The case for HPV vaccination

THE human papillomavirus, or HPV, is best known for causing cervical cancer, but it’s also the culprit behind many cancers of the mouth, throat, anus, and genitals. Unlike many forms of cancer, for which we lack the knowledge and tools to prevent, scientists have figured out how to dodge HPV-triggered cancers — by HPV vaccination. Vaccination against HPV thwarts the viruses’ spread, wrecking its ability to jump between people. Wiping out HPV could mean shutting down a big source of cancer cases — more than 3% of all diagnoses in the United States alone.

What is HPV?

HPV is a family of more than 150 viruses whose members infect human skin and mucosa, the moist membranes lining the nostrils, mouth, and genital cavities. Scientists name each member, or type of virus, with a number, in order of the viruses’ discovery. Many types are harmless, some cause warts on the hands or feet, and others make fleshy bumps sprout on the genitals. HPV infection is common: More than one-half of all women between the ages of 14 and 59 catch a genital HPV. Though some “low risk” types trigger skin growths, they don’t lead to the unchecked growth typical of cancer. A handful of HPVs, however, do.

Like their less-dangerous relatives, “high-risk” types slip into people’s bodies through tiny tears in the body’s mucosa. Normally, the body sweeps out pesky HPV intruders, but when high-risk HPVs stick around, they can cause cancer. They set up shop in the moist membranes of the anus, genitals, and mouth, shedding new viral spawn as old cells slough off. New viruses hide in these flakes of dead cells and can move from body part to body part — like from the vagina to the anus — or from person to person.

Human cells infected with high-risk HPVs have trouble stopping mistakes made in new cells. The infected cells are like an auto assembly line with no supervisor: New cars roll off the line, but some are missing pieces. Just as production mistakes can make a car ride dangerous, mistakes in infected mucosa can drive a cell toward cancer. In cervical cancers, early signs of the disease show up as precancerous lesions — clumps of cells that can morph into cancer. Because HPV-linked cancers grow slowly, more than 20 years can pass between infection and signs of the disease.

The Pap smear, a test that collects and examines cervical cells, can catch these signs early, giving patients a chance to treat the disease before it tumbles out of control. The test has been valuable for women: From 2000 to 2009, cervical cancer rates in the U.S. dropped. Used with a DNA test to spot high-risk HPVs, traditional Pap smears may be even more powerful. Still, in 2009, nearly 12,000 women were diagnosed with cervical cancer. And rates of other HPV-linked cancers have been creeping up. Nearly 13,000 new cases of mouth and throat, or oropharynx, cancer were reported in 2009; the vast majority was in men. Anal cancer rates are also climbing, especially for black and white adults. Unlike cervical cancer, there isNIKE