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The thing about HPV that I just don't see enough of is the fact that genital and anal warts are called "condylomas," which, to be snarky and horrible, is always what I hear when someone says the Secretary of State's first name.

Posted by Jubilation T. Cornball | April 8, 2008 11:48 AM

people need to calm down about HPV. After testing positive for it I then had a cancer screening which freaked me out, it was only then that I learned that EVERYONE gets HPV. You don't even have to have had sex. Any sort of touching will give it to you within your lifetime. And the vaccine only prevents a few out of the thousands of strains.

Posted by UnRed | April 8, 2008 11:52 AM

@2: It doesn't help that now they have that commercial on TV about a woman whose paps were always normal, but she got the HPV test anyway, and then she had... CERVICAL DISEASE!!!!! That test saved her life!!!!! What the treatment might be for "cervical disease" they never say, but if she hadn't received it, she probably would have DIED. Thanks, HPV test!

Posted by Aislinn | April 8, 2008 12:07 PM

and this is why my hypochondriac mother thinks she has restless leg syndrome, fibromyalgia, and probably erectile dysfunction.

Posted by unred | April 8, 2008 12:12 PM

Well, getting the HPV vaccine is a useful thing for girls and boys, especially BEFORE they become sexually active (middle school at the latest), in that it impacts about 70 percent of the HPV strains - but you still should have pap smears.

Posted by Will in Seattle | April 8, 2008 12:14 PM

@2: Yes, the vaccine only prevents a few of the strains. Specifically, "the four most serious variants."

This really isn't rocket science. Some strains of HPV are worse than others. The vaccine protects against the really bad ones, so that the patient is less likely to develop cervical cancer.

Posted by AnonymousCoward | April 8, 2008 12:14 PM

there are about a hundred strains of HPV. 15 of them cause cancer, and about 5% of sexually active adults are positive for one of these strains at any given time. when you consider all strains of HPV [not just the high-risk ones], about 25% of people are positive.

about 14,000 cases of cervical cancer are diagnosed in the US each year. about 4,000 of these women die. these numbers would be much, much higher without pap smears and HPV testing.

a rarely reported HPV not-so-fun fact: gay men get anal and rectal cancer at rates that approach cervical cancer in women, yet there are no formal screening guidelines for this population.

Posted by brandon | April 8, 2008 12:16 PM

i love you science!

Posted by ray | April 8, 2008 12:20 PM

@7: I'm sure proctologists can't wait to get in on that action.

Posted by Greg | April 8, 2008 1:37 PM

It's worth reading Bernadine Healey's commentary in a recent issue of U.S. News and World Report:

Cocksucking (and pussy-eating) guys and girls who do so unprotected have been developing oropharyngeal cancer at rising rates over the last 3 decades, probably mostly from HPV-16 and -18.

Someone going to this talk should ask Denise Galloway why it's taking so long to get Gardasil approved for men.

Maybe guys who are oral-active/unprotected should ask their doctors about getting Gardasil off-label.

And maybe new couples going monogamous should get tested for HPV along with other STDs before going unprotected.

Posted by rob | April 8, 2008 5:35 PM

@8: Science loves you too!

Almost everyone does get HPV; the important question is which HPV. By making life difficult for the four variants most likely to result in cancer (and warts), the vaccine grants a strong selective advantage towards benign variants in the HPV population. Nifty. We're basically domesticating the virus. Even the non-vaccinated (thanks to poverty, crazy parents or caution/stupidity) will be better off....

@10: Agreed. Everyone who hasn't already contracted HPV should at least consider off-label use--men too! It's damn expensive if your insurance isn't paying, and most off-label uses are not covered.

Still, isn't it a bit pleasant that women's health, for once, took the priority over men's?

I believe the studies for men are still ongoing, including here in Seattle. Volunteer!

Posted by Jonathan Golob | April 8, 2008 6:03 PM

@11: Healey (see @10) says "...when it comes to HPV-related tonsil and tongue cancer, men are at greater risk than women." Gotta dig into PubMed to find out why that is. I wouldn't in any way want to make light of surgery or other treatment for cervical cancer, but it does seem to have fewer implications for daily living at least initially than surgery or treatment for oropharyngeal cancer. There are obviously many, many variables in the whole situation. For example, how does prior HIV or herpes infection affect HPV transmission vulnerability or efficiency, not to mention likelihood of cancer down the road? Circumcised vs. uncut cocks? Are men doing most of the transmission since straights predominate and men tend to have more partners than women? If so, a strictly rational approach to controlling spread would seem to emphasize vaccinating men over women.

But yeah, I'm glad women's concerns are emphasized over men's for a change. However, I'm concerned that factors affecting primarily gay people of either gender will be ignored for too long.

I would volunteer for clinical trials in a heartbeat if I didn't live in a rural part of California.

Posted by rob | April 8, 2008 7:51 PM

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