The Senate Finance Committee is scheduled to mark-up the Breast and Cervical Cancer Treatment Act this Wednesday (June 14). However, the bill scheduled to be considered does not contain the HPV education and prevention provisions, including the condom warning label, overwhelming passed by the House.
What is HPV?
HPV (human papillomavirus) is a sexually transmitted virus. It is the causeof virtually all cervical cancer. The virus is present in 99.7 percent of all cervical cancers according to a study published last year in the Journal of Pathology. HPV has also been linked to oral cancer and cancer of the vagina, prostate, penis and anus, as well as genital warts. Many of those infected, however, have no visible symptoms.
How widespread is HPV and cervical cancer?
At least 24 million Americans are infected by HPV according to the National Cancer Institute (NCI). Yet no one knows the true size of the epidemic because, unlike 58 other diseases, the Centers for Disease Control and Prevention (CDC) does not monitor or require case reports of HPV.
While everyone infected with HPV will not develop cancer, every year 15,000 cases of cervical cancer are diagnosed and 5,000 women die from the disease. Hundreds of thousands of other women will be diagnosed and treated for pre-cancerous conditions which some researchers estimate are about 4 times more common than invasive cervical cancer.
Do condoms prevent HPV infection?
Many sexually active Americans think that using a condom can protect them, this is not the case with HPV. According to the NCI, the evidence that condoms do not protect against HPV is so definitive that “additional research efforts by NCI on the effectiveness of condoms in preventing HPV transmission is not warranted.” According to Dr. Richard Klausner, the Director of the NCI, “condoms are ineffective against HPV because the virus is prevalent not only in mucosal tissue (genitalia) but also on dry skin of the surrounding abdomen and groin, and can migrate from those areas into the vagina and cervix.” The American Cancer Society has concurred, stating that “research shows that condoms (“rubbers”) cannot protect against infection with HPV.”
Why have so few Americans ever heard of this pervasive disease that kills thousands of women every year?
Despite the fact that it is the most common sexually transmitted virus in the United States, over three-fourths of the respondents in a recent poll have never heard of HPV. CDC, the federal agency charged with disease prevention, provides no guidance to states on how to curtail the spread of HPV or leadership to health care providers on how to counsel or even recognize those with the virus. Because of this failure, thousands will die every year and millions more will become infected and pass the disease onto others. In addition, the organization which claims to advocate for women’s health, the American College of Obstetricians and Gynecologists (ACOG), has aggressively opposed Congressional efforts to educate the public about HPV.
How does H.R. 4386, the Breast and Cervical Cancer Treatment Act, address the issue of HPV prevention?
H.R. 4386 would make HPV and cervical cancer prevention a priority. The bill directs the CDC to determine the prevalence of HPV, specifically what populations is the disease most affecting, and to develop and disseminate educational materials for the public and health care providers regarding HPV, its impact and prevention. Finally, condom labels and government sponsored informational materials would be required to state the facts that condoms do not prevent the transmission of HPV and that HPV can cause cervical cancer.
This bipartisan proposal was approved unanimously by the Commerce Committee last fall.
Why is ACOG opposed to telling the truth about HPV and condoms?
ACOG has been AWOL in the fight against HPV. ACOG opposes efforts to make HPV a reportable disease. Without proper surveillance- now made easier with the development of a HPV test- it is nearly impossible to determine the extent of the epidemic or to develop effective prevention interventions. Disease reporting has played a key role in prevention for decades and needs to be part of any strategy to address HPV.
ACOG opposes the requirement to educate the public about HPV and the lack of condom effectiveness against HPV transmission. By withholding this information, individuals at risk will be denied information that could protect the public health and even save lives.
ACOG also opposes the “truth in advertising” provision which would require condom packages to bear information stating that HPV can cause cervical cancer and that condoms do not prevent the transmission of HPV. ACOG is instead recommending that condoms merely state the “effectiveness” of condoms against sexually transmitted diseases.
ACOG has argues that if people know the truth about condoms and HPV, they will stop using condoms. There is no scientific or anecdotal evidence to substantiate this claim. ACOG’s position amounts to a cover-up which continues to hide the truth about HPV and endangers the health and lives ofwomen. ACOG’s position is that women and men with knowledge will make poor choices rather than informed decisions.