HPV and Cervical Cancer Screening and Prevention

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• HPV and Cervical Cancer Screening and Prevention

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Screening Options

• Traditional Pap Test
• Liquid-Based Pap Test
• HPV DNA Test

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Traditional Pap Test

• For a Pap test, a medical practitioner scrapes a
  sample of cells from the cervix.
• The cervical cells are smeared on a glass slide
  and examined under a microscope.
• Medical personnel look for abnormalities in the
  cervical cells that could progress to cancer.

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Liquid-Based Pap Test

• In liquid-based cytology cervical cells are
  placed in liquid in a small bottle. Some of the
  liquid is placed on a slide and then examined
  under a microscope for abnormalities.
• Research has shown liquid-based Pap tests to be
  more accurate than the conventional method
  because blood and mucous are removed, making the
  cells easier to see.
• Liquid-based Pap tests are more expensive and may
  not be available at all clinics.

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The HPV DNA Test

• The HPV DNA test checks directly for high-risk
  HPV.
• HPV testing is FDA-approved in conjunction with a
  Pap test for women age 30 and older and for women
  of all ages as a follow-up to inconclusive Pap
  test results.
• For women over 30, an HPV test in conjunction
  with a Pap test is more accurate than the Pap
  test alone at identifying women with cervical
  cancer or its early signs.
• Women under 30 should not get the HPV test with
  the Pap test unless they receive abnormal Pap
  test results. Young women have more frequent HPV
  infections, which usually clear without medical
  action.

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Screening Guidelines

• Begin cervical cancer screening 3 years after the
  initiation of sexual intercourse, or by age 21
  (whichever comes first).
• Women should be screened annually with a regular
  Pap test or every 1-2 years with a liquid-based
  Pap test. All women under 30 should be screened
  for cervical cancer at least every two years.
• Women age 30 and older with 3 normal Pap tests in
  a row should discuss the recommended frequency of
  cervical cancer screening with their doctor.
• Women who had a hysterectomy may still need to be
  screened regularly, depending on the type of
  hysterectomy they had. They should discuss their
  situation with their doctor.

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HPV Test Results and Guidelines

• For women age 30 and older
• If both the Pap and HPV tests are negative
  (normal) Get tested again in 3 years.
• If the Pap test is negative and the HPV test is
  positive
  Repeat the
  Pap test and HPV test in 6 to 12 months to see if
  the virus has cleared. If the virus is still
  present, talk to your doctor about the next
  steps.
• Both tests are positive
  Talk with your
  doctor about what to do next.

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Prevention HPV Vaccine

• In June 2006, the FDA approved the Gardasil
  vaccine for protection against HPV types 16 and
  18, which cause 70 percent of cervical cancers,
  and types 6 and 11, which are responsible for 90
  percent of genital warts.
• A second HPV vaccine, Cervarix, is completing
  clinical trials. The release of trial results is
  expected in 2009. This vaccine protects against
  types 16 and 18.
• The availability of an HPV vaccine marks a
  tremendous milestone in the effort to prevent and
  ultimately eliminate, cervical cancer.

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Who should receive HPV vaccines?

• To maximize effectiveness, an HPV vaccine should
  be administered before a person becomes sexually
  active.
• The FDA approved Gardasil for girls and women
  aged 9-26.
• The Federal Advisory Committee on Immunization
  Practices (ACIP) recommends that Gardasil be
  given routinely to females aged 11 to 12.
  However, the vaccine can be administered to girls
  as young as 9 and to women aged 13 to 26 who have
  not already received the HPV vaccine.
• Research on vaccinating women over 26 and men is
  underway look for the results in the coming
  months!

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Are the vaccines safe?

• In June 2007, WHOs Global Advisory Committee on
  Vaccine Safety (GACVS) concluded that both
  vaccines had good safety profiles.
• Redness and tenderness at the vaccination site,
  along with low-grade fevers are the most common
  side effects for both vaccines. WHO recommends
  observation for 15 minutes following Gardasil
  vaccination due to reports of dizziness and
  fainting.
• The vaccines are not recommended for women who
  are pregnant.

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With the HPV vaccine, is screening still
necessary?

• Yes! HPV vaccines should be part of a
  comprehensive strategy to eliminate cervical
  cancer.
• Screening will still be needed to target cervical
  cancers caused by HPV types not covered by the
  vaccine and for women who have already been
  exposed to HPV types 16 and 18.
• In regions where cervical cancer screening is not
  possible, vaccination is the best way to protect
  the next generation of women from cervical cancer.