The 2005 Health Information National Trends Survey revealed just 40 percent of US women had ever heard of human papillomavirus and, of those, less than 20 percent knew that HPV infection can sometimes lead to cervical cancer. The survey of 3,076 women ages 18-75 showed 64 percent of those familiar with HPV knew it is an STD, and 79 percent knew it can cause abnormal Pap smears.
"Therefore, one of our main findings is that being aware of HPV does not guarantee accurate knowledge," Dr. Jasmin A. Tiro of the Bethesda, Md.-based National Cancer Institute told attendees of the American Association for Cancer Research's Frontiers in Cancer Prevention Research meeting in Boston.
The survey found that younger women, those with higher education levels, and women exposed to more health information were more likely to have heard of HPV. "But the only factors associated with having accurate knowledge, knowing that it could lead to cervical cancer, was an abnormal Pap test or testing positive on an HPV test," said Tiro.
The Food and Drug Administration in June approved Gardasil, the first vaccine to block the HPV types linked to most cases of cervical cancer and genital warts, for females ages 9-26. Tiro noted the survey was performed prior to Gardasil's FDA approval, so it provides good comparison data to measure future levels of HPV knowledge among the US population. A similar survey on HPV awareness is scheduled for 2007.
"We need to increase women's knowledge of HPV and cervical cancer before chances of them becoming infected so that they can protect themselves, because cervical cancer is one of our greatest success stories from a screening perspective in that women do have options to prevent and detect cervical cancer early," said Tiro.
Yesterday, researchers reported that a two-year study of Merck & Co.'s experimental vaccine Gardasil found that it was highly effective at preventing cervical cancer, nearly every case of which is caused by the common STD human papillomavirus (HPV).
More than 30 types of HPV infect the human genital area. Some types cause genital warts, while others cause cancer. HPV is often harmless in most people because their immune systems fight it off. But the virus persists in some women, causing abnormal growths on the cervix, some of which turn cancerous. Gardasil targets HPV types 16 and 18, which together cause 70 percent of cervical cancers; other types cause the rest. It also protects against the two types responsible for 90 percent of cases of genital warts, 6 and 11.
At an infectious disease conference today in San Francisco, Merck researchers are expected to present results of the study, which involved more than 12,000 women, ages 16-26, from 13 countries. Half received Gardasil and half placebos. Among the women who received all three doses of Gardasil and were not infected with HPV at the study's start, researchers found no precancerous cells or early-stage cervical cancer associated with types 16 or 18. Among those who received the placebos, there were 21 cases. However, some in the vaccinated group did develop precancerous cells associated with other HPV types; Merck did not disclose how many.
Dr. Eliav Barr, a research director at Merck, said the ideal time to vaccinate girls is before they become sexually active and risk being exposed to a cancer-causing HPV type. The vaccination will require three shots over six months. It is not clear how long Gardasil will provide protection, how much it will cost, or whether booster shots will be necessary, said Barr.
Although Merck will seek Food and Drug Administration approval to vaccinate girls and women later this year, the company plans eventually to seek approval to use Gardasil in boys and men. Merck has not disclosed any data on whether Gardasil works in men.
New York Times (10.07.05):: Denise Grady
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