The Human Papillomavirus (HPV) is an infection that typically shows up on one pap smear and is gone by the next without any threat to a woman’s health, but researchers are finding that the infection tends to last longer in college-aged black women and this lingering could lead to a higher risk of cervical cancer.
“African American women are more likely to have persistent high-risk HPV infection,” said study author Kim Creek, vice-chair and professor of pharmaceutical and biomedical sciences at South Carolina College of Pharmacy, in Charleston.
“If you are infected [with HPV], your body recognizes it as a viral infection and usually clears the virus within one or two years,” he said. “It is those women who have difficulty clearing it that are at higher risk of cervical disease and cervical cancer.”
The researchers assessed HPV infection and persistence in college-age women enrolled at the University of South Carolina beginning in 2004, and followed the women throughout their college years. HPV status was evaluated every six months in Pap test samples from 326 white women and 113 black women.
The rate of new high-risk HPV infection was similar between the two groups of women, but at any visit, black women were 1.5 times more likely to test positive for high-risk HPV infection. About 56 percent of black women were also still infected with the virus two years after they were first diagnosed, compared with 24 percent of white women.
Creek is unsure why black women have difficulty clearing the virus from their bodies but he said, “We think that it likely has something to do with the immune system.” He added that black women are 40 percent more likely to develop cervical cancer and two times more likely to die from the disease than European or American white women. This study suggest that the difference may not just be a result of lack of access to medical care but that there may be a biological basis behind the varying rates. Considering how much is at stake for black women who become infected with HPV, Creek said the HPV vaccine may be even more beneficial in this population.
While this study certainly warrants further investigation, Dr. Diana Contreras, director of gynecologic oncology at Long Island Jewish Medical Center in New Hyde Park, said it’s too soon to determine how to to effectively handle HPV in black women:
“We are beginning to understand that HPV may behave differently in different ethnic groups,” she said. “This study is very provocative, but the jury is still out on screening and treatment, and we have to be careful about drawing too many conclusions.”
Until researchers come up with a more definitive approach, it seems skipping an annual pap smear may not be as applicable to black women. If anything, we might need to be even more diligent about gynecologic testing.
