Cervical Cancer, HPV, human papilloma virus

Assessment and Plan:

• Infection with the human papillomavirus (HPV) is the cause of almost all cervical cancers (1).

• Consider the use of the HPV vaccine for patients and use of preventive measures such as sexual abstinence, avoidance of multiple partners, and the use of condoms.

• Cervical cancer screening with cytology (Pap smear) once every 3 years for women ages 21 to 65 years, or screening with cytology and human papillomavirus (HPV) testing every 5 years for women ages 30 to 65 years is strongly recommended by the U.S. Preventive Services Task Force (USPSTF) (2).

• A beta-carotene level from fruit and vegetable food sources of more than 0.28 to 0.37 micromol/L have been associated with a reduced risk of lung, mouth, throat, and cervical cancers, and a blood beta-carotene concentration less than 0.28 micromol/L has been linked with a higher risk of several cancers (3). Beta-carotene supplements may increase the risk of lung cancer and are not recommended. (3)

• An intake of a variety of 5 fruits and vegetables daily provides the individual with about 5.2 to 6 mg/day of food based beta-carotene (3). According to Martini et al in the University of Minnesota Cancer Prevention Research Unit Feeding Studies, an intake of 5 mg per day of beta carotene was required to establish beta carotene levels to a plasma level of 0.37 umol/L (5).

• Natural therapy for human papilloma virus (HPV) lesions: Green tea extracts applied either as an ointment twice per week (polyphenon E ointment), an oral dose daily (poly E or (-)-epigallocatechin-3-gallate [EGCG]), or as a combination of the ointment and the oral form daily, showed response rates of 74%, 75%, and 50-60% respectively (6). These green tea extract medications are available by prescription.