The HPV vaccine and its effect on cancer screening and prevention
Introduction
Human Papillomavirus(HPV) is the most common sexually transmitted infection in the United States, according to Centers for Disease Control and Prevention(CDC) around 20 million people are infected with HPV and additional 6.2 million people are newly infected every year. According to National Health and Nutrition Examination Survey in 2003-2004 among sexually active women (57% of 14 to 19 years and 97% of 20 to 59 years) HPV was highest prevalent in youngest age group (40% of 14-19 years and 50% of 20-24 years). Infection rates decrease after age of 24 years. There are more than 100 types of HPV viruses out of which 40 cause genital infections. Out of these some 14 types of HPV are considered high risk because of their association with cervical and other genital cancers. CDC carried out a sentinel survey of cervical infections by high risk HPV in 2003-2005. They found that overall prevalence was 23%, and younger age groups from age 14 to 29 comprised more than half of cases. This survey also found that HPV 16 or 18 were found in 8% of cases.
According to World Health Organization (WHO) in a summary report in 2009 estimated that 11.4% of women in general population have HPV infection and 70.9% of invasive cervical cancers are due to HPV type 16 and/or 18. They have estimated that every year 493,243 new cases of cervical cancer are diagnosed and out of them 273,505 die from the disease. In the world cervical cancer is ranked as second most common cancer in women and second most common cancer in women between ages of 15 to 44 years. In US according to WHO 13.3% women in general population have HPV infection and 76.6% cervical cancers are...
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...er some time and then better integration of vaccine and screening will be possible. There are some unanswered questions about vaccine that will become clear as the time goes by. After the introduction of HPV vaccine the whole strategy of cancer screening has to change. HPV testing should be included as the primary screening test and cytology should be used for patients who are positive on HPV test. This will decrease the rate of false positive cytology examinations and will be more cost effective.
Conclusion
Introduction of HPV vaccine has created an opportunity to further reduce the incidence of cervical cancer. Screening cytology needs to be continued along with the screening as vaccine does not cover all the strains that cause cancer. So both vaccination and cavcer screening has to be used together and cost effectively to fight against cervical cancer.
There is an ongoing debate concerning if this HPV vaccine should be mandated or remain optional, because it is still undetermined if the vaccine is even necessary. Adams believes the vaccine is not necessary due to alternative preventative measures such as “adequate sunlight exposure and vitamin D consumption, supplementation with probiotics, adequate intake of selenium, and zince, increased consumption of trace minerals and iodine, regular phrysical exercise and many other safe, natural, non-paten...
“Human papillomaviruses are small, double-strained DNA viruses that infect the epithelium and cause common skin warts.” (CDC, 2012). Most HPV infections are asymptomatic and resolve on their own. About forty strains of HPV infect the mucosal epithelium, which can lead to cervical cancer. Cervical cancer was first thought to be linked to sexual activity in the 1960s, and in the early 1980s, in was proven that cervical cancer cells contained HPV DNA. The first publications of this were not until the 1990s. (CDC 2012). Because the detection of HPV was so recent, there are still many unknown factors regarding transmission and treatment.
Peripheral blood samples were collected from 150 individuals for use in this study. 77 of the 150 samples were collected from individuals with histologically confirmed cervical carcinoma. 25 of the 77 samples were collected from individuals with stage I cervical carcinoma. 23 of the 77 samples were collected from individuals with stage II cervical carcinoma. 18 of the 77 samples were collected from individuals with stage III cervical carcinoma. 11 of the 77 samples were collected from individuals with stage IV cervical carcinoma. 73 of the 150 samples were collected from healthy individuals with no cervical carcinoma. Ten cervical carcinoma sera samples and eight normal sera samples were used to biopan; the remaining 67 cervical carcinoma samples and 65 normal samples were used to evaluate predictive value by receiver operating characteristics (ROC) curves. Total RNA was extracted from the sample cells using the acid guanidinium thiocyanate-phenol-chloroform method using Trizol as the reagent. Random hexamers were used in cDNA synthesis. BMI-1 was amplified by polymerase chain reactions (PCR). The PCR products were analyzed using agarose gel electrophoresis to confirm appropriate size and sequencing. Cells were washed and
Park, Alice. "Why HPV Is Still Not a Straight Shot." Time 31 Aug. 2009: 49-49. Print.
...g in the injected area. Gardasil is not 100% effective, and it may not protect against all HPV types, including high risk HPV's. This vaccine is not meant to cure any existing HPV virus. The vaccine is given in 3 shots, each with a 6- month period of time in between. People can get it as early as 9 years of age, both male and female, all the way to age 26. Gardasil is covered by most health insurances. For those uninsured Merck is willing to provide vaccines, since Gardasil is not very cheap (“Learn about Gardasil” 2012).
It seems clear that, even though there are some relative risks, the HPV vaccine is a necessary addition to a child’s vaccine schedule. In an in-person interview with a family practice nurse practitioner, she expressed the following as her medical advice to unsure and unnerved parents. “When faced with a concerned parent, I explain to them this about his or her decision. Even if your child is a virgin until they get married, their partner might not be and your child would then be at the same risk in adulthood as they are now as a teenager. If someone could then tell you that a vaccine could prevent a majority of cervical cancer for your child later on in life, then that is a pretty big deal. This vaccine also prevents contraction of the STD and its genital warts.” (Flores, Joey). This medical professional is in the majority with the consensus of her peers, but it seems that there is still a low vaccination rate, even 10 years after the vaccine was approved. According to a 2014 study conducted by the CDC, there is still an overwhelming amount of concern among parents. The main reasons for concern documented are lack of knowledge, feeling that the vaccine was not needed or unnecessary, safety/side effect concerns, not being recommended by the child’s physician, and the child not being sexually active at the current
HPV DNA can be identified in 99.7% of all cervical cancers, with HPV types 16, 18, 45 and 31 being the most frequent. (Bosch et al 2005)
To conclude, I think mandating the HPV vaccine is not a good idea, but however I do recommend the vaccine for girls of age. There are a lot of impediments if the vaccine was to be mandated in order to attend school, being that there are individuals who are against certain vaccines. A member of a school board stated that she is all for girls to getting the vaccine because it will protect them from a devastating disease, but if its mandatory then you have to get into do you start to keep children out of school so the legal implications is what I’m a little uncomfortable with (Gaston, 2007). The ethical implications is that it will undermine the abstinence-based prevention message, interfere with one’s principle autonomy, religious values and beliefs, distributive justice matters and many implications on cost.
Adams, Heather P., and Erica L. Carnright. "HPV Infection And Cervical Cancer Prevention." Clinician Reviews 23.9 (2013): 42-50. Academic Search Complete. Web. 10 Nov. 2013
They also go on to say, “Two HPV types (16 and 18) cause 70% of cervical cancers and precancerous cervical lesions.” The most common forms of cancer caused by HPV are cervical cancers, anal cancer, vaginal, vulvar, and penile cancers, and have been seen to cause oropharyngeal cancer (National Cancer Institute). Some are more common than others and they are also less dangerous. Cervical cancer is the most common type of cancer caused by HPV. According to the World Health Organization, “In 2008, there were an estimated 529,000 new cases and 274, 00 deaths due to cervical cancer.” HPV is very dangerous and it is something that has to be taken
The first vaccine for human papilloma Virus (HPV) Gardasil was developed in 1993 by CSL. The technology used in Gardasil was later licensed from CSL by Dr. Kathrin Jansen of Merck in 1995. Together, Jansen and Merck, both were yeast experts used yeast from a library which had been developed from research on a hepatitis-B vaccine succeeded in developing large quantities of the shells which provided the foundation for Gardasil. By 2006, Merck had received FDA approval for Gardasil, as the first vaccine for human papilloma Virus (HPV), which had been identified as the cause of cervical cancer (Bethel University, 2011). Prior to FDA approval, Merck had begun to launch an intensive campaign for states to make the vaccine mandatory for girls ranging
Virulence factors of the causative agent: HPV contain certain proteins, E6 and E7, that inactivate the host’s tumor suppressor proteins. Which ultimately result in the rapid dividing rate that can’t be regulated
While Gardasil tends to protect against the Human Papillomavirus it doesn’t appear to protect against all strains of the virus. After Gardasil hit the market individuals started feeling the side effects fairly rapidly, and it’s known to cause paralysis, seizures, and autoimmune diseases, but does the vaccine out way the risk of getting cervical cancer (The Dangers, 2012)?
HPV can cause cervical cancer/or genital warts. There are studies that show the 50% of sexually active individuals has experienced this infection at some point in their life and males generally cay the virus. HPV is usually diagnosed as part of a gynecological exam. HPV is usually diagnosed as part of a gynecological exam. (Greenberg, Bruess, & Oswalt, 2014)
Treatment consists of surgery in early stages and chemotherapy and radiotherapy in advanced stages of the disease. An effective HPV vaccine against the two most common cancer-causing strains of HPV has recently been licensed in the U.S. These two HPV strains together are responsible for approximately 70% of all cervical cancers. Experts recommend that women combine the benefits of both programs by seeking regular Pap smear screening, even after vaccination. Symptoms of advanced cervical cancer may include: loss of appetite, weight loss, fatigue, pelvic pain, back pain, leg pain, single swollen leg, heavy bleeding from the vagina, leaking of urine or feces from the vagina, and bone fractures.