New Study: Cervical Cancer Lingers In Black Women
Provocative new research might help explain why black women are so much more likely than whites to develop and die from cervical cancer: They seem to have more trouble clearing HPV, the virus that causes the disease.
Doctors have long thought that less access to screening and follow-up health care were the reasons black women are 40 percent more likely to develop cervical cancer and twice as likely to die from it. The new study involving young college women suggests there might be a biological explanation for the racial disparity, too.
If further study confirms this novel finding, it would make the HPV vaccine even more important for black women, said Worta McCaskill-Stevens, a prevention specialist at the National Cancer Institute. The vaccine is recommended for all girls starting at age 11.
The study was presented Sunday at an American Association for Cancer Research conference in Chicago.
Certain strains of HPV, the human papillomavirus, cause cervical cancer, but brief infections are very common in young women. They usually go away on their own within a year or so and only pose a cancer risk when they last long-term.
Researchers at the University of South Carolina in Columbia studied 326 white and 113 black students taking part in a wider federal health study. All were given Pap tests — lab exams of cells scraped from the cervix — and HPV tests every six months throughout their years in school.
Although the groups were similar in how many new HPV infections were detected and risk factors such as how many sex partners they had, doctors saw striking differences in how long their infections lasted.
At any checkup, blacks were 1.5 times more likely to test positive for infection with one of the HPV strains that raise cancer risk, said study leader Kim Creek.
“The African-American women weren’t clearing the virus as fast. They were actually holding onto it about six months longer,” for 18 months versus 12 months for whites, he said.
Ten percent of blacks had abnormal Pap tests versus 6 percent of whites.
Two years after initial infections were found, 56 percent of black women were still infected but only 24 percent of whites remained infected.
The government’s National Institute on Minority Health and Health Disparities sponsored the study. Creek is a paid speaker for Merck & Co., one of the makers of HPV vaccines.
The results are “provocative” and need validation in a study that looks beyond this one region, said McCaskill-Stevens of the cancer institute.
“We have known there are genetic differences between the races,” and it’s possible that a gene from certain ancestries such as African might play a role in the ability to clear an HPV infection, she said.
Cervical cancer has declined dramatically in the United States because of Pap tests, which are recommended every three years for women 21 to 65. Starting at age 30, women can also have an HPV test every five years; they’re not recommended before then because brief infections are so common, they would give too many false alarms.
About 12,000 new cases and 4,200 deaths from cervical cancer occur each year in the United States, mostly in women who have never been screened or not in the past five years.
Paps cost $15 to $60; HPV tests run $50 to $100.
Doctors don’t know how the vaccine will affect HPV test results or how long the vaccine lasts, so women should still be screened for cervical cancer if they are within the recommended screening ages.
The New Sex Disease
Doctors used to think this STD threatened only women. Then the men started dying.
The culprit: Human papillomavirus (HPV), the same sexually transmitted infection associated with cervical cancer in women. A huge spike in the number of head and neck cancers linked to HPV over nearly two decades is raising alarms about the risk of the sexually contracted infections in a whole new population: men.
A study in the Journal of Clinical Oncology reports there’s been a 225 percent uptick in HPV-positive oropharynx cancers since 1998, according to data from three U.S. cancer centers. The study also predicts that by 2020, oropharyngeal cancer will be the most common HPV-associated cancer in the U.S. surpassing cervical cancer.
Previously, tobacco and alcohol use had been the main causes of these tumors, which occur in the tonsils, base of the tongue and upper throat. But over the past few years, studies have shown HPV is playing a role in these cancer rates, likely due to an increase in oral sex even as tobacco use has fallen.
While HPV is the most common sexually transmitted disease, studies show women’s bodies usually clear the virus from the cervix quickly; only an infection that persists for years is a cancer risk. It’s not known if oral HPV acts in a similar way, nor is it clear if oral sex is the only way it’s transmitted, said Dr. Gregory Masters of the American Society for Clinical Oncology.
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Regardless, more than 11,000 cervical cancer cases will be diagnosed this year, a number that has been dropping steadily thanks to better Pap smears. The researchers calculated that annual cases of cervical cancer will drop to 7,700 by 2020 – compared with about 8,700 cases of HPV-positive oropharyngeal cancer – about 7,400 of them in men.
The report raises the question: Can the vaccine that’s currently given to young women protect men against oral HIV?
HPV vaccination is approved for boys to prevent genital warts and anal cancer, additional problems caused by human papillomavirus. But protection against oral HPV hasn’t been studied in either gender, said report author Dr. Maura Gillison, a head-and-neck cancer specialist at Ohio State.
A spokeswoman for Merck & Co., maker of the HPV vaccine Gardasil, said the company has no plans to study the vaccine on oral cancer.
Regardless, the cancer society said the report suggests that patients with HPV-linked oral tumors have better survival odds than those with other types of this cancer, possibly because they tend to be younger.
Have a sore throat that lasts longer than two weeks? See a doctor. Just because you’re not a smoker or drinker doesn’t mean you can’t get throat cancer.
Visit BlackDoctor.org’s STD center for more info on HPV and other sexually transmitted diseases.