Older but wiser?

Posted by Liz on Dec 26, 2008 in cervical cancer | 2 comments

Age and wisdom don’t always go hand-in-hand.

Indeed, recently published data show that nearly 1 in 16 older women in the United States are infected with high-risk human papilloma virus (HPV).  HPV, of which there are 40 types, is classified as low-risk or high-risk, depending on whether or not it causes genital warts (low-risk) or cancer (high-risk).

Left undetected, HPV (which resides in the skin and mucous membranes) can be easily transmitted during sexual activity. What’s more, the virus causes virtually no symptoms until the infection reaches more advanced stages. In addition to cervical cancer, HPV can increase the risk for cancers of the vulva, vagina, penis and anus.

In this study, researchers conducted interviews with 1,550 women, ages 57 to 85, residing in Chicago. Additionally they drew  vaginal samples and tested them for 13 high-risk types of HPV.

Study results, which were published in the November issue of Obstetrics & Gynecology, showed that the prevalence of high-risk HPV was 6% in this population; this corresponds to 1.8 million women (2006 Census data). Additionally, 63%  had multiple type infections.

Factors contributing to higher HPV risk included being single, smoking, having had 2 or more sexual partners and having previously had cancer or a hysterectomy.

HPV vaccine for older women?

The new, controversial HPV vaccine — Gardisil — is only  indicated for girls, ages 9 through 12, and may also offer protection for females through the age of 26, so long as they have not been previously vaccinated.  A condom may offer some amount of protection, but because HPV can affect areas that are not covered by a condom, the risk may remain in certain individuals. Short of that, the only way to truly prevent transmission is to avoid sexual activity altogether.

Merck did submit an application to extend use of Gardisil through the age of 45 but as of today, the U.S. Food & Drug Administration continues to express concern that the data do not support this extension.

Fortunately, there are options for women over age 30

The American Cancer Society now recommends that in addition to the pap smear (which can miss precancerous cells in up to 50% of cases), women over age 30 should have an HPV test. Like a pap, it simply require a swab and can be done at the same time. If results are negative in both, it is not necessary to have either again for 3 years.

It’s important to note that although there is no treatment for HPV, the immune system is able to clear both low- and high-risk types in 90% of cases. And of course, vigilance is a wonderful way to treat cervical cancer early, when necessary.

Be older and wiser

The take-away message is that older women remain at risk for HPV and have an increased risk for more severe infections.

Knowledge is power. Take the time to be tested, learn more about HPV, and open the lines of communication with your partner. At least 50% of men and women who have sex will develop HPV at some point in their lifetime, and the Centers for Disease Control and Prevention estimates that at least 6.2 million American become infected yearly.