Sexually transmitted diseases


IT is quite alarming that 45 to 50 percent of men and women in the United States have an HPV—genital Human Papillomavirus (HPV)—infection. This information was recently reported by the Center for Disease Control’s National Center for Health. It is, indeed, the most common sexually transmitted disease in the country. Here are the details, which are conservative statistics since this does not include institutionalized higher risk individuals, like prisoners, addicts, and the homeless:

“Using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, researchers found the following:

•  Oral HPV prevalence was 7 percent for adults under age 70. The prevalence of high-risk oral HPV was just 4 percent.

•  For adults under age 60, the prevalence of genital HPV was 43 percent in 2013 to 2014. It reached 64 percent among black adults. Non-Hispanic Asian adults had the lowest prevalence at 24 percent.

Roughly 23 percent of adults had high-risk genital HPV, with the highest prevalence among black males (40 percent).

HPV and cancer

There are more than 108 different types of genital HPV, more than 30 of these are sexually transmitted, causing infection involving the skin of the penis, vagina (vulva), cervix, and even the anus and rectum.

US government statistics show that 25 percent of men and 20 percent of women have the strain of human papilloma virus or human wart (virus) that causes cancer. To protect individuals who are 25 and younger from acquiring this HPV-related cancer, the vaccine listed below is available today.

Cervical cancer

Cervical cancer is malignant tumor of the cervix (mouth of the womb). It is the second most cancer in women and the third most common gynecologic cancer, the second being cancer of the ovary. The most common gynecologic malignancy is endometrial (inner wall of womb) cancer, which is the fourth most common cancer in women. The first being cancer of the breasts, followed by colorectal cancer and lung cancer. Cervical cancer develops in women at the mean age of 50 years old, although it can occur in women as young as 20. In the Philippines it is the number 2 most common form of cancer among women. In the United States it accounts for least 3000 deaths, and globally, about 300,000, annually.

How prevalent is cervical cancer?

More than 20 million of Americans have HPV infection. In the Philippines, there are about 5000 new cases of cervical cancer each year. By age 50, about 80 percent of American women will have acquired genital HPV. However, more alarming than that is the fact that there are between 10,000 to 25,000 women walking around (not seen by physician) who have undiagnosed pre-invasive lesions in their cervix. If diagnosed early, these women could be saved. For every four survivors of breasts cancer, there are less than 3 women who survive cervical cancer, which shows how virulent cervical cancer is.

What causes cervical cancer?

Human Papilloma Virus (HPV, also known as genital herpes virus) accounts for most, if not all, cervical cancers. At least 50% of sexually active men and women are infected with genital HPV, especially those with multiple partners. There are about 20 million American men and women infected with HPV, many linked with abnormal pap tests, genital warts and cervical cancer. It is estimated more than 10,000 new cases of cervical cancers are discovered annually. Between half a million to a million Americans have genital warts, transmitted thru sexual contacts. The so-called high risk HPV may cause positive Pap test, and it could cause cancer of the cervix, vulva, vagina, penis, anus or rectum. The low-risk , milder form, causes single or multiple bumps of genital warts (kulugo) and could be cauliflower shaped.

Is the cure for cervical cancer?

Better than the cure! A vaccine that prevents cervical cancer has been in use since it was introduced in June 2006 and found to be “effective 100%, in the short term, at blocking the cancer and lesions likely to turn to cancer” (like the pre-invasive lesions), according to drug manufacturer, Merck & Co.

The vaccines, which are genetically engineered, Gardasil and Cervarix, which block infection caused by two of the more than 108 types of human papilloma virus (HPV), strains 16 and 18. These two sexually transmitted viruses are responsible for about 70 percent of cervical cancers. HPV, in one form or the other. The other strains of the virus cause painful genital warts, and sometimes, cervical cancers too. The newer versions of these vaccines are effective for more strains of HPV.

How early should the vaccine be given?

Students in grammar school, middle school and high school should be vaccinated before they become sexually active, because once they catch HPV infection, there is no cure; herpes is for life. This was the recommendation of Dr. Gloria Bachmann, director of The Women’s Health Institute at Robert Wood Johnson Medical School in Brunswick, NJ., who said this vaccine is a “phenomenal breakthrough. This is, today, the standard of care.

Can oral sex cause cancer?

The most common cause (70 percent) of throat cancer is oral sex with a partner who has active HPV infection. About 4 percent of adults who practice oral sex will have oral infection with a high-risk form of cancer-causing HPV. Experts say head and neck cancer will surpass cervical cancer as the most common cause of HPV-related cancer by 2020. Without being flippant, the use of seran wrap or plastic film to cover the female pelvis (similar to the use of condom for males), if oral sex is to be practiced at all, could be of some protection against HPV contamination. However, the CDC review of 138 peer-reviewed scientific studies showed that the use of condom is not effective in reducing the risk of STDs. Out of 100 women who used condom religiously, 37 of them still developed HPV. At least 1 percent of condoms are defective.

Syphilis higher among homosexuals

While society regards syphilis as an STD of the past, it is actually still very much with us, domestically and globally. Rarer than it was a century ago, syphilis remains a much dreaded disease.

Men who have sex with men have much higher rates of syphilis infection, according to a study. The rate is 106 times more than the rate of syphilis among heterosexual men, and 167 times higher than the rate of infection among women.

Homosexuals had a rate of 309 cases per 100,000 population for a primary and secondary syphilis, compared to 2.9 and 1.8 cases per 100,000 for heterosexual men and women, respectively. The region with the highest rates are located in the Southern region, with a rate of 748 per 100,000 in North Carolina.

This may sound like over simplification and quite obvious, but the best way, the surest way, to prevent getting any sexually transmitted diseases is not to have sexual contact with someone infected, or possibly infected, with HPV/HIV/Syphilis/Gonorrhea..

***

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: scalpelpen@gmail.com

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