2. Reasons to talk about cervical cancer 1. Prevalence of women
2. Prevalence of disease1 3. Prevalence of crappy Pap smears 3.
Human Papillomavirus More than 100 types 60+ cutaneous types skin
warts. 40 mucosal types high risk types (particularly 16 and 18)
cervical cell abnormalities & certain anogenital cancers low
risk types (particularly 6 and 11) cervical cell abnormalities
genital warts respiratory papillomatosis 4. HPV Prevalence Most
common STD 6.2 million new cases annually 20 million currently
infected 80 million infected at least once between the ages of
15-49 9.2 million sexually active individuals 15-24yo infected with
genital HPV 5%-30% with HPV are infected with multiple types of the
virus 316,000 initial visits to physicians offices (2004)-genital
wart diagnosis 5. Genital HPV Infection Lesion type Number Percent
Visible warts 1.4 million 1% Subclinical (via colposcopy) 5 million
4% Subclinical (DNA testing) 14 million 10% Prior infection (+
antibodies) 81 million 60% No prior or current infection 34 million
25% 6. Epidemiology of HPV & Cervical Cancer Over 99% of
cervical cancers have HPV DNA detected within the tumor 70% of
cervical cancer is caused by one of two types of HPV, 16 or 18 The
quadrivalent HPV vaccine protects against Types 6, 11, 16 and 18 7.
FYI 8. Facts and Figures Grade of Cervical Disease Number of Women
Tested Number of women HPV+ % HPV + % HPV 16+ Normal 266,611 33,154
12 20 ACSUS 12,983 6,810 52 23 LSIL 17,805 13,480 76 25 HSIL 7,743
6,616 85 48 CIN1 11,043 8,108 73 28 CIN2 4,754 4,068 86 40 CIN3
11,618 10,753 93 58 ICC 40,679 36,374 89 63 9. Cut to the Chase
Some women that test negative do have HPV About half with ASCUS are
HPV+ More than 70% with any other result are infected with HPV 16
10. Cervical ca - Two Faces of Evil Medical Problem2 Public Health
Problem2 Initial HPV infection Persistent infection Cervical Cancer
Infection from Joe to Jane Infection from Jane to Jeff Infection
from Jane to Jenny And on, and on, and on 11. The year was 1979 12.
Three Mile Island 13. 86 cents per gallon 14. YMCA 15. Clarke and
Anderson study First study to ask if Pap smears prevented cervical
cancer Case-control design 212 cases v. 1060 controls Statistically
significant difference p
