WOMEN'S HEALTH WATCH

HPV Test Reveals More Than Pap Smear Does

Researchers in Europe have found that testing for the human papillomavirus (HPV) uncovered more precancerous lesions, compared with a regular Pap smear. The newer liquid-based Pap test, while having marginally improved sensitivity, also produced more false-positive results. Approximately 3 lesions were detected by HPV testing for every 2 found with traditional cytology. Adding the cytology to the HPV testing did not increase its sensitivity significantly, and it increased the false-positive rate for HPV as well.

The researchers conducted a large, randomized, controlled trial of 33,364 women aged 35 to 60 years. Half of the women were screened with conventional Pap smears and half with HPV tests and liquid-based Pap tests. The investigators found that HPV testing combined with the liquid-based Pap resulted in a 47% increase in sensitivity but also increased the rate of false positives by 60%. HPV testing alone increased sensitivity by 40%. Based on these findings, researchers recommend that testing for cervical cancer be done with the HPV testing alone. The findings were published in the June 7, 2006, issue of the Journal of the National Cancer Institute.

Young Girls Should Get Cancer Vaccine, Experts Say

The Advisory Committee on Immunization Practices (ACIP) agreed to recommend Merck and Co's Gardasil (quadrivalent human papillomavirus [HPV]; types 6, 11, 16, 18 recombinant vaccine) for the vaccination of US girls as young as age 9 and young women up to age 26. The vaccine was approved by the FDA for the prevention of HPV, a sexually transmitted disease that can cause cervical cancer. The goal is to immunize girls before they become infected. About 15% of 15-year-old American girls already are infected with at least one strain of HPV.

Clinical trials have shown that a 3-dose course of the vaccine can prevent almost 100% of the lesions that can become cervical cancer, as well as genital warts. Officials of the Centers for Disease Control and Prevention, who are advised by the ACIP, say that more than 50% of sexually active women and men will be infected with one or more genital HPV types in their lifetimes. Girls who do get the vaccine will still need to see their health care provider for cervical cancer screening, however, because the vaccine does not provide protection against all types of HPV that cause cervical cancer.

Calcium Found to Help Relieve PMS

A recent study conducted at St. Luke-Roosevelt Hospital in New York, NY, has found that calcium supplementation can relieve the physical and emotional toll of premenstrual syndrome (PMS) by almost 50%. Approximately half of the 497 women participating in the study who took at least 1200 mg of calcium supplements during the course of the study experienced fewer mood swings that involved depression, sadness, anxiety, nervousness, breast tenderness, bloating, and other aches and pains.

The US Department of Agriculture's Human Nutrition Research Center in Grand Forks, ND, reported similar results after studying 10 women with PMS who spent half the study period on a daily diet containing 600 mg of calcium, the other half taking up to 1300 mg. The women were less irritable, weepy, and depressed and did not experience backaches, cramping, and bloating when they were consuming more calcium. The Grand Forks study also showed that most women get about 587 mg of calcium a day, nowhere near the 1000 mg they should be taking to stay healthy.

The Connection Between Menopause, Weight, and Cancer

Researchers have found that women who gain weight shortly before or after menopause might be increasing their risk for breast cancer, but losing weight after menopause could reduce that risk. The researchers used data from the Nurses' Health Study to follow more than 87,000 women aged 30 to 55 for 26 years, evaluating weight changes since age 18 and breast cancer incidence. A separate group of ~50,000 women was studied for 24 years to assess weight changes after menopause and incidences of breast cancer.

After adjusting for various breast cancer risk factors, the researchers found that women who gained 55 lb or more after age 18 had almost 1.5 times the risk of cancer, compared with those who maintained their weight. A gain of 22 lb after menopause was associated with an increased risk of 18%, but losing 22 lb after menopause decreased the risk by 57%.

The researchers suggest that fat tissue becomes the main source of estrogen after menopause, and that increased levels of circulating estrogen explain the increased postmenopausal cancer risk. The results appear in the July 12, 2006, issue of the Journal of the American Medical Association.