University of South Carolina study says black women may be more prone to high-risk HPV than white women

A new study showing that black woman have more difficulty clearing a high-risk human papillomavirus (HPV) infection than white women of a similar age is being called “landmark” by a local gynecological oncology expert.

The study suggests a biological basis for the increased risk of cervical cancer in black women, but the reason for it remains unknown and still under study.

“We used to believe all disparities between blacks and whites were related to access to health care,” said Dr. Jennifer Young Pierce of the Medical University of South Carolina, who also is involved in HPV research but not this study. “This study provides evidence how we deal with viruses based on race.”

The study, conducted by the University of South Carolina’s College of Pharmacy, was presented to the American Association for Cancer Research meeting in Chicago this week.

The study’s lead author, Kim Creek, vice chairman of the college’s pharmaceutical and biomedical science department, said the rates of screening with Pap tests between black and white women in the study were the same, but a major difference appeared.

“African-American women are 40 percent more likely to get cervical cancer and are twice as likely to die from cervical cancer as European-American women,” said Creek during a press briefing in Chicago. “These results suggest that African-American women have more difficulty than European-American women clearing a high-risk HPV infection.”

Infection with HPV is not predictive of which women will eventually develop cervical dysplasia or cancer, said Creek.

“Most HPV infections are cleared by the immune system in about 18 months,” said Creek, emphasizing that the persistence of high-risk HPV infection is a risk factor for the development of high-grade neoplasia and cervical cancer.

Study details
Creek and colleagues initiated the Carolina Women’s Care Study in 2004 to evaluate the extent of HPV infection and persistence among college-age women attending USC. In this longitudinal study, 467 study participants — 70 percent white and 24 percent black — received biannual pelvic exams while they attended the university.

The researchers found that the study participants had similar demographic characteristics and similar behaviors associated with increased risk for cervical lesions, such as age at sexual debut and average number of sexual partners.

High-risk HPV status was evaluated every six months in Pap-test samples collected from the 326 white and 113 black women.

The researchers found that there was no real difference in the incidence of new HPV infections between the two groups, demonstrating that exposure to the virus was essentially the same.

“But interestingly, if we looked not at incidence but at prevalence — if there were any differences in the total number of HPV-positive visits — we found a striking difference,” said Creek, noting that black women were 1.5 times more likely to test positive for high-risk HPV infection.

‘Missed the point’
The take-home message is the importance of HPV vaccination and regular screening, he said.

Thad Bell, a family physician based in North Charleston who gives regular health tips on the radio, said the new study is interesting from a biological standpoint. From a practical, clinical standpoint, the takeaway message now is the importance of getting girls and boys immunized against the HPV virus.

“There is still a lot of disdain about immunization. When people heard of the HPV vaccine, they went down the wrong track — they thought it would encourage (young people) to have sex,” Bell said. “They totally missed the point.”

He said he worries that the black community may view the study initially as prejudicial, but that research seems to promise more information.