The connections between human papillomavirus, or HPV, and cervical cancer so influenced medicine that German physician Harald zur Hausen won the Nobel Prize in Physiology or Medicine in 2008 for his work linking the two. City of Hope pathologist Sharon Wilczynski, M.D., Ph.D., was among the researchers who made these connections in the 1980s to early 1990s — work that has since led to a vaccine to help prevent cervical cancer.
During Cervical Health Awareness Month, Wilczynski took some time to explain the role HPV plays in cervical cancer and how women can protect themselves.
|Sharon Wilczynski helped find the connection between a virus and cervical cancer. (Photo by Markie Ramirez)|
eHope: What are the main risk factors for cervical cancer?
Sharon Wilczynski, M.D., Ph.D.: Infection with human papillomavirus, or HPV, is by far the most significant risk factor. HPV is present in more than 95 percent of cases. There are some rare types of cervical cancer that are not associated with the virus, but these are few.
EH: What is HPV?
SW: HPV is a type of virus that causes warts, including genital warts. There are over 100 different types. Two types found in about 75 percent of all cervical cancers are HPV 16 and HPV 18. Another 12 to15 types are associated with the rest of the cervical cancers.
EH: Does everyone with HPV get cervical cancer?
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SW: No, not at all. The virus is necessary for cancer, but not the sole cause. HPV infects most adults, but their immune systems eventually eliminate the virus. However, some women develop a persistent HPV infection that over time can lead to cervical cancer.
EH: How effective is the new vaccine for HPV at preventing cervical cancer?
SW: Gardasil protects against both HPV 16 and 18 as well as two other types, so it covers about 75 percent of cancers. At least as important, however, is the protection it gives against the preinvasive condition, or cervical dysplasia. This happens as cells are in the initial stages of the process of becoming cancerous. Removing these cells requires a surgical procedure, which could raise risks for other complications. Being vaccinated may help avoid this.
EH: Can women stop doing Pap tests once they have the vaccine?
SW: No! And I can’t emphasize this enough. Women still should have Pap tests to screen for cervical cancer whether or not they’ve had the vaccine. The vaccine covers 75 percent of the risk, and that’s important, but there’s still the other 25 percent.
People tend to forget that before Pap tests became available, cervical cancer was the leading cause of cancer death for women (in the 1930s and 40s) — even more than breast cancer. And it’s still a leading cause in underdeveloped countries. Pap tests virtually eliminated the risk of death. The vaccine is an important preventive tool, but Pap tests are still necessary.
Talk to your doctor to learn about regular screening and whether the HPV vaccine is right for you. Low-income women or those without health insurance may qualify for a free or low-cost Pap test through the National Breast and Cervical Cancer Early Detection Program. To find out if you qualify, find your local program or call 800-CDC-INFO.
In California, cervical cancer screening and treatment are covered by the Every Woman Counts program. For more information, call 800-511-2300.