HPV: 5 Things All Women Should Know
Few people work with the goal of putting themselves out of business, but that’s exactly what Connie Trimble, M.D., director of the Johns Hopkins Center for Cervical Dysplasia, aims to do.
In addition to treating patients, Trimble researches vaccines to treat human papillomavirus (HPV). The virus is the most common sexually transmitted infection, with more than 6 million Americans infected each year. You’ve probably seen television ads for the HPV vaccine. If you have kids, your pediatrician has probably recommended the vaccine to guard against some cancers that are linked to HPV. It can sound pretty scary: a common infection that causes cancer.
So should women worry about HPV? According to Trimble, the answer is no.
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Trimble discusses five things she wants women to know about HPV, cancer risk and the importance of vaccines.
Women Don’t Need to Feel Ashamed About HPV
“Anyone who’s ever had sex may have been exposed to HPV,” says Trimble, adding that she wishes she knew how to get rid of the unnecessary stigma associated with the disease.
“Raising awareness can give you choices, and knowing you have choices is empowering.”
Certain Types of HPV Are Linked with Cervical Disease
While more than 100 types of HPV exist, only about a dozen of them are associated with cervical disease. “Together, HPV 16 and HPV 18 account for 70 percent of all cervical disease,” says Trimble. Genital warts are a form of low-risk HPV, and they do not cause cancer.
Doctors monitor HPV with Pap tests that look for abnormal cervical cells called lesions. Low-grade lesions — where the changes are only mildly abnormal — often clear up on their own. These are not considered precancerous.
All cervical cancers arise from untreated, high-grade lesions, which do contain precancerous cells. If your immune system is healthy, it typically takes about 10 to 15 years for cervical cancer to develop from a high-grade lesion. But not all high-grade lesions become cancer — a person’s own immune system can eliminate them.
HPV Very Rarely Becomes Cervical Cancer
While HPV does cause cervical cancer, the risk of developing cervical cancer from the virus is still quite low.
For 90 percent of women with HPV, the condition will clear up on its own within two years. Only a small number of women who have one of the HPV strains that cause cervical cancer will ever actually develop the disease.
Cervical dysplasia, where cell changes occur in the cervix at the opening to the uterus, is a more common outcome from HPV infection.
“I have a huge group of patients with persistent HPV infection who have never had any reason to need treatment,” Trimble says. “So if you have HPV, you can put it on your nuisance list and take it off your worry list.”
HPV Causes Head and Neck Cancers Too
One of the biggest — but lesser-known — dangers of HPV involves the risk of head and neck cancer, with HPV spreading to the throat via oral sex.
“The rate of cancers in the back of the throat is skyrocketing,” Trimble says. “Experts are using the word epidemic to describe it. It’s on track to outpace cervical cancer.”
While women can get these cancers, most of the people who get it are heterosexual males. There is currently no way to screen for it, making it all the more important that parents get their children — including boys — vaccinated.
Vaccines Save Lives
Trimble thinks it’s sad that there’s so much controversy over the HPV vaccine, which has overwhelmingly been proven safe and can prevent devastating cancers linked with HPV. In fact, Trimble has dedicated her research to developing therapeutic vaccines capable of fighting HPV once someone has contracted the virus. (Preventive vaccines are given to healthy people to ward off infections; therapeutic vaccines are used to help people who already have a disease.) In a recent study using a therapeutic vaccine, she and her team were able to successfully treat half of patients who had high-grade lesions, and they’re working on raising that number.
“At least 20 percent of human cancers are caused by a specific infection,” says Trimble. “That implies it would be possible to prevent or treat disease by helping the immune system recognize infection. Once you’ve done that, you’ve won.”
Ultimately, Trimble says HPV is a wimpy infection, and she’s encouraged by the huge immune responses these therapeutic vaccines can trigger.
As she explained in a TED talk called “Kicking Cancer’s Butt,” Trimble says, “My goal is to cure cancer, and it’s beginning to look like that’s possible.”
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