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| ==Prevention== | | ==Prevention== |
| Primary preventive measures to prevent HPV infection include the following:<ref>{{cite journal |author=Harper DM, Franco EL, Wheeler CM, ''et al'' |title=Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial |journal=Lancet |volume=367 |issue=9518 |pages=1247-55 |year=2006 |pmid=16631880 |doi=10.1016/S0140-6736(06)68439-0}}</ref><ref name=CDC_HPV>{{cite web |url=http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm |title=STD Facts - HPV Vaccine |date = 2006-08-01 | accessdate=2007-08-17}}</ref><ref>{{cite web |url=http://women.webmd.com/news/20060608/cervical-cancer-vaccine-approved |title=Cervical Cancer Vaccine Approved |accessdate=2007-08-17 |work=WebMD}}</ref><ref>{{cite journal |author=Holmes KK, Levine R, Weaver M |title=Effectiveness of condoms in preventing sexually transmitted infections |journal=Bull. World Health Organ. |volume=82 |issue=6 |pages=454-61 |year=2004 |pmid=15356939}}</ref><ref name="Winer">{{cite journal |author=Winer RL, Hughes JP, Feng Q, ''et al'' |title=Condom use and the risk of genital human papillomavirus infection in young women |journal=N. Engl. J. Med. |volume=354 |issue=25 |pages=2645-54 |year=2006 |pmid=16790697 |doi=10.1056/NEJMoa053284}}</ref><ref>{{cite journal |author=Bleeker MC, Berkhof J, Hogewoning CJ, ''et al'' |title=HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions |journal=Br. J. Cancer |volume=92 |issue=8 |pages=1388-92 |year=2005 |pmid=15812547 |doi=10.1038/sj.bjc.6602524}}</ref> | | Primary preventive measures to prevent HPV infection include the following:<ref>{{cite journal |author=Harper DM, Franco EL, Wheeler CM, ''et al'' |title=Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial |journal=Lancet |volume=367 |issue=9518 |pages=1247-55 |year=2006 |pmid=16631880 |doi=10.1016/S0140-6736(06)68439-0}}</ref><ref name=CDC_HPV>{{cite web |url=http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm |title=STD Facts - HPV Vaccine |date = 2006-08-01 | accessdate=2007-08-17}}</ref><ref>{{cite web |url=http://women.webmd.com/news/20060608/cervical-cancer-vaccine-approved |title=Cervical Cancer Vaccine Approved |accessdate=2007-08-17 |work=WebMD}}</ref><ref>{{cite journal |author=Holmes KK, Levine R, Weaver M |title=Effectiveness of condoms in preventing sexually transmitted infections |journal=Bull. World Health Organ. |volume=82 |issue=6 |pages=454-61 |year=2004 |pmid=15356939}}</ref><ref name="Winer">{{cite journal |author=Winer RL, Hughes JP, Feng Q, ''et al'' |title=Condom use and the risk of genital human papillomavirus infection in young women |journal=N. Engl. J. Med. |volume=354 |issue=25 |pages=2645-54 |year=2006 |pmid=16790697 |doi=10.1056/NEJMoa053284}}</ref><ref>{{cite journal |author=Bleeker MC, Berkhof J, Hogewoning CJ, ''et al'' |title=HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions |journal=Br. J. Cancer |volume=92 |issue=8 |pages=1388-92 |year=2005 |pmid=15812547 |doi=10.1038/sj.bjc.6602524}}</ref><ref>{{cite journal |author=Moscicki AB |title=Impact of HPV infection in adolescent populations |journal=The Journal of adolescent health : official publication of the Society for Adolescent Medicine |volume=37 |issue=6 Suppl |pages=S3-9 |year=2005 |pmid=16310138}}</ref><ref>{{cite journal |author=Bleeker MC, Berkhof J, Hogewoning CJ, ''et al'' |title=HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions |journal=Br. J. Cancer |volume=92 |issue=8 |pages=1388-92 |year=2005 |pmid=15812547 |doi=10.1038/sj.bjc.6602524}}</ref> |
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| *Following regualr screening recommendations | | *Following regualr screening recommendations |
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| === Condoms ===
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| Although condoms are highly effective for preventing the transmission of other [[sexually transmitted disease]]s (STDs), recent studies have concluded that condoms only offer partial protection, at best, against the transmission of genital HPVs.<ref>{{cite journal |author=Holmes KK, Levine R, Weaver M |title=Effectiveness of condoms in preventing sexually transmitted infections |journal=Bull. World Health Organ. |volume=82 |issue=6 |pages=454-61 |year=2004 |pmid=15356939}}</ref><ref name="Winer">{{cite journal |author=Winer RL, Hughes JP, Feng Q, ''et al'' |title=Condom use and the risk of genital human papillomavirus infection in young women |journal=N. Engl. J. Med. |volume=354 |issue=25 |pages=2645-54 |year=2006 |pmid=16790697 |doi=10.1056/NEJMoa053284}}</ref>
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| This may be due to the fact that HPVs can infect genital skin areas that are not covered by condoms. On the other hand, some studies have suggested that regular condom use can effectively limit the ongoing persistence and spread of HPV to additional genital sites in individuals who are already infected.<ref>{{cite journal |author=Moscicki AB |title=Impact of HPV infection in adolescent populations |journal=The Journal of adolescent health : official publication of the Society for Adolescent Medicine |volume=37 |issue=6 Suppl |pages=S3-9 |year=2005 |pmid=16310138}}</ref><ref>{{cite journal |author=Bleeker MC, Berkhof J, Hogewoning CJ, ''et al'' |title=HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions |journal=Br. J. Cancer |volume=92 |issue=8 |pages=1388-92 |year=2005 |pmid=15812547 |doi=10.1038/sj.bjc.6602524}}</ref>
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| Thus, condom use may reduce the risk that infected individuals will progress to cervical cancer or develop additional genital warts. A 2006 study of 82 college students suggests that condoms can be up to 70% effective for preventing genital HPV infection if used for every sexual encounter.<ref name="Winer" /> [[Planned Parenthood]] recommends condom use to reduce the risk of contracting HPV,<ref>{{cite web |url=http://www.plannedparenthood.org/sexual-health/std/hpv.htm |title=Planned Parenthood - HPV |accessdate=2007-08-17}}</ref> but the [[Centers for Disease Control and Prevention]] maintain that "While the effect of condoms in preventing HPV infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease."<ref>{{cite web |url=http://www.cdc.gov/std/HPV/STDFact-HPV.htm |title=STD Facts - Human papillomavirus (HPV) |accessdate=2007-08-17 |format= |work=}}</ref>
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| === Microbicides ===
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| Ongoing research has suggested that several inexpensive chemicals might serve to block HPV transmission if applied to the genitals prior to sexual contact.<ref>{{cite journal |author=Howett MK, Kuhl JP |title=Microbicides for prevention of transmission of sexually transmitted diseases |journal=Curr. Pharm. Des. |volume=11 |issue=29 |pages=3731-46 |year=2005 |pmid=16305508}}</ref> These candidate agents, known as [[microbicide|topical microbicides]], are currently undergoing clinical efficacy testing. A recent study indicates that some [[Personal lubricant|sexual lubricant]] brands that use a gelling agent called [[carrageenan]] can inhibit papillomavirus infection ''[[in vitro]]''.<ref>{{cite journal |author=Buck CB, Thompson CD, Roberts JN, Müller M, Lowy DR, Schiller JT |title=Carrageenan is a potent inhibitor of papillomavirus infection |journal=PLoS Pathog. |volume=2 |issue=7 |pages=e69 |year=2006 |pmid=16839203}}</ref> See [[Carrageenan#Sexual lubricant and microbicide]] for details.
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| Clinical trials are needed to determine whether carrageenan-based sexual lubricant gels are effective for blocking the sexual transmission of HPVs ''[[in vivo]]''.
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| === Nutrition ===
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| ==== Vitamin A ====
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| In a clinic-based case-control study to assess serum micronutrients as risk factors for cervical dysplasia, subjects in the lowest serum [[retinol]] quartile were at increased risk of [[Cervical intraepithelial neoplasia|CIN]] I compared with women in the highest quartile.<ref>{{cite journal |author=Yeo AS, Schiff MA, Montoya G, Masuk M, van Asselt-King L, Becker TM |title=Serum micronutrients and cervical dysplasia in Southwestern American Indian women |journal=Nutrition and cancer |volume=38 |issue=2 |pages=141-50 |year=2000 |pmid=11525590 |doi=}}</ref>
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| ==== Vitamin C ====
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| Risk of type-specific, persistent HPV infection was lower among women reporting intake values of [[vitamin C]] in the upper quartile compared with those reporting intake in the lowest quartile.<ref>{{cite journal |author=Giuliano AR, Siegel EM, Roe DJ, ''et al'' |title=Dietary intake and risk of persistent human papillomavirus (HPV) infection: the Ludwig-McGill HPV Natural History Study |journal=J. Infect. Dis. |volume=188 |issue=10 |pages=1508-16 |year=2003 |pmid=14624376 |doi=}}</ref>
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| ==== Vitamin E ====
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| HPV clearance time was significantly shorter among women with the highest compared with the lowest serum levels of [[tocopherol]]s, but significant trends in these associations were limited to infections lasting </=120 days. Clearance of persistent HPV infection (lasting >120 days) was not significantly associated with circulating levels of tocopherols. Results from this investigation support an association of micronutrients with the rapid clearance of incident oncogenic HPV infection of the uterine cervix.<ref name=Goodman_2007>{{cite journal |author=Goodman MT, Shvetsov YB, McDuffie K, ''et al'' |title=Hawaii cohort study of serum micronutrient concentrations and clearance of incident oncogenic human papillomavirus infection of the cervix |journal=Cancer Res. |volume=67 |issue=12 |pages=5987-96 |year=2007 |pmid=17553901 |doi=10.1158/0008-5472.CAN-07-0313 |url=http://cancerres.aacrjournals.org/cgi/content/full/67/12/5987}}</ref>
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| A statistically significantly lower level of [[alpha-tocopherol]] was observed in the blood serum of HPV-positive patients with cervical intraepithelial neoplasia. The risk of dysplasia was four times higher for an alpha-tocopherol level < 7.95 mumol/l.<ref>{{cite journal |author=Kwaśniewska A, Tukendorf A, Semczuk M |title=Content of alpha-tocopherol in blood serum of human Papillomavirus-infected women with cervical dysplasias |journal=Nutrition and cancer |volume=28 |issue=3 |pages=248-51 |year=1997 |pmid=9343832 |doi=}}</ref>
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| ==== Folic acid ====
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| Higher folate status was inversely associated with becoming HPV test-positive. Women with higher folate status were significantly less likely to be repeatedly HPV test-positive and more likely to become test-negative. Studies have shown that lower levels of antioxidants coexisting with low levels of folic acid increases the risk of CIN development. Improving folate status in subjects at risk of getting infected or already infected with high-risk HPV may have a beneficial impact in the prevention of cervical cancer.<ref>{{cite journal |author=Piyathilake CJ, Henao OL, Macaluso M, ''et al'' |title=Folate is associated with the natural history of high-risk human papillomaviruses |journal=Cancer Res. |volume=64 |issue=23 |pages=8788-93 |year=2004 |pmid=15574793 |doi=10.1158/0008-5472.CAN-04-2402 |url=http://cancerres.aacrjournals.org/cgi/content/full/64/23/8788}}</ref><ref>{{cite journal |author=Kwaśniewska A, Tukendorf A, Goździcka-Józefiak A, Semczuk-Sikora A, Korobowicz E |title=Content of folic acid and free homocysteine in blood serum of human papillomavirus-infected women with cervical dysplasia |journal=Eur. J. Gynaecol. Oncol. |volume=23 |issue=4 |pages=311-6 |year=2002 |pmid=12214730 |doi=}}</ref>
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| ==== Carotenoids ====
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| Higher circulating levels of [[carotenoids]] were associated with a significant decrease in the clearance time of type-specific HPV infection, particularly during the early stages of infection (</=120 days). Clearance of persistent HPV infection (lasting >120 days) was not significantly associated with circulating levels of carotenoids.<ref name=Goodman_2007 />
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| The likelihood of clearing an oncogenic HPV infection is significantly higher with increasing levels of [[lycopene]]s.<ref>{{cite journal |author=Sedjo RL, Papenfuss MR, Craft NE, Giuliano AR |title=Effect of plasma micronutrients on clearance of oncogenic human papillomavirus (HPV) infection (United States) |journal=Cancer Causes Control |volume=14 |issue=4 |pages=319-26 |year=2003 |pmid=12846362 |doi=}}</ref> A 56% reduction in HPV persistence risk was observed in women with the highest plasma [lycopene] concentrations compared with women with the lowest plasma lycopene concentrations. These data suggests that vegetable consumption and circulating lycopene may be protective against HPV persistence.<ref name=Sedjo_2002>{{cite journal |author=Sedjo RL, Roe DJ, Abrahamsen M, ''et al'' |title=Vitamin A, carotenoids, and risk of persistent oncogenic human papillomavirus infection |journal=Cancer Epidemiol. Biomarkers Prev. |volume=11 |issue=9 |pages=876-84 |year=2002 |pmid=12223432 |doi=}}</ref><ref name=Giuliano_2003>{{cite journal |author=Giuliano AR, Siegel EM, Roe DJ, ''et al'' |title=Dietary intake and risk of persistent human papillomavirus (HPV) infection: the Ludwig-McGill HPV Natural History Study |journal=J. Infect. Dis. |volume=188 |issue=10 |pages=1508-16 |year=2003 |pmid=14624376 |doi=}}</ref><ref>{{cite journal |author=Giuliano AR, Papenfuss M, Nour M, Canfield LM, Schneider A, Hatch K |title=Antioxidant nutrients: associations with persistent human papillomavirus infection |journal=Cancer Epidemiol. Biomarkers Prev. |volume=6 |issue=11 |pages=917-23 |year=1997 |pmid=9367065 |doi=}}</ref>
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| ====CoQ10====
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| Women who had either CIN or cervical cancer had markedly lower levels of [[CoQ10]] in their blood and in their cervical cells than the women who were healthy.
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| ==== Fruits and Vegetables ====
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| Higher levels of vegetable consumption were associated with a 54% decrease risk of HPV persistence.<ref name=Sedjo_2002 /> Consumption of papaya at least once a week was inversely associated with persistent HPV infection.<ref name=Giuliano_2003 />
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| ====Fish Oil====
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| In a 1999 study, [[Docosahexaenoic acid]] inhibited growth of HPV16 immortalized cells.<ref>{{cite journal |author=Chen D, Auborn K |title=Fish oil constituent docosahexa-enoic acid selectively inhibits growth of human papillomavirus immortalized keratinocytes |journal=Carcinogenesis |volume=20 |issue=2 |pages=249-54 |year=1999 |pmid=10069461 |doi=}}</ref>
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| ==References== | | ==References== |