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Which came first the chicken or the egg. Mmmpf, what a riddle, I lived quite a while on this big blue ball and still I don't know the answer to that question. Any takers? In the case of HPV versus Cervical Cancer the story is quite different. We do know the answer, Human Papilloma Virus can cause changes in a woman's cervix that can develop into Cervical Cancer. Cervical Cancer can be fatal, especially if as with many cancers it goes undetected for prolonged periods of time. Medical science has done well to develop a screening test for HPV, the "PAP" Smear. There is also a test utilizing DNA analysis to identify HPV.

Compliance with PAP screening recommendations among women in middle to upper levels of socioeconomic categories is generally good. However, within the community of women in lower socioeconomic categories compliance is poor. Testing typically should be accomplished annually in women between the ages of 21-30 and every two to three years for women above the age of 30 (Center for Disease Control recommendation-CDC Treatment Guidelines 2006).

Another important factor related to HPV screening that often goes unrecognized is that that the prevalence of precursor lesions for cervical cancer occur 5 times more often in women who attend STD Clinics than for women who attend family planning clinics (CDC Treatment Guidelines 2006). I would surmise that women who attend STD clinics are more frequently participating in unprotected sexual encounters and thus are at greater risk for HPV than those who attend family planning clinics where condoms are typically available.

In my opinion these two issues are two-thirds of the basis for the argument for utilizing a vaccine against HPV. These issues are primarily based in sexual health education, and sexual behavior. Unfortunately, in our society sexual health education quite often is an after thought to disaster. Need I say more than HIV/AIDS. Sexual behaviors can be changed or augmented through education, however the education effort must be one of immense proportion, and recurrent in nature.

So far we have two issues, poor screening compliance specifically among women of lower socioeconomic status, and sexual behaviors that include participating in unprotected sex. It is believed that utilizing a condom during sex may lower the possibility of contracting HPV. However it is accepted that utilizing a condom does not preclude transmission of HPV. That is the risk of a women contracting HPV from unprotected sex (oral,vaginal,anal)

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