LITTLE PROTECTION

Condoms offer little protection from STDs
STD strikes one young woman in five
Lifetime risk of virus: 75%: Condoms fail to stop the leading cause of cervical cancer
September 5, 2000
Siobhan Roberts
National Post

At least one in five women between the ages of 15 and 24 has human papillomavirus, a sexually transmitted disease that is the leading cause of cervical cancer, a new Canadian study has found.

Barrier contraceptives such as condoms have proven ineffective in stopping the spread of HPV, which is known to cause genital warts, and nothing short of abstinence can protect people from contracting the disease.

Of the nearly 1,000 Ontario women tested, 24% of those aged 20 to 24 were HPV positive, according to the study published today in the Canadian Medical Association Journal. Women aged 15 to 19 had the second-highest prevalence of HPV, at 20%.

"The current wisdom is that a woman's ... risk of being infected with HPV at some point in their life is 75%," said Dr. Alice Lytwyn, a pathologist at Women's College Hospital in Toronto, and one of 10 doctors who worked on the Survey of HPV in Ontario Women.

"[HPV] is a type of virus that can be spread simply by having intimate skin contact before penetration."

The virus is widely regarded as the leading sexually transmitted disease in North America, added Dr. David Hager, a specialist in the field of obstetric and gynecological infectious diseases at the University of Kentucky Medical School in Lexington.

"There are an estimated four [million] to six million new cases annually in the United States. And studies have shown that as many as 45% of college students have been shown to be HPV positive."

Human papillomavirus is a viral sexually transmitted disease that can cause genital warts that remain invisible or grow to be the size of a nickel. There is no cure for HPV because it is a viral STD, as opposed to a bacterial STD, which can be eradicated with antibiotics. Treatment is limited to removing lesions as they appear.

And while regular testing is effective in reducing the chances of developing cervical cancer from HPV, only abstinence will prevent contracting the virus itself. Condoms, according to a Health Canada report, are ineffective in preventing transmission of HPV.

"Barrier contraceptives ... do not appear to be effective in preventing HPV infection," the report states.

HPV is thought to be the cause of 90% of all cases of cervical cancer in women.

Cervical cancer affects 500,000 women worldwide annually, and it is the second-leading cause of death from cancer among women.

Statistics from Health Canada indicate that approximately 400 Canadian women die from cervical cancer annually, with 1,300 new cases diagnosed each year.

"Sexual abstinence would be the only way to prevent HPV," said Dr. Lytwyn, adding that might not be such a realistic ideal to advocate.

Ninety percent of all HPV cases are subclinical, meaning the carrier exhibits no symptoms of the disease, but still carries the virus and is capable of passing it on.

"I think people do look upon it as something as common as the common cold," Dr. Lytwyn said.

"However, 5% to 10% [of women who contract it], can go on to develop [cervical] cancer."

"If there is anything that should be emphasized with HPV, it is how discordantly it impacts women," Dr. Hager said. "It is not a fair player. Far and away the majority of the malignant cases are in women," he said.

The only course of detecting the virus in women is through a regular Pap smear.

"What the pap smear can do is detect the changes in the cells in the cervix before it becomes cancer," explained Dr. Lytwyn. "And then you can treat those changes before they become cancer."

The study also found that self-administered tests would be as effective in detecting the virus as a swab taken by a physician.

"Perhaps we will be able to develop a test that women can self-administer, and that way we will be able to reach those women for screening who are reluctant to come in for a pelvic exam," Dr. Lytwyn said.