University of Virginia Health System

Women's Health

Herpes, HPV May Spell Cervical Cancer

Study finds combo may create higher risk for women

New research suggests that herpes and another common sexually transmitted virus can be a deadly combination, raising the risk that infected women will develop cervical cancer.

The findings seem to explain why some women are more prone to cervical cancer.

"We know that HPV (human papillomavirus) causes cancer, but a lot of people have HPV and never get cancer," explains Stephen E. Hawes, an assistant professor of epidemiology at the University of Washington at Seattle and author of a commentary on the new study.

Pap Tests Stop Disease In Its Tracks

An estimated 13,000 American women fall victim to cervical cancer each year and 4,100 will die, according to the American Cancer Society. However, tests known as Pap smears (also called Pap tests) let many more stop the disease in its tracks before it becomes serious. Deaths from the cancer dropped by 74 percent from 1955 to 1992, after the tests became popular.

Scientists think at least 90 percent of cervical cancer cases are caused by HPV, which may be the most common sexually transmitted disease. HPV causes inflammation, which makes the cervix more hospitable to cancerous cells by preventing them from dying naturally, Hawes explains.

"This process can take years to develop—20 to 30 years after you have your initial HPV infection," he says.

Herpes Makes Matters Worse

Some scientists have suspected that herpes could make things worse. An international group of researchers tested that theory by examining medical records from seven countries of 1,263 women with cervical cancer and 1,117 women free of the disease.

The findings appeared in a recent issue of the Journal of the National Cancer Institute.

The researchers from the International Agency for Research on Cancer found signs of infection with herpes simplex virus 2 in about 44 percent of the women with cancer, but only in 26 percent of the other women.

They also found HPV in nearly 95 percent of the women with cancer, but only in 15 percent of the healthy women. Of all women who were infected with HPV, herpes increased their risk of cervical cancer by two to three times.

Dr. Tom Wright, a pathologist at Columbia University, says the findings confirm those of a 1991 study in Latin America. However, it is still unclear how herpes works to make women more susceptible to cervical cancer since the virus does not cause as much dangerous inflammation, he adds.

There is hope for the future, however. "The biggest issues right now are the development of vaccines to prevent infection with high-risk types of HPV and new molecular tests to identify those women at greatest risk for developing cervical cancer," he says.

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)     

American Cancer Society

American College of Obstetricians and Gynecologists

CA: A Cancer Journal for Clinicians

International Agency for Research on Cancer

Journal of the National Cancer Institute

National Institutes of Health

The New England Journal of Medicine

December 2002

Pap Tests Stop Disease In Its Tracks

Herpes Makes Matters Worse

New Cervical Cancer Detection Guidelines Issued

Vaccine May Avert Cervical Cancer

Online Resources

In Other Women's Health News:

Concerned that many women are over-screened and over-treated for possible cases of cervical cancer, the American Cancer Society has issued new guidelines that revise standards for when and how often women should get early detection tests.

Under the new guidelines:

• Cervical cancer screening should begin about three years after a woman begins having vaginal intercourse, but no later than at age 21.
  
  
• A Pap test should be performed every two years. At or after age 30, women with three consecutive normal Pap tests may get screened every two to three years. A physician may want to screen more frequently if a woman has the HIV virus that causes AIDS, or if she has other conditions that leave her with a weakened immune system.
  
  
• Women 70 or older with at least three normal Pap test results and no abnormal ones in the last 10 years can choose to stop cervical cancer screening.
  
  
• Screening after a total hysterectomy—including removal of the cervix—is unnecessary, unless the procedure was performed as a result of cervical cancer. Women who have had a hysterectomy that does not include removal of the cervix should be screened according to the guidelines above.

The new guidelines are published in the November/December issue of CA: A Cancer Journal for Clinicians.

Always consult your physician for more information.

Vaccine May Avert Cervical Cancer

The likelihood that cervical cancer will become less of a killer has taken a huge step forward.

Researchers report a perfect success rate for a vaccine against a virus responsible for half of all cases of the disease, which is the second-leading cause of cancer deaths among women worldwide.

More than 30 varieties of the human papillomavirus (HPV) have a clear link to cancer. While most cases of HPV resolve on their own, the remaining ones are responsible for over 90 percent of all cervical cancers.

HPV-16, the variety for which the vaccine was created, infects 20 percent of adults. HPV-16 is also the strain most commonly linked to cancer, and is present in 50 percent of all cervical cancers.

The results appear in a recent issue of The New England Journal of Medicine. Another article in the same issue of the journal, however, reports a lower level of effectiveness for a vaccine against herpes simplex virus type 2 (genital herpes): The vaccine was 73 percent to 74 percent effective for women.

Genital herpes affects one in five women in the United States, but does not lead to cancer.

Always consult your physician for more information.