Now that I have raised the ire of anyone who now has cervical cancer, or has survived, or has lost a loved one to this disease, let me delve further into the importance of ending the focus on cervical cancer.
I am certainly not insensitive to the issue of cervical cancer. I myself have dealt with precancerous lesions of the cervix. Neither am I lacking in empathy for those who are survivors, I am a survivor myself -- twice!
The fact still remains that cervical cancer is diagnosed in approximately half a million women across the globe each year and that half of that number succumb to the disease on an annual basis.
There are significant organizations whose sole focus is the prevention of cervical cancer, and they work tirelessly to educate others and raise money for everything from research to the development of educational materials and, in some cases, even patient assistance.
Cancer is a term which still strikes fear in the hearts and minds of most people diagnosed with it and even those who aren’t, but I don’t think anyone with cervical cancer would align themselves with groups fighting lung cancer, pancreatic cancer or colon cancer.
While the commonality which exists because they are also a form of cancer there is a significant difference. That difference is the fact that cervical cancer, unlike the other cancers mentioned, is the result of a virus -- the human papillomavirus (HPV).
Cervical cancer was the first cancer identified in 1983 as being the result of HPV (HPV16). The connection was only strengthened in 1984 when a second strain of HPV (HPV18) was also identified as the cause of cervical cancer.
Between the two strains alone, they combine to account for approximately 70 percent of all cervical cancers. Various other strains of the human papillomavirus make up the difference, bringing the total of all cervical cancers attributed to HPV to 99.9 percent.
Since the approval of the first HPV vaccine (Gardasil) in 2006, its manufacturer Merck Pharmaceuticals has initiated numerous public education campaigns aimed at driving home the connection between the human papillomavirus and cervical cancer. The organizations which have cropped up against cervical cancer have consistently done the same.
The end result has been that those who are aware of HPV will tell you that it is the virus which causes cervical cancer. If this were a singular cancer, such as lung cancer, I would say that their efforts have been an overwhelming success. The problem is that it isn’t a singular cancer.
In testimony given to the Administrative Committee on Immunization Practices by Maura Gillison, MD and lead author on oropharyngeal research and an oncologist at Ohio State University, at the current rate HPV-induced oropharyngeal cancer will exceed cervical cancer in numbers by the year 2020 (less than a decade).
According to the CDC cases of anal cancer are increasing at an annual rate of 3 percent which is quite significant, and there are more than 5,000 diagnosed cases of anal cancer annually.
In addition to this, the CDC, whose figures are not current but are in some cases seven years old, indicate that HPV is also responsible for 65 percent of vaginal cancers, 50 percent of vulvar cancers, 35 percent of penile cancers and 60 percent of oropharyngeal cancers. If these are older figures, one must wonder what they actually are today.
HPV excludes no one. It will infect male or female regardless of age, nationality or ethnicity, though some groups have a somewhat higher risk. These cancer statistics from high risk HPV do not even take into account the benign (non-cancerous) conditions resulting from HPV.
There are estimated to be approximately 250,000 cases of genital warts annually in U.S. men alone and HPV is also responsible for the majority of cases of recurrent respiratory papillomatosis which affect infants and young children.
If those of us affected by HPV and others whom for whatever the reason advocate against cervical cancer truly want to be heard, then it is time that we align ourselves, combine our voices and our numbers and advocate against the one thing that connects us all -- HPV. Not a particular form of cancer caused by HPV, but the virus itself.
The focus on cervical cancer has on some level functioned to lessen the public’s understanding of the true extent of the danger that HPV represents. Focusing on cervical cancer instead of HPV itself functions to exclude the cases of anal, vaginal, vulvar, penile and oropharyngeal cancer diagnosed each year. It also functions to alienate its victims.
Those of us with an HPV-induced cancer not cervical in nature experience the physical and emotional pain and anguish just as those with cervical cancer do. We live with the damage in some form or another and what we go through in terms of treatments/procedures are, in some cases, more severe than cervical cancer.
As a two-time survivor of anal cancer resulting from HPV and speaking for those of us with precancerous or cancerous lesions other than cervical, we are no less
significant simply because our numbers may be smaller.
In many cases, the focus on cervical cancer to the exclusion of anal cancer has left many an anal cancer patient misdiagnosed and having to endure far more severe treatment because of advanced disease states when the diagnosis is finally made.
The lack of education amongst physicians of other specialties such as colorectal and oral surgeons certainly does not benefit the patient. And, while HPV has been identified as causing 90+ percent of anal cancers, there is still no organized screening program as there is with the Pap smear, to pick up the same cellular changes which occur in the cervix.
The HPV test is also, regardless of which one since there are now numerous companies offering the test, not advertised or promoted for anal HPV.
Since 1983, HPV has gone from being rcognized as responsible for one cancer (cervical), to being acknowledged as responsible for six, and there may be more to come. It is long past time to stop creating divisiveness through a myopic focus and to recognize that what is needed, what is desperately needed, is to unify the voices of every individual who suffers from HPV related cancer.
Our adversary should not be seen as cervical cancer or anal cancer or any of the other cancers for which HPV is responsible, but HPV itself! I have been aware for over two decades that HPV is responsible for far more than cervical cancer but most are not. I know for myself only because I have been unfortunate as to have experienced it virtually everywhere else in addition to cervical. Most have not.
It is essential to expand the public’s knowledge about HPV beyond that of cervical cancer alone. Only once we come together in unity as victims of HPV and not one of its cancers, will our voices truly be heard and the need to recognize this issue on the larger scale that it exists, get the attention it deserves.
"CDC - HPV-Associated Cancers Statistics." Centers for Disease Control and Prevention. N.p., n.d. Web. 26 Feb. 2012. http://www.cdc.gov/cancer/hpv/statistics
"Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males — Advisory Committee on Immunization Practices (ACIP), 2011." Centers for Disease Control and Prevention. N.p., n.d. Web. 26 Feb. 2012. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a3.htm
"CDC - What CDC Is Doing About HPV-Associated Cancers." Centers for Disease Control and Prevention. N.p., n.d. Web. 26 Feb. 2012. http://www.cdc.gov/cancer/hpv/what_cdc_is_doing
"Oral Sex, Throat Cancer And HPV Vaccines” // Pharmalot 4th, Ed Silverman // October, and Pharma Blog . N.p., n.d. Web. 26 Feb. 2012.
Reviewed February 27, 2012
by Michele Blacksberg RN
Edited by Jody Smith