Dr. Donnica Discusses Cervical Cancer Vaccine on GMA
(Far Hills NJ, 4/6/05): Dr. Donnica Moore, President of Sapphire Women's
Health Group and host of DrDonnica.com will appear on ABC's "Good Morning America"
tomorrow, April 7, 2005 to discuss exciting data about the cervical cancer vaccine
in development just released in the medical journal Lancet Oncology.
These new data confirm previous studies showing that a vaccine to prevent human
papilloma virus (HPV)--the sexually transmitted virus that causes cervical cancer
and genital warts--could reduce persistent infection and disease by 90%. "This
is important information for all women and men," emphasizes Dr. Donnica "because
HPV infection is widely spread throughout the majority of our adult population,
and most people don't know that they are infected."
Up to 70% of sexually active women will become infected with HPV during their
lifetime. Worldwide, cervical cancer is the second most common cause of cancer-related
death in women. HPV causes nearly 470,000 cases of cervical cancer each year.
Although most cases of cervical cancer occur in the developing world where
routine cervical screening programs are not readily available, in 2004 nearly 31,000
women died from cervical cancer in Europe and more than 4,000 women
died from cervical cancer in the United States. HPV infections are also
responsible for genital warts in 1-2% of young adults. Genital warts can cause
pain as well as sexual dysfunction. Recurrence is common and treatment is inconvenient,
uncomfortable, and expensive.
There are more than 100 strains of HPV which have been identified. Ten of them
have been shown to significantly increase the risk of cervical cancer. This
study, conducted by Luisa Villa (Ludwig Institute for Cancer Research, Brazil)
and colleagues, tested the effectiveness of a vaccine which targets four strains
of HPV: types 16 and 18, which are associated with 70% of cervical cancers and
types 6 and 9, which are associated with 90% of genital warts. The study evaluated
552 healthy women aged 16-23 from Brazil, Europe and the USA. These women were
not pregnant, had no previous abnormal cervical smears and reported a history
of four or fewer sexual partners. 277 women were randomly assigned to receive
3 doses of the intramuscular vaccine over a 6 month period; 275 women received
a placebo. The women were followed up for 36 months and underwent regular gynecological
examinations, tests for HPV DNA, and cervical smears. After 3 years, the incidence
of persistent infection or disease with HPV 6, 11, 16, or 18 fell by 90% in
those who received the vaccine compared with those who took the placebo. The
vaccine was 100% effective against precancerous cervical lesions and genital
warts associated with these four HPV types. There were no vaccine related serious
adverse events reported.
The study authors suggest that universal HPV vaccination might be most effective
if implemented in 10-13 year olds, who are likely to be HPV negative. According
to another study, a female college student had a 60% likelihood of becoming
infected with HPV during her four years in college. Vaccinating 10 to 13 year
olds is likely to meet with some resistance, however, by parents reluctant
to admit that their children might become prematurely sexually active or might
ever become at risk for a sexually transmitted infection. Dr. Donnica wants
to dispel any stigma associated with HPV infection. "Contracting an HPV infection
doesn't mean that you're promiscuous; it means that you had sex one time with
one person who probably didn't even know that they were infected," she said.
Dr. Villa comments that "In the developed world, full implementation of
cervical-cancer screening has substantially shifted the burden of HPV infection
from cervical cancer mortality to management of precancerous lesions. In these
countries, in addition to further reduction in incidence of cervical cancer,
universal HPV vaccination might decrease the medical, psychological, and economic
costs associated with the management of abnormalities detected by screening.
Inclusion of HPV 6 and 11 in a vaccine could also diminish the incidence of
genital warts. In developing countries that have not implemented screening programs
for cervical cancer, a universal HPV vaccine could substantially reduce the
incidence of the disease."
There are currently two different vaccines for HPV in development. The one
studied in this clinical trial is expected to enter the FDA approval process
sometime in 2005. It is hoped to be available in the United States in 2006.
Until then, to reduce your risk of cervical cancer, practice safe sex, have
routine Pap smears, and if you are a woman over 30 years old, ask your doctor
if you should have the DNA with Pap test which can identify if you have been
infected with HPV.