The first tear fell as the video was ending. Jason Mendelsohn, seated on the speaker’s panel, brushed it from the corner of his left eye. My attention captured, I watched as he brushed another one from his right eye. A woman in the row in front of me snuffled and now, I had welled up myself. Later, scientist Julie Torode, Ph.D., would choke up and apologize several times while delivering her presentation.
Men and women crammed the bland government-issue space for the “Let’s End HPV-Related Cancers” Congressional Briefing yesterday. We had convened at the Sam Rayburn Building. The seats filled and a crowd stood at the back of the room. Interns held their sack lunches, listening intently. Lisa Moore, a thirty-year-old Indiana woman with cervical cancer, had just shared her thoughts by video — the belief that “If something like this is preventable, I don’t understand why people don’t want it prevented. If this was a leukemia vaccine, or breast cancer or prostate cancer or anything not related to sex there’d be no question. Cancer sucks…it takes everything, and it kills ya.” Lisa Moore died in 2017. Her experience sums up the conundrum created by human papilloma virus.
To date, the world has fumbled the ball in dealing with HPV, at least partly out of embarrassment and discomfort with sexual matters. Human papilloma virus — HPV for short — spreads person-to-person through oral, vaginal or anal sex. Usually it clears spontaneously, but for some individuals it lingers. When persistent, the virus causes genital warts and a variety of cancers in both men and women. These include cervical, penile, anal, vulvar and oral cancers which may take decades to appear. HPV is gender neutral.
According to the Centers for Disease Control and Prevention, most sexually active Americans become infected with HPV at some time during their life, unless they are vaccinated against it. As the most common sexually transmitted infection, an estimated seventy-nine million Americans now carry the virus.
The health and economic burden of HPV is high. More U.S. men (over fourteen thousand) are diagnosed with HPV-related oral cancer each year than women (three thousand). This cancer typically involves the back of the throat, tongue and/or tonsils. Twelve thousand U.S. woman receive a diagnosis of cervical cancer annually. Male oral HPV-related cancers now outpace cervical cancer cases. The cost in the U.S. each year to diagnose and treat HPV-related disease is over ten billion dollars.
Yesterday was not my first health policy rodeo. As a past President of the American Medical Women’s Association, I’ve represented the organization at a myriad of health efforts. I’ve served on President Obama’s Opioid Task Force, testified to the FDA on mammography safety, heard a Senator discuss his lung cancer and watched Al Gore carry in a stack of Medicare papers to underline the need for simplified records and on and on. But I never witnessed weeping like yesterday.
The tragedy of HPV lies in its preventability coupled with our failure to do so. The experts assure us: we have the tools we need. Vaccination combined with screening for disease and proper treatment can push HPV into a corner.
We’ve had an HPV vaccine for ten years. A boy or girl vaccinated fully before their entry into sexual activity can expect to live their life free of the virus. Young adults who missed out on vaccination may also benefit from receiving it now. Yet HPV vaccination rates lag when compared to those for meningococcal disease, tetanus or diphtheria. Click for more information about HPV.
But I’m optimistic. Standing room only at a Congressional health briefing is a rarity. People in leadership positions are interested and appear ready to deal with this. Young people are eager for information. In 2018, the World Health Organization issued a call to action to make HPV-related cancers rare. Countries from Australia to those in sub-Saharan Africa are galloping along in a race to be the first to achieve this goal. The U.S. has the potential to be first. But win, place or show, this derby will cut misery and save lives. It has to.
Click for information on the Union for International Cancer Control.
Click for more information about HPV from the World Health Organization