Human Papilomavirus: The Latest Celebrity Pathogen

Recently human papilomavirus (HPV) has been making a lot of news.  The story involves big business, cancer, government policy, and sex.  Iâ€™m surprised HBO hasnâ€™t made a series about it.

HPV is a sexually transmitted virus that causes genital warts, cervical cancer, and has recently been associated with oral cancers.  Merck recently released Gardasil, a vaccine that protects against the strains of HPV that cause most (but not all) of the cases of cervical cancer and genital warts.  A vaccine to prevent cancer!  That alone was newsworthy.  The CDC recommended the vaccine for all girls and women 11 to 26 years of age.  Since then, some state legislatures have mandated vaccinating school-aged girls, which has led to noisy political battles between opponents and supporters of the legislation.

This issue of The New England Journal of Medicine is practically a wall-to-wall HPVfest: three scientific articles, three editorials, and two perspective articles all about HPV.  The studies prove that the vaccine decreases the risk of precancerous cervical abnormalities that eventually lead to cervical cancer, but the magnitude of the reduction was smaller than expected.  This LA Times article has an excellent summary of the issue.  The vaccine is safe, but cervical cancer takes years to develop, so the vaccineâ€™s ability to prevent cervical cancer will be revealed by these ongoing studies years from now.

Meanwhile, until the next germ catches the spotlight, you can expect HPV and Gardasil to continue generating controversy.

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