Another Good Reason to Go
for a Pap Test
Infection with the human papilloma
virus (HPV) is widespread among sexually active female students at Rutgers
University, according to a study conducted by Albert Einstein College of
Medicine researchers. Results were published in the February 12 issue of
the New England Journal of Medicine.
Of the 608 female students who were followed at six month intervals over a period of three years, 60 percent had the sexually transmitted virus at some point during the study. The average age of the women was 20. Experts believe that the infection rate among Rutgers students is not unique, but is probably representative of students at large urban universities throughout the US.
There are about 35 strains of HPV that affect the anogenital mucosa. In the majority of cases affecting young women, the virus does not produce symptoms or tissue changes, and comes and goes silently in less than a year, causing no apparent long-term effects.
But in a small percentage of young women the virus produces genital warts. These small growths, which are usually flesh colored and painless, often appear inside the female genitals. Most women do not know they have genital warts, which can be identified on a pelvic examination or by a Pap test. The Pap test sometimes picks up vaginal HPV infections, too. The warts generally are removed surgically.
"The worry here is that the human papilloma virus, which sometimes causes genital warts, can also cause cervical cancer," says Debra S. Heller, MD, associate professor of clinical pathology and laboratory medicine at UMDNJ-New Jersey Medical School. "Many women carry the virus but don't develop warts. They are still at increased risk for cervical cancer, however."
Other risk factors for cervical cancer include early sexual activity, multiple sex partners, HIV infection, or a male partner who has had multiple partners. "Some women carry the virus for life without being aware of it, but we don't know why in some cases HPV becomes activated and can lead to cancer," she states.
She advises a yearly Pap test for all women starting by age 18 - or when a woman becomes sexually active - and continuing after menopause or hysterectomy. The Pap test can detect pre-cancerous cervical changes, and cervical cancer in its early and treatable stages.
"Cervical cancer is generally very slow growing," says Heller, "and can take up to 10 years from the first cellular changes to development of an invasive tumor." Of those who die of the disease, 80 to 85 percent have not had a Pap test in more than five years, according to the College of American Pathologists.
"Cervical cancer is one of the more preventable and curable cancers,"
Heller concludes, "but a Pap test is the necessary first step."