Sex

THE RELATIONSHIP BETWEEN sex and cancer is bidirectional. Simply put, sex can lead to cancer, and cancer can lead to problems with sex. Research has identified a sexually transmitted virus that can result in cervical cancer. In the last year, breakthrough advances in medicine have lead to the development of a vaccine that can prevent infection by this virus. The psychological and physiological effect of cancer, surgery, chemotherapy, radiotherapy, and hormonal treatments for cancer can have a deleterious effect on sexual function and well-being. Despite the relevance of sexuality to quality of life (QoL), it generally remains a silent casualty of cancer. Although these associations between sex and cancer are not widely known, increasing awareness may be the critical intervention for promoting cancer prevention and QoL.

There are approximately 10,000 new cases of cervical cancer in the United States each year. Worldwide, cervical cancer is the second most common cancer in women, claiming nearly a quarter million lives each year. In the mid-1980s, it was discovered that a sexually transmitted virus, the human papillomavirus (HPV), was a major cause of cervical cancer. Since then, researchers have identified about a dozen high-risk types of HPV that cause cervical cancer and that may play a role in cancers of the anus, vulva, vagina, penis, and head and neck as well. It is known that two types, HPVs 16 and 18, are responsible for 70 percent of cervical cancers. In June 2006, the U.S. Food and Drug Administration approved a vaccine that is highly effective in preventing infection with HPV types 16 and 18.

There are approximately 30 different types of HPV that can be sexually transmitted and that cause genital HPV. It is important to note that sexually transmitted HPV is highly prevalent, asymptomatic, and typically harmless, often resolving on its own. In fact, it is estimated that three of four Americans between 15 and 49 years of age have been infected with genital HPV at some point during their lifetime. Moreover, there are approximately 6.2 million new cases of sexually transmitted HPV in the United States each year, with at least 20 million people estimated to be currently infected.

At present, HPV is screened in women only through a Papanicolaou test alone or in combination with an HPV DNA test; both tests conducted through collecting cervical cells and sending them to a laboratory for analysis. There are no approved screening tests for HPV in men. The major risk factor for HPV infection is having many sexual partners. Among HPV-in-fected women, the risk of developing cervical cancer is increased among those who smoke or have many children. The surest way to prevent cervical cancer is to abstain from sexual activity (i.e., any genital contact with another individual). Sexual activity within a long-term, monogamous relationship with another person who is HPV free is likely to prevent HPV infection. There is no convincing evidence that use of a condom prevents HPV infection, though evidence shows substantial reduction in the risk of infection among newly sexually active women whose partenrs did use condoms consistently, and condom use has been associated with a lower risk of cervical cancer.

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