Diane Harper, MD, MPH, MS, Senior Associate Director, MICHR, Professor, Family Medicine and Obstetrics and Gynecology at the University of Michigan talks about HPV and what it means for patients.
Interview conducted by Ivanhoe Broadcast News in April 2019.
This impacts younger women, this cancer?
HARPER: This impacts women. So very interesting question – there are now three peaks to cervical cancer. The first peak is in the late 30s. The second peak is in the 50s. And now the third peak is in the 70s. And so we see this happening. And this third peak is just now being recognized as also being important. While we have cervical cancer being caused by this virus, we see that the natural history of about 15 years from infection to cancer is carried out multiple times throughout a woman’s lifetime.
What’s the lifesaving potential here?
HARPER: The life saving potential is that women who live in areas that have either no access to tertiary care or women who are in developing countries where the greatest burden of cervical cancer is may not need to have to have a surgery center. They may not need to have to have an operation where there is blood loss, where there is the potential for infection in an open surgical site, that if we could take this shot to the field and be able to provide it, it would be an amazing way to offer therapy to people already infected.
What are the next steps?
HARPER: Our cure rate isn’t 100 percent. It’s a smaller percentage. A quarter to a third of women will benefit from this. And that’s more than twice what placebo is, and that’s an important part because there is some natural regression of that. So the next steps for this is to figure out do we want to tweak the molecule to see if we can get a higher coverage rate? Or do we combine this with something else to be able to get a better cure, or potentially in such as head and neck cancer, can we combine this with a chemotherapeutic agent in people who already have cancer to help their cure rates become even better.
How many women in the United States are infected with HPV and how many cancers does it cause every year and how many deaths?
HARPER: HPV is a very common sexually transmitted infection. And we anticipate about 80 percent of men and women will have had an HPV infection at least once in their life. It’s a large amount. Of those, about 90 percent will go away all by themselves. Of the remaining 10 percent, about 5 percent – half of them are going to go into this pre cancer lesion. Because we have cervical cancer screening and have had cervical cancer screening since 1960, the number of women who get cervical cancer is small in comparison to other cancers such as breast cancer. But nonetheless, between 12 and 14 thousand women every year in the United States get cervical cancer. And of those, about 4000 die. And we have the opportunity to get that to zero. We have the opportunity to make sure that women are screened, to make sure that women are treated, to make sure that women have either prevention against HPV infection to begin with or continued surveillance, continued screening, continue to go in and see my doctor and get me tested.
Is there anything I didn’t ask you, Dr. Harper, that you would want people to know?
HARPER: I just would think that even though we have done this trial in women with cervical cancer that given the biology of HPV, I think this could also be possible for men and specifically for curing anal high grade disease because the treatment for anal cancers is an even worse surgery. And so I’m hopeful that we’ll be able to extend this into the MSM population or just men who have anal cancers that are associated with HPV.
END OF INTERVIEW
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