Written: 12/2007
The goal of this project is to spread awareness of one of the most common viruses in the world. The virus is human papillomavirus (HPV). HPV is so common because there are more than one-hundred types of the virus. This project concentrates on the some of the forty types of genital HPV- the types that are considered to be 'high-risk'. These types are transmitted through skin-to-skin contact. There are about twenty million people in the United States who are infected with the virus. Another 6.2 million people are infected each year. The virus affects both females and males.
Most infections do not cause any symptoms and go away on their own. Due to this, an infected person may not be aware that the virus is present. This is why there is such a high number of cases of the virus. The virus is usually spread without knowing it. It is estimated that, at one point or another, 50% of sexually active people will be infected with at least one type of HPV.
There are sixteen high-risk types. These types often do not go away on their own and can cause different types of cancers in men and women. Two of these types, Types 16 and 18 are linked to cervical cancer in women. These two types are responsible for 70% of all cases of cervical cancer. Cervical cancer is the third-leading cause of cancer-related deaths in the world and seventh in the United States. This is one reason it is important to know the implications of HPV.
Through the increased awareness of the virus, we hope to reduce the number of HPV and related cervical cancer cases in Connecticut, and eventually other states and countries. The plan concentrates on women who may be uninsured or underinsured. With these resources, these women may have the opportunity to help themselves in a way they otherwise would not be able to. The plan is divided into four sections. These four sections are: vaccinations, screenings, education, and research. Although each part of the plan can help reduce the numbers by itself, the overall goal of the plan can only be achieved with each part of the plan working together. The following is a breakdown of the plan that includes some background information for each portion. There is also a breakdown of the budget allotted for each portion of the plan. It describes how the money will be spent within each category.
Although there is no treatment for HPV, the health conditions caused by the virus can be treated. However, it is better to protect yourself before you become infected. GardasilTM is a vaccine that protects against four types of HPV. These are Types 6, 11, 16, and 18. It is given in three doses, and is most effective if all three doses are given. If only one or two are given, it will still provide some protection, but not the 100% protection that you would get from all three doses. Also, if the vaccine is given to someone who has already been infected, it can still protect against the types the person has not been previously infected with.
The majority of the budget ($2.5 million) would be allocated for vaccinations. Each dose costs about $120.00. Some insurance companies may not be able to cover these costs which means women may not be able to get the vaccine. We would reduce the costs and make the vaccination available to females between the ages of 11 and 26. We would also work with the Vaccines for Children program through the Centers for Disease Control, which provides vaccines for children until 19 years old. This collaboration will allow us to provide full vaccinations (all three doses) for many of the state's women.
The most common method used to diagnose cervical cancer is through a Pap smear. These tests detect about 70% of all cases. Other than detecting the presence of abnormal cells, these tests can reduce the risk of cervical cancer. The procedure produces an inflammatory cytokine response which can clear the presence of the virus. It is recommended that the first test is done no later than thee years after their first sexual contact, or by the age of 21 years old. Yearly tests should be done until the age of thirty, at which point, it can be done every three years until 65 years of age.
We have allocated $1.5 million to cover the costs of preventative Pap tests for women. Compared to the vaccine, these tests are inexpensive. The tests, on average, cost between $25.00 and $65.00 each. While working with willing doctors, the cost of these tests may be available at a lower cost. This will hopefully interest more women in getting this test done. If it is possible to reduce the cost to about $15.00 per test, 100,000 tests can be provided for the women who fall in the above categories.
The next portion of the plan is educating young adults about the disease. The budget for this section is $750,000.00 over a five-year period. (This is the only portion of the plan that has been given a set amount of time. Once the budgets for the other three portions are used up, they will not be replenished. We hope another program will be able to take off from where this plan left off.) The education budget will be divided between two components. The majority of this will go towards hiring speakers who will go to middle school and high schools throughout the state to educate students about the virus and its implications. The plan will concentrate on this age group because they tend to be the most impressionable and this is the age group that has one of the highest risks of becoming infected with some type of HPV. The speakers will also discuss the vaccine and how it protects against the virus, how it is given, side effects, and the like. They will also promote the importance of early detection and prevention. As a side note, they can promote safe sex practices and condom use, which will help reduce the number of HPV infections, along with other sexually-transmitted diseases.
The speakers will be hired for their knowledge of the topic. Their work with us will be part time so they can continue with their other careers. Ten speakers will be hired for a five-year period. This will mean that at least one speaker available at all times. Each will have to give 15 to 20 presentations per year. They will be given just under $15,000.00 per year, which will be used to cover expenses.
Another $5,000.00 will go towards the printing of flyers. A company that will print five thousand flyers for just under one hundred dollars will be used. This will provide about 252,800 flyers. These flyers will be handed out mainly to the female students. These flyers will be fact sheets that include important information on the virus, its implications, the vaccine, and other facts. It is our hope that these will lead to parental interest and the thought of getting their daughters vaccinated. It will also include websites and phone numbers, if more information is needed.
The remainder of the budget will go towards research. Although it is a relatively small amount of money for research, the $250,000.00 will be used to start further studies on how the virus causes cervical cancer and how it can be prevented. The research will focus on possible ways to prevent the amplification of the virus. It is already known which oncogenes cause the amplification, but this research will begin to study how to prevent this amplification. If it is possible to find a way to stop this amplification, the virus will not be able to cause changes in the cells of the cervix, which would prevent cancer from developing.
Most people are surprised to find out that a virus can cause cancer. However, this is about all they know about human papillomavirus. The purpose of this plan is to educate people, especially young adults, about the virus and other related information. It will also provide vaccines and screenings for women who may not have been able to afford them otherwise. It is our hope that this plan will be able to decrease the prevalence of HPV, in turn, decreasing the lethality of cervical cancer in women in Connecticut. If this is the case, it may be possible to put this plan into action in either other states or countries. Eventually, this could lead to a decrease in those countries that are most affected by the disease.