HPV Vaccine For Young Men, Too

A few weeks ago, the Centers for Disease Control and Prevention and the Food and Drug Administration changed their recommendation for the HPV (Human Papillomavirus) vaccine for teenage males from “approved” to “recommended.”  Translation:  This important vaccine, once recommended for pre-teen, teen and 20-something young women, is now recommended for teen-aged and 20-something guys, too.
Here’s why:
The HPV vaccine is safe for males. I personally worked on HPV vaccine safety studies (full disclosure: I was compensated by Merck for my time). We have known for a while that HPV is safe in males – just as it is in girls and women. The only significant side effect is that teenage males will sometimes faint after getting a shot — but that seems independent of the ingredients in the shot itself. (Keeping young men seated for 15 minutes afterward reduces fainting risk.)
The HPV vaccine protects against several forms of cancer. Most people think about HPV as just preventing cervical cancer in women. Obviously, men do not develop cervical cancer. But there are plenty of other important benefits that make this vaccine worthwhile:

• We know from other studies that HPV vaccine prevents anal cancer in men (HPV is the only known cause of anal cancer). 
• It may prevent penile cancer in uncircumcised men.
• HPV-16 is more prevalent in adults at high risk for oral cancer. Men who  drink alcohol, smoke, chew tobacco, or have many sexual partners are six times more likely to have HPV-16 (the strain associated with 85 percent of HPV-related cancers) in their mouth. HPV vaccine prevents HPV-16 from flourishing in the mouth, animal studies show.
• The vaccine may help prevent the transmission of HPV to women, as well. Experts are still debating this, but since several strains of HPV cause cervical cancer in women, stopping the spread of this virus in every way possible is important. (Young women should receive the vaccine, too.) 

Don’t wait ‘til he’s older. Still worried? Some parents will say: “my son is so young and this is about sex!” But this vaccine is most effective if guys receive all three doses before they are sexually active.  And — like it or not — most kids will soon be young adults and will have sex.
So when your medical practitioner wants to give your 11- to 26-year- old son the series of three HPV immunizations, say yes. Health insurance now pays for the vaccine. If you do not have insurance and your child is not eligible for free immunizations, the HPV vaccine series will cost over $600. Expensive, but you may decide it’s worth the price.  

Source : http://www.philly.com

HPV Vaccine To Prevent Cervical Cancer

Cervical cancer may not sound familiar in the ears of society. However, a cancer that lodged in the cervix of these women will not cease to haunt the women in Indonesia. If there is a myth, cervical cancer is preventable. In fact, vaccination of human papilloma virus (HPV) is the primary prevention of cervical cancer by helping the formation of antibodies.
 

"Indeed, in developing countries, knowledge about this cancer is still lacking. This is due in terms of geography and also the limitations of manpower and funds, "said Dr. Supriyadi Gandamiharja. Dr. SpOG (K), Konsulen Sub - Section Gynecology - Oncology, Department of Obstetrics and gynecology RSHS, while conveying the material in the Seminar and Talkshow "Save Your Area", Prevent and Cervical Cancer Early Detection, in the Auditorium Building Lt.2 Teaching Hospitals (RSP ) Unpad-RSHS, Sunday (19/02).
 

Cervical cancer that affects women is caused by HPV, with HPV type 16 and type 18 together cause 71% of cases of cervical cancer. This cancer can affect all ages, but the incidence will increase in women over the age of 40 years.
 
"For married women, cervical cancer can be detected through Pap Smear Test, test VIA (Visual Inspection with Acetic Acid), and Thin Prep," said dr. Supriyadi in front of about 350 participants. Also attending as a speaker at the event, dr. Lien Rohalina Cancer Foundation Oesadi of Indonesia, Bandung and Siti Maryam, a patient with cervical cancer.
 
In contrast to other viral infections such as hepatitis are often characterized by symptoms of fever, HVP virus causes no symptoms because the cells that attack specific parts of the cervix. However, dr. Supriyadi added that cervical cancer can be prevented, one way is to find and treat pre-cancers before they become cervical cancer.
 
"Nurture reproduksimu organ, making the organ reproduksimu for healthy reproduction. Inspect regularly, and do the vaccination, "the message dr. Supriyadi.
Met on the sidelines of the event, Chairman of the Committee Jessica Nadia, sked., Said that the seminar was organized by students of Professional Education Specialist (PPPDS) parts of Obstetrics and Gynecology FKUP-RSHS.
 
"This event was organized as an effort to increase public awareness and concern about the importance of prevention and early detection of cervical cancer of women," explains Jessica.
 
In addition, the committee also opened the service PAP smear and HPV Vaccination in place. The enthusiasm of participants of the seminar was also seen in the booths that provide the committee, such as stand-service laboratory serving Prodia PAP Smear and stand-RSHS FKUP serving HPV vaccination.
 
"For HPV Vaccination, especially for the register at the event, will be given a discount of 30% of RSHS. If the vaccine is usually a one-time, the patient must pay about 900ribu dollars, in the event the patient only pays 630ribu rupiah. And, the vaccine should be done for 3 times, "explains Jessica.
 
However, the price is quite expensive to vaccinate, did not dampen the desire of one seminar participant. Gita, for example. Student from one of the colleges in the city of Bandung was deliberately come and attend seminars and enroll to vaccinate. Important to him, to prevent cervical cancer early.
 
"Yes, I came here to do the vaccinations. I know, the cost of vaccination was indeed expensive. 3 times the vaccination could almost 3 million dollars. Here, I can do the vaccinations with affordable price, "says Gita.
 
Jessica then added that if the view of the problems occurred, he expects the public will increasingly understand the dangers of cervical cancer and get the right information and clear about the benefits of prevention and regular screening.
 
"If there are still many myths about cervical cancer out there, we align the events ni. It is hoped the participants will be more aware of the dangers of this cancer, and can pass this information to the public a lot, "added Jessica. *
 

Reported by: Lydia Okva Anjelia

Source : http://www.unpad.ac.id

HPV testing followed by smear could improve cervical screening

Testing for the human papillomavirus (HPV) – a virus most women will encounter at some point in their lives – followed by a smear test if they are HPV positive, provides the most effective approach for cervical screening, new research shows today (Wednesday).

The study, published in the British Journal of Cancer*, gave around 26,000 women both smear and HPV tests to determine how best to use HPV testing for cervical screening.

Up to 8 out of 10 people in the UK will be infected with the HPV virus at some point in their lives.

Previous studies have shown that HPV testing could be more effective at picking up women with severe cervical cell changes, but there have been some outstanding questions about how an HPV based programme should be implemented. For example, it has been unclear how best to manage women with positive results from an HPV test.

Having carried out these tests, researchers looked at how likely women with different combinations of test results were to have severe cervical cell changes – known as CIN3.
They concluded that using HPV testing as the first line screening test, as well as smear testing for women who received a positive HPV result, could improve the performance of an HPV test for cervical screening.
Using this combination approach would mean that only women with the highest risks of having CIN3 were referred for further tests - reducing unnecessary examinations and picking up more serious cervical cell changes.

Dr Chris Meijer, study author based at the VU University Medical Centre in Amsterdam, said: “From a health-economic perspective cervical screening with a primary, stand-alone HPV test seems to be preferable based on this study.

“But a smear test is still a very useful way to estimate a woman’s risk of severe cervical changes and can help maximise the benefits of HPV testing in a cervical screening programme.”
Under the new screening process proposed by the researchers, women with a negative HPV test had an extremely low risk of CIN3, regardless of their smear test result, and so could safely return to routine screening every five years.**

Those who had a positive HPV test, and whose smear test results showed abnormal changes in the cervix, had a 42 per cent chance of having CIN3 and would be sent for a colposcopy to examine the cervix more closely.

But if smear test results in HPV positive women were normal, the researchers calculated that the woman had a five per cent risk of CIN3. This is too high a risk to safely return to normal screening, but not high enough to warrant an immediate colposcopy, and so the researchers recommended a follow-up smear in a year to monitor the cell changes.

If the result of this second test was also normal, the woman had a 1.6 per cent risk of CIN3 – which is low enough to return to routine screening.

If the second smear result was abnormal, the researchers said there was a 25 per cent risk of CIN3 and the woman would be referred for colposcopy.

Since 2008 in the UK, girls aged 12-13 have been vaccinated against two types of HPV which account for over 70 per cent of cervical cancers in the UK.

HPV testing can still be useful - even among women who have been vaccinated - to catch cervical cell changes caused by other HPV types. It can also protect women who haven’t been fully vaccinated.
More research will be needed to confirm the best strategy for cervical screening when most women have been vaccinated.

Sara Hiom, director of information at Cancer Research UK, said: “This study provides a very useful insight into how HPV testing could work if it were used as a major part of cervical screening.

“The findings help answer some of the questions that would need to be considered should the UK refine its highly effective cervical screening programme.

“The process outlined in this study would need to be fully tested to see if it is as effective as the study results suggest, and to establish some of the practicalities of using this combination of tests in the UK screening setting.

“The UK’s cervical screening programme already saves about 5,000 lives every year, but as with most tests, it is not perfect. So we welcome any new evidence which can help make cervical screening even more effective.”



Source : http://info.cancerresearchuk.org/news/archive/pressrelease

Genital HPV Infection

What is genital HPV infection?

Genital human papillomavirus (also called HPV) is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat. Most people who become infected with HPV do not even know they have it.
HPV is not the same as herpes or HIV (the virus that causes AIDS). These are all viruses that can be passed on during sex, but they cause different symptoms and health problems.

What are the signs, symptoms and potential health problems of HPV?

Most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body’s immune system clears HPV naturally within two years.  But, sometimes, HPV infections are not cleared and can cause:

• Genital warts
• Rarely, warts in the throat -- a condition called recurrent respiratory papillomatosis, or RRP.  When this occurs in children it is called juvenile-onset RRP (JORRP).
• Cervical cancer and other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils).

The types of HPV that can cause genital warts are not the same as the types that can cause cancers. There is no way to know which people who get HPV will go on to develop cancer or other health problems.

Signs and symptoms of HPV-related problems:

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. Health care providers can diagnose warts by looking at the genital area during an office visit. Warts can appear within weeks or months after sexual contact with an infected partner—even if the infected partner has no signs of genital warts. If left untreated, genital warts might go away, remain unchanged, or increase in size or number. They will not turn into cancer.
Cervical cancer usually does not have symptoms until it is quite advanced. For this reason, it is important for women to get regular screening for cervical cancer. Screening tests can find early signs of disease so that problems can be treated early, before they ever turn into cancer.
Other HPV-related cancers might not have signs or symptoms until they are advanced and hard to treat.  These include cancers of the vulva, vagina, penis, anus, and oropharynx (back of throat including base of tongue and tonsils). For signs and symptoms of these cancers, see www.cancer.gov.
RRP is a condition in which warts grow in the throat. These growths can sometimes block the airway, causing a hoarse voice or troubled breathing.

How do people get HPV?

HPV is passed on through genital contact, most often during vaginal and anal sex. HPV may also be passed on during oral sex and genital-to-genital contact. HPV can be passed on between straight and same-sex partners—even when the infected partner has no signs or symptoms.
A person can have HPV even if years have passed since he or she had sexual contact with an infected person. Most infected persons do not realize they are infected or that they are passing the virus on to a sex partner. It is also possible to get more than one type of HPV.
Rarely, a pregnant woman with genital HPV can pass HPV to her baby during delivery. Very rarely, the child can develop juvenile-onset recurrent respiratory papillomatosis (JORRP).

How does HPV cause genital warts and cancer?

HPV can cause normal cells on infected skin to turn abnormal. Most of the time, you cannot see or feel these cell changes. In most cases, the body fights off HPV naturally and the infected cells then go back to normal. But in cases when the body does not fight off HPV, HPV can cause visible changes in the form of genital warts or cancer. Warts can appear within weeks or months after getting HPV. Cancer often takes years to develop after getting HPV.

How common are HPV and related diseases?

HPV (the virus). Approximately 20 million Americans are currently infected with HPV. Another 6 million people become newly infected each year. HPV is so common that at least 50% of sexually active men and women get it at some point in their lives.
Genital warts. About 1% of sexually active adults in the U.S. have genital warts at any one time.
Cervical cancer. Each year, about 12,000 women get cervical cancer in the U.S. Almost all of these cancers are HPV-associated.
Other cancers that can be caused by HPV are less common than cervical cancer. Each year in the U.S., there are about:

• 1,500 women who get HPV-associated vulvar cancer
• 500 women who get HPV-associated vaginal cancer
• 400 men who get HPV-associated penile cancer
• 2,700 women and 1,500 men who get HPV-associated anal cancer
• 1,500 women and 5,600 men who get HPV-associated oropharyngeal cancers (cancers of the back of throat including base of tongue and tonsils) [Note: Many of these cancers may also be related to tobacco and alcohol use.]

Certain populations are at higher risk for some HPV-related health problems. This includes gay and bisexual men, and people with weak immune systems (including those who have HIV/AIDS).
RRP is very rare. It is estimated that less than 2,000 children get juvenile-onset RRP every year in the U.S.

How can people prevent HPV?

There are several ways that people can lower their chances of getting HPV:

• Vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer. These vaccines are given in three shots. It is important to get all three doses to get the best protection. The vaccines are most effective when given at 11 or 12 years of age.
  • Girls and women: Two vaccines (Cervarix and Gardasil) are available to protect females against the types of HPV that cause most cervical cancers. One of these vaccines (Gardasil) also protects against most genital warts. Gardasil has also been shown to protect against anal, vaginal and vulvar cancers. Either vaccine is recommended for 11 and 12 year-old girls, and for females 13 through 26 years of age, who did not get any or all of the shots when they were younger. These vaccines can also be given to girls beginning at 9 years of age. It is recommended to get the same vaccine brand for all three doses, whenever possible.
  • Boys and men: One available vaccine (Gardasil) protects males against most genital warts and anal cancers. This vaccine is available for boys and men, 9 through 26 years of age.
• For those who choose to be sexually active, condoms may lower the risk of HPV. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom - so condoms may not fully protect against HPV.
• People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That's why the only sure way to prevent HPV is to avoid all sexual activity.

How can people prevent HPV-related diseases?

There are ways to prevent the possible health effects of HPV, including the two most common problems: genital warts and cervical cancer.

• Preventing genital warts: A vaccine (Gardasil) is available to protect against most genital warts in males and females (see above).
• Preventing Cervical Cancer: There are two vaccines (Cervarix and Gardasil) that can protect women against most cervical cancers (see above). Cervical cancer can also be prevented with routine cervical cancer screening and follow-up of abnormal results. The Pap test can find abnormal cells on the cervix so that they can be removed before cancer develops. An HPV DNA test, which can find HPV on a woman's cervix, may also be used with a Pap test in certain cases. Even women who got the vaccine when they were younger need regular cervical cancer screening because the vaccine protects against most, but not all, cervical cancers.
• Preventing Anal Cancers:  A vaccine (Gardasil) is available to protect against most anal cancers in males and females. Screening for anal cancer is not routinely recommended because more information is still needed to find out if screening and follow-up interventions prevent these cancers.  However, some experts recommend yearly anal Pap tests to screen for anal cancer in gay and bisexual men and in HIV-positive persons. This is because anal cancer is more common in those populations.
• Preventing Penile Cancers: There is no approved screening test to find early signs of penile cancer.
• Preventing Oropharyngeal Cancers: There is no approved test to find early signs of oropharyngeal cancer[see www.cancer.org]
• Preventing RRP: Cesarean delivery is not recommended for women with genital warts to prevent juvenile-onset RRP (JORRP) in their babies. This is because it is not clear that cesarean delivery prevents JORRP in infants and children.

Is there a test for HPV?

The HPV tests on the market are only used to help screen women at certain ages and with certain Pap test findings, for cervical cancer. There is no general test for men or women to check one’s overall "HPV status," nor is there an approved HPV test to find HPV on the genitals or in the mouth or throat.

Is there a treatment for HPV or related diseases?

There is no treatment for the virus itself, but there are treatments for the diseases that HPV can cause:
Visible genital warts can be removed by the patient him or herself with prescribed medications. They can also be treated by a health care provider. Some people choose not to treat warts, but to see if they disappear on their own. No one treatment is better than another.
Cervical cancer is most treatable when it is diagnosed and treated early. But women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment. [see www.cancer.org]
Other HPV-related cancers are also more treatable when diagnosed and treated early. [see www.cancer.org]
RRP can be treated with surgery or medicines. It can sometimes take many treatments or surgeries over a period of years.







Source : http://www.cdc.gov/std/hpv/stdfact-hpv.htm

Cervical Cancer Screening

Cervical cancer is the easiest female cancer to prevent, with regular screening tests and follow-up. Two screening tests can help prevent cervical cancer or find it early—

• The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
• The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.

The Pap test is recommended for all women, and can be done in a doctor's office or clinic. During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory will check to be sure that the cells are normal.
If you are getting the HPV test in addition to the Pap test, the cells collected during the Pap test will be tested for HPV at the laboratory. Talk with your doctor, nurse, or other health care professional about whether the HPV test is right for you.
When you have a Pap test, the doctor may also perform a pelvic exam, checking your uterus, ovaries, and other organs to make sure there are no problems. There are times when your doctor may perform a pelvic exam without giving you a Pap test. Ask your doctor which tests you are having, if you are unsure.
If you have a low income or do not have health insurance, you may be able to get a free or low-cost Pap test through the National Breast and Cervical Cancer Early Detection Program. Find out if you qualify.

When to Get Screened

You should start getting regular Pap tests at age 21, or within three years of the first time you have sex—whichever happens first. The Pap test, which screens for cervical cancer, is one of the most reliable and effective cancer screening tests available.
The only cancer for which the Pap test screens is cervical cancer. It does not screen for ovarian, uterine, vaginal, or vulvar cancers. So even if you have a Pap test regularly, if you notice any signs or symptoms that are unusual for you, see a doctor to find out why you're having them.
In addition to the Pap test—the main test for cervical cancer—the HPV test may also be used to screen women aged 30 years and older, or women of any age who have unclear Pap test results.
If you are 30 years old or older and your screening tests are normal, your chance of getting cervical cancer in the next few years is very low. For that reason, your doctor may tell you that you will not need another screening test for up to three years. But you should still go to the doctor regularly for a check-up that may include a pelvic exam.
It is important for you to continue getting a Pap test regularly—even if you think you are too old to have a child, or are not having sex anymore. If you are older than 65 and have had normal Pap test results for several years, or if you have had your cervix removed (during an operation called a hysterectomy), your doctor may tell you it is okay to stop getting regular Pap tests.

For more information, please read the U.S. Preventive Services Task Force overview of cervical cancer screening recommendations.

How to Prepare for Your Pap Test

You should not schedule your Pap test for a time when you are having your period. If you are going to have a Pap test in the next two days—

• You should not douche (rinse the vagina with water or another fluid).
• You should not use a tampon.
• You should not have sex.
• You should not use a birth control foam, cream, or jelly.
• You should not use a medicine or cream in your vagina.

Pap Test Results

 It can take up to three weeks to receive your Pap test results. If your test shows that something might not be normal, your doctor will contact you and figure out how best to follow up. There are many reasons why Pap test results might not be normal. It usually does not mean you have cancer.
If your Pap test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. It is important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

Source : http://www.cdc.gov/cancer/cervical