Women's Health Weekly (10.16.03) - Wednesday, October 22, 2003
A recent paper contends that high cervical cancer death rates
among women in developing countries reflect a lack of access
to Pap smears and other screening programs, not a high
prevalence of human papillomavirus (HPV) infection.
Genital HPV - certain strains of which can lead to cervical
cancer - is common globally, but in countries where women
receive timely screening and treatment, cervical cancer rates
are low. A new US global AIDS law requires an analysis of HPV
prevalence and a study of the impact of condom use on the
spread of HPV in sub-Saharan Africa, ostensibly to combat high
rates of cervical cancer.
According to the paper, "HPV in the United States and
Developing Nations: A Problem of Public Health or Politics?"
by Cynthia Dailard (Guttmacher Report on Public Policy; August
2003;6(3)), evidence from developed nations suggests the law's
focus on HPV prevalence is misplaced and will undermine
confidence in condoms without helping poor women get screening
Despite high rates of HPV infection among Americans, cervical
cancer accounts for only 1 percent of cancer deaths in women.
Pap tests allow early detection and treatment of precancerous
changes in cervical cells. Globally, cervical cancer kills
225,000 women a year, almost 85 percent of them in developing
countries where cervical screening is often unavailable.
Proponents of the US law say that because HPV is spread by
skin- to-skin contact, it cannot be entirely prevented by
condom use, so only abstinence before marriage and monogamy
within it can protect women from HPV and cervical cancer.
According to Dailard, using HPV to undermine global confidence
in condoms places people at risk of contracting a number of
diseases and does not address the issue of providing cervical
cancer screening for developing nations.