Patient Counseling and the History of HPV
March 26, 2007 by Kristen King
Filed under Women's Health
Human papillomavirus, or HPV, has been in the news a lot lately because of the new HPV vaccine, which is intended to prevent cervical cancer resulting from HPV infection when administered to women ages 9 to 26 years. How has the introduction of this vaccine, marketed by Merck under the trade name Gardasil, changed the face of HPV in medicine?
In “How Should We Counsel Women About HPV Testing?” on Medscape, Susan J. Wysocki, RNC, NP, FAANP,
President and CEO, National Association of Nurse Practitioners in Women’s Health, recommends covering the following points when talking with patients about HPV testing and results:
- Cervical cancer is preventable and caused by high-risk types of HPV
- Most women will have an HPV infection at some point in their life
- The virus is usually cleared by an immune response
- Persistent HPV infection by high-risk types is the factor that increases the risk for cervical cancer
- Infection with HPV is common but cervical cancer is rare
- When an HPV test is positive, it does not mean that the virus is new or that a partner has been unfaithful
- HPV can persist in the cells for decades so a positive test does not necessarily indicate a new infection.
Providing this information for patients empowers them to make an educated decision about their care rather than a decision out of fear or social pressure.
And on the more scholarly end of things, the article “The natural history of cervical HPV infection: unresolved issues” from Nature Reviews Cancer takes a long, hard look at the virus through the lens of critical science. The article’s a bit of a heavy read, but it’s worth a shot — and the abstract sums up the main points nicely:
The identification of high-risk human papillomavirus (HPV) types as a necessary cause of cervical cancer offers the prospect of effective primary prevention and the possibility of improving the efficiency of cervical screening programmes. However, for these opportunities to be realized, a more complete understanding of the natural history of HPV infection, and its relationship to the development of epithelial abnormalities of the cervix, is required. We discuss areas of uncertainty, and their possible effect on disease prevention strategies.
Contents © Copyright 2007 Kristen King
Hope everyone continues to educate themselves about Gardasil and the mandatory vaccination about to become law in Virginia, as well as the DPT booster just required for 12 year olds. Kristen King will be posting a review of my novel White Lies: A Tale of Babies, Vaccines, and Deception, which reveals lots of misinformation about the government’s vaccine injury compensation fund, the place parents apply for assistance when their child is one of the statistical risks associated with vaccines. Easy reading, but book clubs reading it always have lots of questions about the way the fund has been handled.
Nice to know book clubs are at the vanguard of protecting the public’s health. I wish the vaccinophobic people who want to drive us back to the dark ages of infectious disease with infant mortality rivaling Niger would direct their fears and ignorance toward other more culpable destructive forces in society like the military.
At So Sioux Me http://www.traceesioux.blogspot.com I have an opinion on the supposed moral implications of the HPV Vaccine. I get very upset that parents would deny the vaccine to their daughter on the grounds that it would condone sex. Sex is not required to get HPV. Plus, back to the Carrie Underwood song Before He Cheats, mentioned on this blog elsewhere. Monogamy on the girl/woman’s part does not guarantee monogamy on a boy/man’s part, which puts girls at risk of getting HPV, even if they are virtuous.
Tracee