STD Awareness: HPV Testing vs. the Pap Test

I love writing about health and medicine, but I hate going to the doctor. I don’t like taking my clothes off for a dermatological exam, I don’t like rolling my sleeve up for a shot, and I don’t like opening my mouth for a dentist. I don’t even like having my blood pressure taken — it gives me the heebie-jeebies, and probably a case of white-coat hypertension too.


For now, pelvic exams are a mainstay — and an important part of cancer prevention.


So when it comes to something even more invasive, like the Pap test to screen for cervical cancer, I’m one of those people pining for a magic wand — a tool that a health care provider can wave over your fully clothed body to detect disease. The Pap test may have transformed a scourge like cervical cancer into one of the most easily detected and treated cancers — and for that I love it — but I still fervently wish for its demise. As long as it’s replaced by something better, of course.

Last month, an article in JAMA inspired a burst of headlines. “HPV test more effective than Pap smear in cancer screening,” said CNN. Or as WebMD put it more succinctly, “HPV Test Beats Pap.” Then, last week, the U.S. Preventive Services Task Force updated their guidelines to recommend that patients 30 and older can forgo the Pap test in favor of HPV testing alone. This news might be welcome to anyone who dislikes regular Pap tests and wishes to avoid stirrups and speculums. Unfortunately, HPV tests aren’t the noninvasive “magic wand” so many of us hope for. From the patient’s perspective, the experience of undergoing an HPV test is no different from the experience of undergoing a Pap test. They both require a pelvic exam — the stuff of stirrups and speculums. Continue reading

STD Awareness: Eliminating HPV-Related Cancers

Earlier this month, every major cancer center and organization in the country released a joint statement calling for the elimination of cervical cancer, along with all other HPV-related cancers. The elimination of a large swath of cancers might sound like a tall order — so far, we’ve only eradicated two viruses from the planet: smallpox and rinderpest. And we’re on the brink of getting rid of a third, the virus that causes polio.

But doing away with human papillomavirus (HPV) would herald a new chapter in disease eradication, because HPV causes cancer, meaning that eradicating HPV will eradicate the cancers caused by it. And the good news is we have all the tools we need to wipe HPV off the face of the earth — we just need to use them.


The tools to wipe a large class of cancers off the face of the earth are right under our noses — we just have to use them.


A quick rundown on HPV is in order. It’s the most common sexually transmitted infection in the world, and causes multiple cancers — cervical, head and neck, anal, vulvar, vaginal, and penile. While it’s most well-known for causing cervical cancer, here in the United States it is transitioning away from its old job, causing more head-and-neck cancers than cervical cancers. Nearly all sexually active people will be infected with HPV at least once in their lives, and though only a fraction of infections progress to cancer, its ubiquity means it still causes hundreds of thousands of cancers every year. In the United States, around 41,000 HPV-related cancers are diagnosed annually, while more than 600,000 are diagnosed worldwide. Continue reading

STD Awareness: Fighting Cervical Cancer Across the World

Tomorrow kicks off World Immunization Week, a reminder that, just as disease can cross borders, so should our efforts to prevent it. Especially when we have an effective vaccine for one of the world’s top causes of cancer — but the people who need it most are less likely to get it.

Almost 90 percent of cervical-cancer deaths strike women in developing countries, where it is the second-most common cancer among women. In fact, over vast swaths of Africa, cervical cancer is the No. 1 cause of cancer death in women. (In the United States, it doesn’t even crack the Top 10.) While cervical cancer rates are holding steady in the developed world, in the coming decades they are projected to increase sharply in less developed regions.


More than 9 out of 10 cervical cancers strike women in countries with no HPV vaccination programs.


Since 2006 there has been a vaccine for human papillomavirus (HPV), the virus that causes cervical cancer. Unfortunately, while this vaccine is making impressive strides in the developed world, it is almost out of reach in the developing world, where it could save the most lives. To fully realize this vaccine’s potential, it needs to be distributed worldwide — not just within rich countries that can afford it.

Fighting Cervical Cancer in the Developed World

HPV has been nicknamed “the common cold of STDs” — because pretty much every sexually active person will get it at some point. It can be transmitted by vaginal, anal, and oral sex, as well as by rubbing genitals together, even without penetration. HPV can cause cancers of the throat, anus, vagina, vulva, and penis — but is most “famous” for causing cancer of the cervix (the tissue that connects the vagina to the uterus). If you have a cervix, there are two big things you can do to protect its health: receive regular Pap testing after becoming sexually active, and get vaccinated against HPV before becoming sexually active. When you take both of these steps, you’ll maximize what modern medicine has to offer. Continue reading

Pro-Choice Friday News Rundown

  • Republican legislators in Arizona sure have a lot of nerve. They want to mandate that doctors performing abortions ask “why” a woman is terminating her pregnancy. What is the “why” behind this invasive questioning other than wanting to intrude upon the privacy of a woman undergoing a perfectly legal medical procedure? (AZ Central)
  • We at Planned Parenthood will always stress the importance of comprehensive sex education in schools. If you happen to think that sex education isn’t crucial to children’s development, I welcome you to read this disturbing but informative piece over at the New York Times. In the age of widespread smartphone access, young, impressionable kids are learning about sex from the worst source possible — online porn. (NY Times)
  • Speaking of the NYT, why does columnist David Brooks have such a fundamental misunderstanding of late-term abortions (and the fact that only slightly more than 1 percent of abortions are performed at 21 weeks or later, according to the Guttmacher Institute) and the reasons women have them? This is a highly educated, privileged man with access to soooo many educational resources and statistics on the subject … It’s almost like he’s being willfully ignorant! (Slate)
  • How Trump’s Global Gag Rule Is Devastating Abortion Rights & So Much More One Year Later (Bustle)
  • Alarming news: Head and neck cancers caused by HPV are expected to outnumber cervical cancer cases in the next few years. (U.S. News & World Report)
  • Additionally, men infected with HPV-16, the type responsible for most HPV-related cancers, are 20 times more likely to be reinfected with the same type of HPV after one year. (Science Daily)
  • Thank you, Cosmo, for highlighting Planned Parenthood’s efforts to increase access to telemedicine abortion in 2018. Ensuring women have choices and access to safe procedures will always be a meaningful endeavor for us. (Cosmopolitan)
  • Women who were denied an abortion are three times more likely to be unemployed than women who were able to access one. Women’s access to reproductive health care has an undeniable economic impact! How many times do we have to highlight this connection? (Rewire)
  • Excuse me if I sound radical, but Trump and the Republicans’ war on Medicaid is tantamount to genocide of the poor. (Salon)

STD Awareness: Transgender Men and Cervical Health

Healthy cervical cells as seen under a microscope. Image: National Cancer Institute

Just one month ago, headlines screamed that the Centers for Disease Control and Prevention (CDC) received a list of “banned words” from the Trump administration. One of those words was transgender, raising the alarm that the current president might be eyeing policies that would further marginalize the trans population and harm their health. (Other forbidden words include fetus, evidence-based, and vulnerable.) Some have argued it wasn’t Trump policy per se, but self-censoring on the part of the CDC to protect their budgets from being slashed by legislators hostile to transgender rights, abortion rights, science, people of color, and poor people.

In any case, refusing to use words like transgender can have grave consequences for trans health. If the CDC can’t reference the trans population when requesting money for services and studies, they will be hobbled in their ability to serve that population’s needs.


Recommendations for cervical cancer screening are the same for anyone with a cervix, whether trans or cisgender.


January is Cervical Health Awareness Month. Anyone who has a cervix can develop cervical cancer — including transgender men who have not had their cervixes surgically removed. In observance of the month, and in defiance of directions to avoid the word transgender, today we’ll discuss the importance of cervical health in trans men — and why taxpayer-funded entities like the CDC and the National Institutes of Health must be able to study and serve this population.

Transgender men (or trans men for short) are individuals born with female reproductive organs, but who identify as male. Likewise, cisgender women were born with female reproductive organs and identify as female. Both trans men and cisgender women were born with cervixes, and wherever a cervix exists, the possibility of cervical cancer exists. Continue reading

STD Awareness: Is HPV Now a “Men’s Disease”?

Human papillomavirus, or HPV, is most notorious for causing cervical cancer — making it, in many people’s minds, a “women’s disease.” But this gender-blind sexually transmitted virus can cause cancer in any cell it infects, and is associated with cancers of the cervix, anus, vagina, vulva, penis, and mouth and throat — aka oropharyngeal cancer.

While oropharyngeal cancers used to be caused mostly by tobacco, as people quit smoking an increasing proportion is caused by HPV. In the 1980s, only 15 percent of oropharyngeal cancers were caused by HPV, but nowadays the virus is behind 70 percent of them. A 2011 study predicted that the number of HPV-positive oropharyngeal cancers will surpass cervical cancers by 2020.


HPV is rapidly gaining prominence among men.


It’s only 2017, but we’re ahead of schedule. Earlier this year, researchers reported that, in the United States, oropharyngeal cancer is more common among men than are cervical cancers among women — and oropharyngeal cancer rates are increasing in the male population, while they are relatively stagnant among women. These rates are projected to continue climbing, which will skew oropharyngeal cancer even more heavily toward the male population. But, in the public’s imagination, HPV is most well-known for its association with cervical cancer — while most people haven’t even heard of oropharyngeal cancer.

Oropharyngeal Cancer and HPV

Oropharyngeal cancer can strike the inside of your mouth and throat. Risk factors include tobacco (including cigarettes, snuff, and chewing tobacco), marijuana use, alcohol, and oral infection with HPV. HPV can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as “French kissing” and rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancer. Continue reading

STD Awareness: STI vs. STD … What’s the Difference?

When it comes to sexually transmitted diseases, the terminology can be confusing. Some people use the phrase “STD,” some people insist “STI” is the proper set of initials, and every once in a while you might catch someone using the term “VD.” Over the years, the parlance has changed. What’s the deal?

VD: Venereal Disease

Blaming women for STDs (aka VD) is an age-old tradition.

“Venereal disease” has been in use since at least the 1600s (the Oxford English Dictionary cites a 1667 publication referring to a “a lusty robust Souldier dangerously infected with the Venereal Disease”). Around a century ago, Americans flirted with heavily euphemistic expressions, such as “social diseases,” but mostly, “venereal disease” was the terminology of choice for the better part of four centuries — slightly less euphemistic, as “venereal” was derived from Venus, the Roman goddess of love, sex, and fertility. Additionally, since at least the 1920s it was frequently shortened to “VD.” Those of us of a certain age might still remember hushed talk of VD among our grandparents, parents, or peers.

Around the 1930s, public health experts started wondering if referring to VD as a separate category of disease stigmatized these infections and those who carried them, dampening motivation to fight them with the same fervor with which the community battled other infectious diseases like influenza, smallpox, and scarlet fever. In 1936, Nels A. Nelson proposed replacing “venereal disease” with “genito-infectious diseases,” but that never caught on — you haven’t heard of GIDs, right? Continue reading