HPV hotline is focus of new resource center

No doubt your patients have questions about human papillomavirus (HPV) — it is the most common sexually transmitted disease (STD) in America.1 It is estimated that 80% of sexually active people contract it at some point in their lives, with 5.5 million new infections occurring yearly in the United States alone.2

To help answer questions on HPV, a national hotline has been established as the first project of the new National HPV & Cervical Cancer Preve ntion Resource Center. The center has been launched by the Research Triangle Park, NC-based American Social Health Association (ASHA), a nonprofit organization dedicated solely to the prevention and control of all STDs. Callers can access the hotline at (877) 478-5868 from 2 p.m. to 7 p.m. Eastern time, Monday through Friday.

ASHA has designed the resource center to collect, interpret, and disseminate current research data in lay terms to patients, providers, policy-makers, and the media, says Linda Alexander, PhD, FAAN, ASHA president. The center offers the hotline and a Web site (available through ASHA’s site, www.ashastd.org), and it will expand to include consensus guidelines, a continuing medical education curriculum, and other educational materials.

"The center bridges the gap between the most recent scientific data about HPV and its link to cervical cancer, and [the data’s] access, translation, and utilization by the general public," notes Alexander. "This center should be considered the nation’s champion of communication that cervical cancer is detectable, treatable, and curable."

Approximately 30 HPV types are sexually transmitted, according to resource center statistics. In most cases, the virus is harmless and symptomless. Most people will not have any obvious symptoms, while some will get genital warts, and some will get cancer of the cervix.

While most HPV infections do not lead to serious problems, high-risk HPV types are responsible for nearly all cervical cancers, says J. Thomas Cox, MD, the center’s executive medical director. The primary measure for preventing cervical cancer is early detection by Pap smear screening, which detects cell changes caused by HPV before they become cancerous. The most recent HPV DNA detection technology enhances the performance of Pap screening. (Contraceptive Technology Update reviewed information on HPV testing and treatments in its April 1998 issue, p. 48.)

The incidence of invasive cervical cancer has decreased significantly over the last 40 years, in large part due to early detection efforts. The National Breast and Cervical Cancer Early Detection Program, operated by the Centers for Disease Control and Prevention in Atlanta, estimates 12,800 new cases in 1999, with 4,800 deaths attributed to the infection.

The majority of Americans are unaware of the link between certain types of HPV and cervical cancer, and even many health care providers are unsure of the HPV-cancer link, according to Resource Center information. Among policy-makers, the misinformation and confusion surrounding HPV has fueled discussion. A 1999 congressional debate centered on whether to require screening for and reporting of HPV, condom labeling, and warnings on educational materials about HPV and other STDs.3

Cox, who also serves as director of the Uni versity Health Services’ gynecology clinic at the University of California, Santa Barbara, sees provider education as an important component of the resource center.

Just as certain portions of the center’s Web site will be devoted to information for the lay public, Cox says the provider section will offer constant up-to-date information on HPV’s epidemiology, natural history, diagnosis, treatment, and advances such as vaccine development and immunotherapy. A centerpiece will be on-line continuing medical education, developed with the Hagerstown, MD-based American Society for Colposcopy and Cervical Pathology (ASCCP). The society is an organization of health care professionals committed to improving health through the study, prevention, diagnosis, and management of lower genital tract disorders. It has been active in development of guidelines on HPV testing and Pap smear management.

Cox also points to HPV News, a quarterly ASHA publication, as another valuable provider resource. The newsletter covers psychosocial issues surrounding HPV and offers medical news on possible diagnostic tools and treatments. (See resource box, above, for ordering information.)

The resource center will feature the most up-to-date news on guideline updates for Pap smear management and HPV DNA assay testing, says Cox. It will offer information based on the upcoming guidelines for management of low-grade squamous epithelial lesions (LSIL), scheduled to be published in the March issue of the Journal of Lower Genital Tract Disease published by the ASCCP. (See resource box for ordering information.) Further information on LSIL will become available this year from the multiyear ASCUS (atypical squamous cells of undetermined significance)/ LSIL Triage Study sponsored by the National Cancer Institute of Rockville, MD.

This year promises to be a watershed in terms of new scientific information in the HPV field, Cox observes. The resource center should prove to be an important aid in keeping both providers and patients up to date on new developments, he says.

References

1. American Social Health Association. ASHA Launches National HPV & Cervical Cancer Prevention Resource Center. Research Triangle Park, NC; Jan. 18, 2000.

2. National HPV & Cervical Cancer Prevention Resource Center. First HPV Hotline Answers America’s Questions. Research Triangle Park, NC; January 2000.

3. American College of Obstetricians and Gynecologists. ACOG takes stand against proposed HPV legislation. ACOG Today 2000; 44:5.

A one-year subscription to HPV News is $25, or $45 for two years and $60 for three years. An annual subscription includes four quarterly issues and the booklet, "HPV in Perspective: A Patient Guide." To subscribe, contact:

American Social Health Association, ASHA Resource Center, P.O. Box 13827, Research Triangle Park, NC 27709. For credit card orders, call (800) 230-6039 between 8 a.m. and 5:30 p.m. Eastern time or fax to (919) 361-8425, attention: customer service, along with credit card number, expiration date, printed name, and signature.

Subscription fee for the quarterly Journal of Lower Genital Tract Disease is included with membership to the American Society for Colposcopy and Cervical Pathology. Nonmember U.S. rates are $85, individual; $60, resident; and $125, institution. To subscribe, contact:

American Society for Colposcopy and Cervical Pathology, 20 W. Washington St., Suite 1, Hagerstown, MD 21740. Telephone: (301) 733-3640. Fax: (301) 733-5775.