War On Warts

TV Show ‘Girls’ Adds to the Muddle on HPV Testing

WarOnWarts — Tue, 15 May 2012 18:34:46 +0000

Hannah, the spunky central character in the edgy new HBO series “Girls,” is a creative and endearingly naïve 24-year-old bumbling fearlessly through postcollege life. She works for years at an unpaid internship that never turns into a job and pretends to be far more sophisticated about sex than she actually is. She’s a loyal friend, but whatever you do, don’t ask her about human papillomavirus, or HPV. She’s clueless.

The much-discussed third episode of the series, which aired in late April, was rife with misinformation about HPV, a reflection of the real confusion felt by twentysomethings — or perhaps just by the show’s writer, Lena Dunham, who plays Hannah.

First, our hapless heroine is tested for HPV, an infection linked to cervical cancer, though what she really had been worried about was H.I.V. This is not entirely implausible; still, the test has not been approved for women under age 30. Medical guidelines strongly discourage its use in young women, as the results generally are not meaningful unless aPap smear also detects signs of abnormal cells.

Hannah can’t believe that the result is positive. Her doctor apparently hasn’t told her that nearly half of women her age have the virus. Usually, it goes away on its own.

Then Hannah is hysterical: She must have her “cervix scraped out.” Actually, it’s the screening test that requires cervical scraping. There is no treatment for an HPV infection.

Hannah accuses her loser boyfriend of infecting her; he swears he tested negative just last week. Here, viewers who were planning to demand their boyfriends get tested, too, are in for a disappointment. There is no HPV test for men, as Hannah’s old college boyfriend notes later in the episode.

Hannah tells her best friend she has “precancer,” though she does not. Precancerous changes would be detectable with a Pap smear, not an HPV test. Her friend, in tears, says, “What if you can’t have children?” Cervical cancer can lead to hysterectomy, and precancerous lesions can complicate pregnancies — but not a passing HPV infection.

It’s hard to know whether blithe ignorance is supposed to be part of Hannah’s charm, or whether the show’s creators just don’t care much for the facts. An HBO spokeswoman said only, “We respect your feedback on ‘Girls’ but must remind you that it is a comedy series and one which we hope people won’t go to for medical advice.”

If only it were so simple. Viewers easily absorb health messages that are embedded in a narrative, research shows. Inaccurate information offered in a story format is recalled more readily than the real facts received during sex education classes or from a doctor, said Al Gunther, a journalism professor at the University of Wisconsin in Madison.

“Storytelling around the fire was our earliest form of communication,” Dr. Gunther said. “Information relayed in that kind of context is more vivid, so it’s much easier to ‘get’ and much easier to remember.” All the more so when viewers identify with a character like Hannah, he added.

In the show’s defense, HPV is a confusing and complicated subject. In women, some strains of the virus cause genital warts, and some cause cancers of the cervix, vagina and vulva; in both sexes, infection can lead to anal and oral cancers.

These strains are common, however, and problematic only when they persist in the body. About 25 percent of the population is infected with HPV at any point in time, but “25 percent of people don’t get cancer,” said Dr. Alan G. Waxman, a professor of obstetrics and gynecology at University of New Mexico in Albuquerque.

The virus is ubiquitous. Most sexually active people are exposed and infected, often repeatedly. “When we think of sexually transmitted infections, the first question is ‘Who’d I get it from?,’ ” Dr. Waxman said. “But it just isn’t that kind of infection. When a woman tests positive for HPV, we don’t know if she got it last month or 10 years ago.”

Good news for Hannah: Most people gain immunity after exposure, said Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society.

“If you have HPV, it’s probably not going to mean anything,” she said. “It doesn’t mean you’re going to get cancer. As long as you get your follow-up tests, cervical cancer is the most preventable cancer.” HPV tests are overused, she said.

So what’s a sexually active twentysomething to do?

By all means, ask your doctor to test you for sexually transmitted diseaseslike H.I.V., chlamydia, syphilis and gonorrhea.

Beginning at age 21, have a Pap smear every three years to detect cellular abnormalities and precancerous conditions, which can be treated. You should get regular Pap smears even if you have had the HPV vaccine, because the vaccine protects againstonly some viral strains. There is generally no need for standalone HPV testing until age 30, although it may be performed if a Pap smear turns up abnormal cells.

Protect yourself. Use condoms to prevent sexually transmitted infections even if you are using other contraceptives. Condoms do provide partial protection against HPV infection, and regular condom use protects against the infection’s progression for reasons that aren’t entirely understood.

Don’t smoke. In addition to all of the other health problems associated with tobacco, smoking increases the chance an HPV infection will become chronic.

Finally, take some advice from HBO itself: Television sitcoms are the last place to look for information about sex.

Don’t listen to Hannah, girls.

source: http://well.blogs.nytimes.com/2012/05/14/tv-show-girls-adds-to-the-muddle-on-hpv-testing/

Pediatricians Recommend HPV Vaccination For Boys

WarOnWarts — Tue, 28 Feb 2012 20:29:56 +0000

The leading group of U.S. pediatricians says it’s now time for boys, as well as girls, to be vaccinated against human papillomavirus.

The American Academy of Pediatrics has updated its guidance to parents and doctors in favor of routine immunization for boys against the virus.

The full story can be read on NPR

CDC Recommends Boys Receive HPV Vaccine

WarOnWarts — Thu, 27 Oct 2011 18:41:45 +0000

Coverage of the decision by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) to expand its recommendation for the HPV vaccine to boys and young men aged 11-21 was widespread, appearing on the three network newscasts, and in national newspapers. The story took up over ten percent of news time. ABC World News (10/25, story 3, 0:30, Sawyer) reported that the committee “recommended boys ages 11 and 12 and young men 13 to 21 be vaccinated. Not just girls, who, as we know, are at risk for cervical cancer.”

On NBC Nightly News (10/25, lead story, 3:00, Williams), NBC’s Chief Medical Editor Dr. Nancy Snyderman said that “One of the reasons the parents have backed away from this vaccine in the past is that because it combines three shots spaced out over several months, and sometimes that means compliance is not so good, and insurance companies have backed away from covering it, but the hope today is that the CDC has recommended it, it will be one step forward getting our kids inoculated and having insurance coverage so parents don’t have to bear the cost.”

The CBS Evening News (10/25, story 6, 2:15, Pelley) reported that “experts argue that kids should get” the vaccine early, “before sexual activity and before they develop these diseases like cancer and genital warts. Now for the future, another important thing is that the earlier this vaccine is given, the better the protection, the better the immune response and the better they’re going to be protected against these diseases in the future.”

Asymptomatic HSV-2 Carriers May Transmit Genital Herpes

WarOnWarts — Wed, 13 Apr 2011 23:30:43 +0000

Researchers at the University of Washington have found just how easily people infected with herpes simplex type 2 virus, which causes genital herpes, can unknowingly pass it on to other people. On average, the researchers found those “who had had past herpes outbreaks were infectious 20.1% of the time, while the asymptomatic group was found to be able to transmit the virus 10.2% of time.” Virus presence was detected “at least once in 83.4% of the people with symptomatic infection and in 68.2% of people with asymptomatic herpes.” The authors say the study shows that even people with asymptomatic herpes type 2 “can transmit it to a sexual partner.”

This further means that pregnant women with no symptoms can pass on the virus to their babies with devastating consequences for the newborn, including death. Moreover, HSV-2 infection can cause complications in people who have weakened immune systems due to chronic disease, and it can increase a person’s likelihood of contracting HIV.

Condom use, drug therapy and disclosure of the disease to partners can help curb the spread of herpes. A blood tests to detect HSV-2 became widely available in 1999, making it easier for people to find out if they have genital herpes even if the infection isn’t active.

Adherence to Schedule for HPV Vaccination Series Low

WarOnWarts — Mon, 10 Jan 2011 20:46:09 +0000

Adherence to recommended schedules for human papillomavirus (HPV) quadrivalent vaccine is relatively low, and even lower among blacks, raising concerns about disease disparity, according to research published online Dec. 13 in Pediatrics.

To determine the level of adherence to the recommended schedule for vaccination and to identify factors associated with completing the three-dose series, Lea E. Widdice, M.D., of the Cincinnati Children’s Hospital Medical Center, and colleagues reviewed data on 3,297 females aged 9 to 26 who initiated HPV vaccination.

Sixty-seven percent of the females self-identified as black and 29 percent as white. The researchers found that more than 50 percent of the doses were received late and fewer than 3 percent were received earlier than recommended. Completion rates by seven and 12 months were 14 and 28 percent, respectively. Completion by seven months was more likely to be achieved in whites, females whose contraception use necessitated intramuscular injections at three-month intervals, and those with private rather than public insurance.

“Adherence to recommended intervals and completion of the vaccine series were low. Lower rates of completion in black patients compared with white patients raises concern that disparities in vaccine completion could exacerbate existing disparities in cervical cancer,” the authors write.

FDA Approves HPV Vaccine for MEN!!!

WarOnWarts — Mon, 27 Dec 2010 18:02:50 +0000

Gardasil (human papillomavirus vaccine), the vaccine that can prevent most cases of cervical cancer in girls, has won the FDA’s blessing as a vaccine to prevent anal cancer, a huge victory for men!

The FDA’s approval for Gardasil as an anal cancer vaccine opens the way for the medication’s maker, Merck and Co. Inc., to market the vaccine to boys and young men between the ages of nine and 26 – an option that will be most meaningful for men who have sex with men, but valuable to all. Nobody likes getting HPV on their penis. It really can devastate many boys and men. When the HPV ends up on their anal area – the risk of anal cancer is high. Although this is most commonly seen in homosexual men, it is not infrequent for heterosexual men to be at risk. It is easy to imagine how HPV can start on the shaft, and with a scratch here, and an itch there – end up on the back side.

This is a great win for men – and we hope that the approval by the FDA will quickly translate to coverage amongst insurance companies to make the vaccine accessible quickly to this new population.

Cryotherapy is one effective treatment for warts

WarOnWarts — Sat, 30 Oct 2010 13:05:53 +0000

Cryotherapy with liquid nitrogen to remove common warts may be more effective than salicylic acid or a wait-and-see approach, according to the results of a randomized controlled trial reported online September 13 in the Canadian Medical Association Journal.

“Cryotherapy is widely used for the treatment of cutaneous warts in primary care,” write Sjoerd C. Bruggink, MD, from Leiden University Medical Center in Leiden, the Netherlands, and colleagues. “However, evidence favours salicylic acid application. We compared the effectiveness of these treatments as well as a wait-and-see approach.”

This is a great treatment for warts – but not the only one. Many more options exist than were tested by this study – so be sure to review all of your options for treating warts with your doctor.

Anal Warts in Men

WarOnWarts — Tue, 12 Oct 2010 18:19:14 +0000

What are anal warts?

Anal warts (also called “condyloma acuminata”) are a condition that affects the area around and inside the anus. They may also affect the skin of the genital area. They first appear as tiny spots or growths, perhaps as small as the head of a pin, and may grow larger than the size of a pea. Usually, they do not cause pain or discomfort to afflicted individuals. As a result, patients may be unaware that the warts are present. Some patients will experience symptoms such as itching, bleeding, mucus discharge and/or a feeling of a lump or mass in the anal area.

Anal warts, thought to be caused by the human papilloma virus, can grow larger and spread if not removed.

It is important to know that Anal warts can be found both heterosexuals and in men who have sex with men. Either way, it is nothing to be ashamed of – and it is something that you SHOULD SEEK TREATMENT FOR.

What causes these warts?

They are thought to be caused by the human papilloma virus (HPV) which is transmitted from person to person by direct contact. HPV is considered a sexually transmitted disease. You do not have to have anal intercourse to develop anal condyloma.

Do these warts always need to be removed?

Yes. If they are not removed, the warts usually grow larger and multiply. If left untreated, the warts may lead to an increased risk of cancer in the affected area. This is similar to the risks of cervical cancer in women.

What treatments are available?

If warts are very small and are located only on the skin around the anus, they may be treated with a topical medication. They may also be treated by a physician by freezing the warts with liquid nitrogen. Warts may also be removed surgically. Surgery provides immediate results but must be performed using either a local anesthetic – such as novocaine – or a general or spinal anesthetic, depending on the number and exact location of warts being treated. Warts inside the anal canal usually are not suitable for treatment by medications, and in most cases need to be treated surgically.

Must I be hospitalized for surgical treatment?

No. Surgical treatment of anal warts is usually performed as outpatient surgery.

How much time will I lose from work after surgical treatment?

Most people are moderately uncomfortable for a few days after treatment, and pain medication may be prescribed. Depending on the extent of the disease, most people return to work the next day.

How long is treatment usually continued?

Follow-up visits are necessary at frequent intervals for several months after the last wart is observed to be certain that no new warts occur.

What can be done to avoid getting these warts again?

In some cases, warts may recur repeatedly after successful removal, since the virus that causes the warts often persists in a dormant state in body tissues. Discuss with you physician how often you should be evaluated for recurrent warts. Abstain from sexual contact with individuals who have anal (or genital) warts. Since many individuals may be unaware that they suffer from this condition, sexual abstinence, condom protection or limiting sexual contact to single partner will reduce your potential exposure to the contagious virus that causes these warts. As a precaution, sexual partners ought to be checked, even if they have no symptoms.

National Men’s Health Week – June 14th to 20th

WarOnWarts — Wed, 16 Jun 2010 01:07:56 +0000

June 14-20^th is National Men’s Health Week and June 20^th is Father’s Day.

Lets celebrate both by sharing the gift of knowledge. Here are some key facts about STD/STI’s that every man should know.

STD/STIs are certainly a critical piece of the sexual health puzzle but being sexually healthy is about much more.

Our most basic advice is:

Abstinence is good and can happen at different times in life
Talk to your parents, they were your age once
Talk to your partner (before you have sex)
Make sure you and your partner know how to use a condom correctly
Find a good healthcare provider and talk to them
Get help if you don’t think you’re in a healthy relationship
Get yourself tested and make sure your partner gets tested (before you have sex)
Take advantage of the vaccines that will help protect you
Learn what you need to know–and keep learning
Your sexual health is important–-you have a right and a responsibility to protect it!

Oral Sex Cause of Throat Cancer Rise

WarOnWarts — Sat, 30 Jan 2010 18:15:26 +0000

Changing sexual practices have led to a dramatic rise in throat cancer in the United States over the past two decades, and experts say they fear an epidemic of the disease.

The comments were made Wednesday at a news conference held by the American Association for Cancer Research to discuss research into the role of the sexually transmitted human papilloma virus ( HPV) in head and neck cancer.

Increasing rates of HPV infection, spread through oral sex, is largely driving the rapid rise in oropharyngeal cancers, which include tumors of the throat, tonsils, and base of the tongue, said Scott Lippman, MD, who chairs the thoracic department at the University of Texas M.D. Anderson Cancer Center.

Studies of oropharyngeal tumor tissue stored 20 years ago show that only around 20% are HPV positive, Lippman said. Today it is estimated that 60% of patients are infected with the virus.

“The percentage of oropharyngeal cancers that are HPV positive is much higher now than it was 20 years ago,” he said. “This is a real trend, and that is why there is concern of an epidemic given that fact that oropharyngeal cancer is increasing at an alarming rate.”
Changing Face of Throat Cancer

Smoking and alcohol abuse were once considered the only major risk factors for these cancers, but this is no longer the case.

American Cancer Society Chief Medical Officer Otis Brawley, MD, said as many as half of the oropharyngeal cancers diagnosed today appear to be caused by HPV infection.

“Changing sexual practices over the last 20 years, especially as they relate to oral sex, are increasing the rate of head and neck cancers and may be increasing the rates of other cancers as well,” he said.

He added that there is some evidence that oral HPV infection is also a risk factor for a type of cancer of the esophagus.

“The paradigm is changing,” Lippman said. “The types of patients we are seeing now with oropharyngeal cancers are not the patients we have classically seen who were older, smokers, and have lots of other problems. These are young people, executives, a whole different population.”
Oral Sex Not Safe Sex

The experts agreed that it is critical for the public to understand that oral sex doesn’t equal safe sex.

The message was unofficially promoted in the early days of the HIV epidemic and it is still widely believed by many, especially teens.

Studies suggest that teens are often unaware of the risks associated with unprotected oral sex, including the transmission of HPV, chlamydia, and gonorrhea.

“There is a huge public health message here,” Brawley said.