a vaccine.
FLASH ON VACCINES, and most people think of scientists tinkering with slides and serums. (That was Jansen’s realm.) Koutsky’s role, as an epidemiologist, was to design studies that demonstrated the vaccines’ safety and effectiveness, an endeavor considered so significant that Koutsky is first author on the scientific papers announcing the vaccine breakthroughs.
Two of Koutsky’s key studies, published in 2002 and 2007 in the New England Journal, proved HPV vaccines were effective. “You can have a million vaccines out there,” Koutsky says, “but do they work? Can you point to data that say this product is safe, this product is effective, it does what we think it should do in a group of people”?
In a May 10 editorial in the New England Journal, Dr. Christopher Crum writes: If the promise implicit in the study by Koutsky et al. is realized, we could, in our lifetime, see the gradual but progressive dismantling of the barriers to preventing cervical cancer. The captives of our current system — both patients and their caregivers — may be set free.
For most people, the immune system tackles and virtually clears HPV infections in one to three years. But about 15 percent of the time, the virus lingers. This can lead to warts or cancer in men, women and youths. That’s why our health system promotes frequent Pap smears and removal of suspicious pre-cancerous lesions. Such intensive monitoring and treatment carries a hefty price tag, never mind the stress.
“The HPV vaccine ranks with the hepatitis B vaccine as the two most important vaccines to be given to prevent cancer,” says Dr. King Holmes, chairman of the UW’s Department of Global Health and director of the Center for AIDS and STD. “Laura brought the HPV vaccine trials forward in the most efficient manner possible. There were no missteps. As a result, this is a vaccine that got out to women more quickly and with all of the right considerations.”
Creating a vaccine and getting it to the public was a monumental task involving hundreds of scientists, thousands of volunteers, layers of logistics on everything from syringe length to inadvertent pregnancy.
Koutsky’s team had to figure out how many volunteers to recruit, how many shots to give and when, how long it takes to become infected (or not), when you have enough information to stop. They enrolled 12,167 young women in a randomized, double-blind, placebo-controlled trial at 90 sites in 15 countries and followed them for three years.
In all, it took more than two decades to create Gardasil, the new Merck vaccine that protects against four types of HPV (two cancer viruses and two wart viruses) using Koutsky’s 1980s natural-history study as a starting point.
In the world of vaccines, that’s fast.
LAURA KOUTSKY was born in Seattle in 1953 and grew up in the Montlake and Laurelhurst neighborhoods, the middle of five children of a surgeon dad and stay-at-home mom.
Her mother, Ruth, says Laura always knew how to make her laugh, and even as a young child would befriend underdogs. Her sister describes Laura as an artistic, happy-go-lucky kid, a cheerleader and athlete who loved swimming, water skiing, doodling and exploring around their Whidbey Island cabin. Even though their father was a doctor, Koutsky says her parents never pressured the kids to go into medicine or the sciences, though they did emphasize a responsibility to give back to society.
“I was not driven at the age of 5 to become an epidemiologist,” Koutsky says. “I wasn’t even driven at the age of 20!”
In retrospect, however, she recalls vaccinations were a big deal. The family’s home movies chronicle childhood birthdays, Christmas morning — and the day they all got the polio vaccine.
At Roosevelt High School, a teacher sparked Koutsky’s interest in biology, which became her major at the University of Oregon. One summer, she studied invertebrate zoology at the Oregon Institute of Marine Biology outside Coos Bay. Every day, she wandered the tide flats for hours in hip waders. “It was fascinating. It had to do with patterns and relationships and evolution. Worms. Insects, mammals.”
Yet she soon realized careers in marine biology begin by washing a lot of glassware on research vessels. A friend suggested the Peace Corps.
Koutsky landed in the South Pacific kingdom of Tonga with an array of colorful homemade dresses and her usual enthusiasm. She credits the Peace Corps with directing her talent, strengthening her internal resolve.
“I learned there’s a lot in life that isn’t going to turn out the way you think it will, and you have to find solutions for problems you’d never thought you’d confront; and in the end, you will feel good if you solve these problems.”
She was charged with teaching high-school biology but had no textbooks, no paper, no writing utensils. There was a chalkboard. But no chalk. “So you get to be friends with the other teachers,” Koutsky says, “and arrange to use their chalk when they’re not using it.”
Luckily, Koutsky could draw. Cells, granules, organ systems. A natural teacher, she was also a great listener, recalls fellow Peace Corps volunteer Julianne Hickey. Students would go to her for additional help. They could tell if she was home by whether her black bike was parked out front. After the Peace Corps, Koutsky applied to the UW’s School of Public Health with an eye toward international health. She was rejected. “They were underwhelmed by my undergraduate transcript. B-minus.”
Around that time, while shopping at Northgate, she ran into a former junior-high classmate who was headed to medical school and leaving behind her job as research assistant in the lab of King Holmes, a world expert on sexually transmitted diseases.
“I wouldn’t recommend just anybody for my job,” Julie Adam says. “But I had always believed in Laura. She’s very intelligent, she has ethics, a big heart. She was able to bridge many groups of people. And she’s a hard worker.”
Over the next year, while gathering data about chlamydia in pregnancy, Koutsky fell in love with epidemiological research. “The idea of being able to ask questions about what was causing a disease!” She was immersed in patterns and relationships, just like during her beloved summer on the tide flats, only this time in a landscape of diseases and populations. It was like being a detective investigating the links between humans, environment, behaviors, organisms and disease.
Koutsky also realized she loved the dynamics of working with scientists who hypothesized, challenged each other’s ideas and contributed different bits to solve a problem: Collaboration. The UW School of Public Health accepted her the following year, and she eventually pursued a doctorate in epidemiology, all the while continuing to work in Holmes’ lab.
“She came in here with her eyes wide open ready to take on anything,” Holmes recalls. “My initial impression was that she was incredibly enthusiastic and at the same time very level-headed. It became apparent as we worked on many different projects that everything she put her hand to came out successfully.”
Come time for her dissertation project, Koutsky proposed studying the link between sexually transmitted diseases and spontaneous miscarriages. Holmes thought the project would be problematic and costly.
Besides, HPV was rising on the horizon as the next big sexually transmitted disease. He wanted Koutsky to tackle it. “She’d worked on 14 different STDs and was unique in having so much experience . . . Of all the young people we had coming along, she was the best prepared to handle it.”
HUMAN PAPILLOMAVIRUSES evolved with humans a million years ago. Ancient Greeks and Romans described genital warts thousands of years ago. But for most of human history, no one understood how sex, HPV and cancer were linked.
People had long suspected a relationship between cervical cancer and sex. In 1842, Italian physician D. Rigoni-Stern reported that nuns had virtually no cases of the disease; cervical cancer was rare among married women; the rate among prostitutes was unusually high. By the 1900s, it became clear. Women with more sex partners were more likely to get cervical cancer.
By the 1960s, researchers surmised that one or more sexually transmitted diseases caused cervical cancer — perhaps herpes or chlamydia, they thought. Then, in the 1970s, Harald zur Hausen, a German cancer researcher training at the University of Pennsylvania, bucked conventional wisdom, demonstrating that HPV was a family of viruses that caused everything from common warts to malicious cancers of the cervix, and more rarely, of the anus, penis, mouth and neck. Until then, nobody realized certain viruses could cause cancer.
Zur Hausen freely shared with labs worldwide the viral-DNA fragments he’d painstakingly isolated, an act credited with speeding up vaccine research. (And unlikely to happen now, Koutsky says, in an age when everyone wants to patent everything.)
Your skin, right now, is probably covered in human papillomavirus; there are more than 200 types. Two, HPV-16 and HPV-18, cause 70 percent of all cervical cancers.
Koutsky’s natural-history studies proved a strong temporal relationship between cervical cancer and those two. Soon after becoming infected with those virus types, women developed abnormal cells; sometimes these progressed to lesions, including the sort that typically turn into cancer. (In the study, lesions were removed before becoming cancerous.)
The fact that it took only months to go from infection to bad Pap — instead of 10 to 20 years as previously thought — meant it would be realistic to test a vaccine.
“No one believed it,” says Dr. Nancy Kiviat, who collaborated with Koutsky on the natural-history study and now directs pathology/cytopathology at Harborview Medical Center. It was Kiviat who developed the assays to test whether women in Koutsky’s early study had HPV and which type. Not an easy task.
“Now, everybody gets the same answer and tests are more standardized,” says Denise Galloway, a microbiologist and collaborator on the natural-history study. “In the late ’80s, early ’90s, everybody was using different techniques, and the results were a mess. HPV was everywhere or was nowhere.”
To double-check lab results, dual samples from each woman were sent to different labs. The results should’ve matched. Not even close. Kiviat worried her lab was wrong. Koutsky pored over the data and recognized consistent patterns in Kiviat’s results. These are right, she reassured her colleague.
Koutsky credits Kiviat with teaching her the power of collaboration. Early in their careers, the two were icy competitors, each recalls. After about a year, Kiviat approached Koutsky:
You know, as a pathologist, I’m going to develop lab expertise and clinical expertise and you’ll have the epidemiologic, analytic, biostatistical expertise. If we work together, we could have the world!
The rivalry melted. They became lifelong friends and collaborators, Kiviat’s lab central to the success of Koutsky’s studies.
Around the same time, DNA technology was moving forward. Until then, the problem with HPV was that you couldn’t grow it in a lab, ruling out a vaccine based on live or attenuated HPV virus. New molecular technology made it (theoretically) possible to snip fragments of viral DNA and insert them into a vehicle that could infect the cell systems of insects or yeast. That would produce a capsid protein, or viral shell, that could stimulate an immune response without transmitting disease.
Enter Kathrin Jansen, a scientist at Merck with expertise in yeast. She was a newcomer to the HPV field when she met Koutsky at a conference.
Jansen believed she could use yeast to make an HPV vaccine; Merck had already made a hepatitis B vaccine using a similar concept. She needed Koutsky’s HPV expertise to design a vaccine trial. Jansen: “If you design a study wrong, involve too few people, you can have a trial that will not reach statistical significance.”
Koutsky’s team enrolled 2,392 young women in a double-blind trial to test the HPV-16 vaccine Jansen had created (an arduous years-of-late-nights-in-lab process using a dozen different yeast strains).
The volunteers received three doses of either placebo or vaccine and underwent Pap tests about every six months. Koutsky’s team figured that by the time 31 women had persistent HPV-16 infection they’d know whether the vaccine had any impact. After 17 months, the 31st woman tested positive for persistent HPV-16. The study was unblinded to a biostatistician. All of the persistent HPV-16 infections were in women who’d received the placebo. None of the vaccinated women had the virus.
“We were clapping and jumping through the hallways” at Merck, Jansen recalls. Immediately, they phoned Koutsky with the good news. Was it by chance that a vaccine for women was developed by women? Coincidence, Jansen says. “But then, it was a lot of fun to have it go that way.”
Next decision: Which strains of HPV to include in the vaccine that would go to the public? Everyone agreed two of the four spots should go to HPV-16 and HPV-18, the virus types causing most cervical cancer. Koutsky wanted to fill the other two slots with two more cancer types. Jansen argued for a couple of genital wart virus types to make the vaccine appealing to men.
Because men don’t have cervixes, they can’t get cervical cancer. But like mosquitoes that transmit malaria to humans, men carry and transmit HPV to women. (Men who have sex with men are also at risk for anal cancer.) If both men and women were vaccinated, HPV rates might decrease faster in the general population, an effect known as herd immunity.
“Look, Laura,” Jansen said. “So what makes it palatable for a young man to get immunized if he doesn’t get a benefit for himself? You count on the goodwill of that person? You know, I imagine it must be quite devastating to have one of those big, ugly things growing on his penis, right? Certainly not very attractive, and the treatment is not particularly pleasant . . .”
Koutsky was convinced.
Licensed last summer, the Merck vaccine protects against two cancer viruses and two genital wart viruses. It’s targeted at girls around age 12, before they become sexually active. That makes it controversial among parents who worry the vaccine could encourage sexual relationships.
Parents have to look at facts, the epidemiologist says: 40 percent of 16-year-old girls are sexually active; 70 percent of 18-year-old girls are. Washington state fully covers the vaccine for girls 18 and younger. At $360 for the three-dose series, that’s a significant savings.
Now that Koutsky’s developed the vaccine, she’s on to the next challenge: Getting it to the public. “It would be a travesty if we have this highly safe and effective vaccine and it doesn’t get used.”
HPV vaccine recommended for women through age 26
Human papillomavirus, a disease that causes 70 percent of cervical cancer cases and 90 percent of genital warts cases, is most common for people in their late teens and early twenties, according to the Centers for Disease Control and Prevention Web site.
HPV was publicized widely earlier this year when Texas Governor Rick Perry tried to make the vaccine, called Gardasil, mandatory for all girls entering the sixth grade. The vaccine, generally thought of in regard to pre-teenage girls, actually is recommended for women through the age of 26 years old.
“If I were a 26-year-old who had never had intercourse or had never been exposed to the virus, I’d get the vaccine,” said Dr. Roger Yandell in the Department of Obstetrics and Gynecology at the Texas Tech Health Sciences Center. “It definitely has more impact on younger girls, though. The cervix changes during menarche, a girl’s first period. That’s when it’s most susceptible to the virus, so we try to start the vaccine just before that takes place.”
The Advisory Committee on Immunization Practices consists of 15 experts - selected by the Secretary of the U.S. Department of Health and Human Services - who provide advice and guidance to the CDC. The committee recommends women through age 26 years old receive catch-up vaccinations, according to the CDC Web site.
“You have to look at what we’re trying to treat,” Yandell said. “Cervical cancer is really what we’re talking about here, and on a lesser scale, genital warts. This is the most common disease for causing either of those.”
Unlike many vaccines, Gardasil is a recombinant vaccine, which means it does not contain any live forms of the virus. According to the CDC Web site, the vaccine is comprised of proteins from the outer coat of the virus.
“There are a lot of different ways to make a vaccine,” Yandell said. “In this case, it works extremely well.”
The Food and Drug Administration first licensed Gardasil in June, 2006, according to the FDA Web site.
The vaccine protects against four different strains of HPV - types 6, 11, 16 and 18, according to the CDC Web site. At least 50 percent of all sexually active people will get HPV at some time in their lives. Approximately 6.2 million Americans get HPV each year.
Yandell said the reason college students need to be aware of this is that the risks increase with higher rates of sexual activity.
“For years - and I mean centuries - we’ve known that women with higher numbers of sexual partners have a greater risk for cancer,” he said. “It’s a sexually transmitted disease, and we’ve known that for a long time.”
There are approximately 100 types of HPV, Yandell said. The virus usually infects a woman’s cervix, altering the cells there. Most strains cause no symptoms and go away on their own, after which the cervical cells return to normal. Some types, however, do not go away. Instead, they continue to change the cells, which eventually can lead to cervical cancer.
“The virus invades the cells,” he said. “It changes them into something half-virus, half-human.”
According to the American Cancer Society Web site, www.cancer.org, approximately 11,150 women will be diagnosed with cervical cancer in 2007. About 3,670 women will die of it this year. According to the Web site, women can prevent most precancers of the cervix by avoiding exposure to HPV.
“We have a vaccine with the potential to eliminate one type of cancer,” Yandell said. “The sooner you get the vaccine, the higher your chance of being protected for the rest of your life.”
There is no treatment or cure for HPV, according to the CDC Web site. It is recommended that all women get the vaccine before contracting any form of HPV.
However, women who already have contracted one form still can benefit from the vaccine because it prevents four strains of HPV.
“The key is to get the immune system to recognize the virus,” Yandell said. “This could be a cure for a very nasty type of cancer. This has the potential to eliminate maybe 90 percent of that.”
10 Percent of Women Infected with Human Papillomavirus by Age 16
A new study by the Health protection Agency estimates at least 10% of young women in England have been infected with one or more strains of the human papillomavirus (HPV) by the age of 16. The study will be discussed on the last day of the Health Protection Agency annual conference in Warwick.
The study, the first of its kind in England , investigated the proportion of women aged 10-29 years who had antibodies indicating they had been infected with HPV. Researchers tested blood samples from 1483 girls and women for types of HPV that can cause genital warts and cervical cancer. Results show that from the age of 14, the risk of HPV infection increases sharply.
Some HPV infections can cause cervical cancers in women and genital warts in both women and men, although most infections with HPV cause no symptoms and clear on their own.
Andrew Vyse, who is presenting the study to the conference said: “This study gives us vital information about how common HPV infection is in young women of different ages. However it does have some limitations and does not give a precise estimate of infection rates in young women in England therefore more work needs to be done.
“The study adds to what we already know about HPV, however we still need to learn more about the risks of infection and of the risks for persistent infection and progression to cancer.
Professor Pat Troop , Chief Executive of the Agency said: “This study is a valuable addition to our understanding of HPV infection in women in England and should contribute to effective policies to prevent genital warts and cervical cancer.
“With the Government’s recent announcement of the possible introduction of HPV vaccination, such research will help us and other public health experts to determine the impact of HPV vaccination.”
Basic facts on HPV
HPV (human papillomavirus) is the common wart virus. It is the cause of the various kinds of warts (genital warts, plantar warts, flat warts) as well as cervical dysplasia, vaginal dysplasia, and cervical cancer. HPV has been implicated as a cause of infertility, miscarriages, vaginosis, vaginitis, vulvar vestibulitis syndrome, prostate disease, and laryngeal papillomatosis.
Common misspellings for human papilloma virus include human papillomavirus, human papilloma virus, human papiloma virus, human papaloma virus, human papalloma virus, human pipiloma virus, human pipilloma virus, and many more.
It is impossible to determine how long someone has had an HPV infection. Neither men nor women are routinely tested for HPV. Women are “indirectly” tested for HPV by a Pap smear which shows “HPV characteristics” if the HPV has damaged some cells resulting in cervical dysplasia. If the cells are not damaged, the HPV goes undetected unless a Digene Hybrid Capture® HPV DNA Test is done.
Other test methods (specific blood tests) may show that there has been HPV infection in the past, but they cannot determine if HPV is currently present. HPV is usually diagnosed because the cervical or vaginal cells obtained by Pap smear or biopsy have the “characteristic appearance of HPV-infected cells” under the microscope.
HPV is not always transmitted sexually. However, the types that cause anogenital warts (also called condylomata acuminata, venereal warts, genital warts, vaginal warts, and penile warts) and cervical dysplasia are most commonly sexually transmitted, like low risk HPV types 6, 11, 42, 43, and 44. For this reason HPV is classified as an STD (sexually transmitted disease) and can be transmitted through sexual intercourse, oral sex, anal sex, or any skin-to-skin contact.
Some women develop genital warts, cervical/vaginal dysplasia, or both, while others become carriers with no signs or symptoms, or they become immune to certain HPV types. Men generally develop genital warts, become carriers, or develop immunity.
HPV is contagious even when warts and dysplasia are not present. Some HPV types have a greater association than others with cervical dysplasia and cancer like high risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. All of the HPV types are contagious.
HPV can lie dormant in humans for an unknown period of years. However, most individuals develop immunity, after which time they are no longer contagious.
It is impossible to prove that someone does NOT have any HPV types. It is relatively easy to prove when someone DOES have HPV, if (1) signs or symptoms are present, or (2) the Digene Hybrid Capture® HPV DNA Test is positive.
Some feel that HPV remains in a carrier state for years; however, this is probably uncommon. There are over 70 types of HPV. This may be the reason some believe that long carrier states are common. What may be viewed as a carrier state may simply be subsequent infections by different HPV types over the years. There are over 300 rhinoviruses (cold viruses), yet no one considers a cold virus to be in a perpetual carrier state that “flares up” periodically.
There is very little cross-immunity between the different HPV types. This means that if one has immunity to one HPV type, that specific immunity is not necessarily good against another HPV type.
Genital warts rising by 30 percent a year
The incidence of genital viral warts on the island is rising by 30% every year in both men and women.
That was the verdict of Dr Constantinos Demetriou, President of the Cyprus Society of Dermatology and Venereology yesterday.
“If the increasing global numbers of sexually transmitted disease carriers spread fear, the numbers in Cyprus are shocking, considering its size,” he said. “These statistics call for an immediate education of the population, for it has become a public health issue.”
A news conference yesterday was the start of an intensive campaign for educating the public regarding genital warts, which are a result of the Human Papilloma Virus (HPV).
“We do not have exact statistics for the island as diagnosis is difficult, with some people not even knowing that they are carriers until they are examined by a doctor.”
He then gave an example. “I am discovering warts in as many as 20 percent of women that come to me for laser hair removal of their bikini line.”
According to Demetriou, it has been estimated that 30 million people are infected every year, globally. “At the same time the problem in Cyprus is reaching disturbing levels due to the lack of education amongst the general public. The virus is not curable but there is prevention.”
The virus, which is mostly spread as a result of sexual intercourse, appears mainly in adults of both sexes with those aged 13-26 being more vulnerable. Symptoms of the virus include burning during urination, excretions of the urethra and vagina and unbearable itching or burning of the genital area during the night, and wounds, glandules and exanthema with or without symptoms in the genital area.
Nevertheless, the great majority of genital HPV infections never cause any overt symptoms and are cleared by the immune system in a matter of months.
Preventive measures against the virus include dermatological examinations once or twice per year, and women should have the Pap Test once every year. Therapeutic measures are taken with drugs, which mainly target the immune system of the carrier. Even though there is no cure, there is definite prevention with a quadrivalent vaccine against cervical cancer, which has the additional strength to offer complete prevention from HPV types 6 and 11, which cause genital warts. The vaccine has been available in Cyprus since January.
The Cyprus Society of Dermatology and Venereology highlights that the vaccine, against cervical cancer and genital warts, should be administered to boys and girls at the beginning of adolescence, as a protective measure against both diseases.
Monica Kyriacou is the medical advisor for Merck Sharp & Dohme, who hold the marketing authorisation for the Silgard vaccine against HPV.
“The vaccine is totally protective against the two main virus types that lead to genital warts,” she explained.
Human Papilloma Virus Vaccines May Decrease Chances of Oral Cancer
The Centers for Disease Control report that nearly 25 million women are infected with some form of the Human Papilloma Virus (HPV). Of those, more than three million are thought to have one of the four strains known to cause cases of cervical cancer and genital warts.
HPV is linked to oropharyngeal cancer and may be linked to oral cancers as well, and vaccines that have been developed to treat HPV might decrease the risk of these cancers, according to a study in the May/June issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD).
James J. Closmann, BS, DDS, the lead author of the study, found that oral and oropharyngeal squamous cell carcinoma (OOSCC) have been linked to high-risk HPV strains, the same strains that cause cervical cancer.
Recently, a vaccine was developed to treat patients with HPV against cervical cancer, and this could have an effect on women’s oral health.
“More than 100 strains of HPV have been identified,” says Dr. Closmann. “They have been shown to cause other benign and malignant disorders, which now include those in the mouth. Nearly 30,000 new cases of oral and oropharyngeal cancer are reported each year. It’s possible that oral and oropharyngeal cancers could be reduced if vaccination were more widespread; however, additional research is needed.”
Additional research could result in a comprehensive test for dentists at patients’ semiannual visits. However, a dentist can perform a head and neck exam to detect early signs, despite the lack of a specific test.
A possible connection between HPV and oral cancers, and the stronger link to oropharyngeal cancers, is even more of an indicator that patients should visit the dentist twice a year to identify irregularities early.
“Visiting the dentist on a regular basis is an important factor in the detection of any oral health complication,” says Laura Murcko, DMD, spokesperson for the AGD. “Taking preventive measures is especially important, and your dentist can check for early signs of oral cancer.”
Oral Health Tips for Women:
- Keep your dentist informed about changes in oral health.
- Visit the dentist regularly, which will help them to detect changes in the mouth.
- Ask your dentist to take a full medical history to determine if you are at risk for certain problems.
- Ask your dentist to perform a complete head and neck exam to detect early signs of certain conditions.