It has long been reported that the risk of HPV progressing to a significant level of precancerous and subsequently cancerous lesion are very low. I have long been concerned regarding just how accurate this information may be.
The rates of cervical cancer over the past half a century have dropped dramatically as a result of cervical screening programs which can identify abnormalities in advance of their becoming cancerous. As a direct result of these programs, high-grade lesions (CIN2, CIN3 and CIS also known as carcinoma in situ) are routinely treated and removed in an attempt to eliminate the potential for cancer.
HPV however, like many other contagious conditions, is not a reportable infection like chlamydia or hepatitis. There is the potential for far more of these lesions to exist because there also is no repository from which to study and track the numbers of these high-grade lesions.
However HPV is known to cause multiple other cancers aside from cervical. One of the most significant is anal cancer. While this cancer has an extremely high cure rate if identified and treated early in its course, all too often it is misdiagnosed as bleeding hemorrhoids thus delaying a true diagnosis for months or even years.
Just like cervical HPV, anal HPV progresses from small changes within the cells and over time increasingly abnormal changes which eventually will result in cancer.
For the most part, HPV and the associated conditions have long been “women’s diseases” while recent studies in both North and South America have shown that 50 percent of men have HPV. Obviously this information is something which the public needs to know and for which men need to take responsibility since they can transmit the virus to women.
In recent studies referenced by Dr. Joel Palefsky, one of the leading HPV researchers and infectious disease specialists in the United States, anal HPV infection was shown to be present in 60 percent of normal healthy women, while only 50 percent were shown to have cervical HPV infections. This indicates that anal HPV infection is more prevalent than previously thought.
Dr. Palefsky intends to initiate a study which would also create a repository for specimens relating to anal HPV. This could be used to study for early signs of transition to higher-grade lesions and cancer which may be useful in the future in determining those most in need of treatment. Dr. Palefsky will be presenting this proposal to the National Institutes of Health early this month.
What has long been needed is such a repository to adequately determine the risk for high-grade cervical lesions as well. Hopefully someone will follow Dr. Palefsky’s innovative and forward thinking in creating just such a repository.
Webcasts | Joel Palefsky, MD —." Sexuality, Reproduction & Menopause. N.P., n.d. Web. 7 Sept. 2011.
"Anal Cancer: Statistics | Cancer.Net." Doctor-approved cancer information from ASCO | Cancer.Net. N.P., n.d. Web. 7 Sept. 2011. http://www.cancer.net/patient/Cancer+Types/Anal+Cancer?sectionTitle=Statistics
"Cervical Cancer Prevention." THE MEDICAL NEWS | from News-Medical.Net - Latest Medical News and Research from Around the World. N.P., n.d. Web. 7 Sept. 2011.
Reviewed September 7, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith