Expanding knowledge, new screening technologies, and effective vaccines have opened new horizons in, and put pediatricians at the forefront of, preventing cervical cancer and other diseases caused by human papillomavirus. Here's what we know now and what it means for your patients. First of two parts.
Jessica A. Kahn, MD, MPH, and Paula A. Hillard, MD
Dr. Kahn is associate professor of pediatrics, division of adolescent medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Dr. Hillard is professor and chief, gynecology, division of adolescent medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Dr. Kahn, the manuscript reviewers, and staff editors have nothing to disclose in regard to affiliations with, or financial interests in, any organization that may have an interest in any part of this article.
Dr. Hillard is a consultant for Merck, Procter and Gamble, Wyeth-Ayerst, and GlaxoSmithKline; has received research support from Berlex, Wyeth-Ayerst, and Duramed; and is on the speakers' bureaus of 3M, Barr Laboratories, Berlex, Merck, Pharmacia-Upjohn, Pfizer, Organon, Ortho-McNeill, Tap, and Wyeth-Ayerst.
Our understanding of human papillomavirus (HPV) infection and its consequences has increased greatly over the past few decades. Screening technologies such as liquid-based cytology and HPV DNA testing are available to help clinicians distinguish between transient infection, which is benign, and persistent infection with high-risk HPV types, which may lead to cervical cancer. Vaccines designed to prevent acquisition of specific HPV types have the potential to prevent cervical cancer, other malignancies, recurrent respiratory papillomatosis, and genital warts.
Pediatricians will be at the forefront of prevention efforts as these technologies are implemented. The first part of this article discusses HPV infection and its clinical consequences, reviews recent data about the natural history of HPV infection in adolescents, and describes technologies for detecting HPV infection. The second part, which will appear in the April 2006 issue, reviews new guidelines for cervical cancer screening and discusses HPV vaccines and your role in preventing HPV-related disease.