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A Q&A with Dr. Noelle Cloven on Cervical Cancer Prevention

March 28, 2019

Dr. Noelle Cloven of Texas Oncology–Fort Worth Cancer Center sheds light on HPV awareness, the role of vaccinations in cervical cancer prevention, and the future of treatment.

What role do vaccinations play in cervical cancer prevention? Why are these vaccinations so effective?
Since cervical cancer is caused by persistent infection with HPV viruses, administration of the vaccine prevents cervical cancer and its precursors. The latest vaccine is 100-percent effective at preventing infection against nine strains of HPV and has the potential to prevent up to 90 percent of dysplasia (precancer) and cervical cancer.

How have vaccinations impacted the decline in cervical cancer diagnoses and deaths in Texas and beyond?
It’s still early for studies to show, but there is early prospective data coming out of Australia, where the vaccine has been mandated for more than 10 years. They have been able to show a significant decrease in precancerous cervical conditions in vaccinated individuals. It will be decades before we realize the full impact of the vaccine, and it also depends on uptake of the vaccine in our communities.

How have you seen cervical cancer prevention evolve during your career, thanks to heightened awareness of the HPV vaccine?
As a clinician, I most often see the late effects of HPV. Women with cervical cancer are generally treated with surgery or a combination of chemotherapy and radiation. This cancer often affects women in the prime of their lives and the long-term effects of treatment are life changing.

When I started my career, the only way to prevent cervical cancer was through lifestyle modification and avoidance of risk factors, such as smoking and unprotected sex. The vaccine was first approved for women up to age 26 in 2006 and was protective against four strains of HPV. Since then, the vaccine has been approved for boys, and most recently, for men and women up to age 45. Because the latest vaccine protects against the nine strains of HPV most likely to cause cervical cancer, it has potential to further decrease cervical cancer, its precursors, and other HPV-related cancers of the genital tract and head and neck.

In your opinion, what is the most notable breakthrough to date in the prevention and treatment of cervical cancer? What’s on the horizon in 2019?
The HPV vaccine is the most significant breakthrough in cervical cancer prevention. Unlike other cancers, we have determined the cause of cervical cancer to be HPV and have developed a way to prevent it before it ever occurs. Current studies are underway to develop vaccines that may be used to treat women who have cancer.

One important thing to note is that vaccinated women still need screening since the vaccine does not prevent all strains of HPV. New guidelines have been developed to increase the efficacy of screening that incorporate testing for HPV at the time of PAP test. These new guidelines allow for less frequent screening with increased detection.

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