Pass the biscuits, and watch your mouth - From the Editor - human papilloma virus

Medical Laboratory Observer, March, 2003 by Celia Stevens

Human papilloma virus (HPV) would definitely not be a topic approved for polite dinner table conversation in the home where I grew up. That's no surprise. When we did a Web search for art ideas for this issue of MLO, we could see why: The photos we found of I-IPV were scarily ugly. Just be glad our cytologistlartist friend Suzanne Adams let us use her pretty pastel Pap smear drawing on our cover!

Seriously, cervical cancer -- the second most common form of cancer among women -- isn't a pretty picture, either. Each year, about 5,000 American women die of cancer of the cervix, and other 15,000 are diagnosed with the disease. It's now clear that nearly all cervical cancers are linked to one of the cancer-causing strains of HPV. If you never develop FIPV, the chances are great that you will never get cervical cancer.

HPV is important, because the understanding of I-IPV that the medical community has gained in the past few years is sure to make an extraordinary difference in women's health in the future. One day, we will be able to get a simple vaccination that will prevent women from acquiring HPV, which should keep us safe from cervical cancer.

What do we know about HPV? We know that it's the most prevalent sexually-transmitted disease in the world, occurring at some point in up to 75 percent of sexually active women, a shocking rate indeed. And, most people who are infected don't know it, because often there are no noticeable symptoms.

We do know that there are several risk factors for I-IPV:

* Sexual activity, especially beginning before age 20.

* Multiple sexual partners.

* Exposure to STDs.

* Mother or sister with cervical cancer.

* Smoking.

* Immunosuppression (such as HIV/AIDS or chronic corticosteroid use for asthma or lupus).

At least two vaccines that could prevent I-IPV are being tested, but estimates are that it will be several years before either are marketed. There's also an attempt to develop a therapeutic vaccine that would boost the immune system of someone already infected with the virus and help her fight off the cancer. However, because there's not yet a vaccine on the market to prevent HPV infection, primary prevention of cervical cancer hinges on the use of condoms and making choices that decrease a person's risk of becoming infected.

For women already hit by HPV, it is important that early, treatable precancerous lesions are identified and treated before the lesions become malignant.

New DNA testing methods for HPV have revolutionized cervical cancer screening. Drs. John Vernick and Carmen Steigman do a good job of explaining the new HPV DNA virus capture assay for us this month.

Testing for genital warts. Share this knowledge with your colleagues, patients and friends. Just remember not to bring up the subject at the dinner table.

Celia Stevens

cstevens@nelsonpub.com