The Pop Reporter is a weekly, customizable electronic magazine that provides summaries and links to research and news reports from around the world on reproductive health and related topics. Choose categories such as HIV/AIDS, Family Planning, Maternal and Child Health, or Youth Health and one or more regions to customize your own e-zine, delivered by your choice of method. Guest commentaries provide unique insight into current research, news, and project results.
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FROM RECENT ISSUES
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FAMILY PLANNING RESEARCH
Cancer risk among users of oral contraceptives: Cohort data from the Royal College of General Practitioner's oral contraception study
(http://dx.doi.org/10.1136/bmj.39289.649410.55)
British Medical Journal. Online access September 11, 2007.
Hannaford PC | Selvaraj S | Elliott AM | Angus V | Iversen L | Lee AJ
Related Abstract: Taking Contraceptive Pill May Reduce Risk Of Developing Cancer, Study Suggests (http://www.sciencedaily.com/releases/2007/09/070911202503.htm)
The objective of this study is to examine the absolute risks or benefits on cancer associated with oral contraception, using incident data. The main outcome measures included adjusted relative risks between never and ever users of oral contraceptives for different types of cancer, main gynaecological cancers combined, and any cancer. Standardisation variables were age, smoking, parity, social class, and (for the general practitioner observation dataset) hormone replacement therapy. Subgroup analyses examined whether the relative risks changed with user characteristics, duration of oral contraception usage, and time since last use of oral contraception. The main dataset contained about 339 000 woman years of observation for never users and 744 000 woman years for ever users. Compared with never users ever users had statistically significant lower rates of cancers of the large bowel or rectum, uterine body, and ovaries, tumours of unknown site, and other malignancies; main gynaecological cancers combined; and any cancer. The relative risk for any cancer in the smaller general practitioner observation dataset was not significantly reduced. Statistically significant trends of increasing risk of cervical and central nervous system or pituitary cancer, and decreasing risk of uterine body and ovarian malignancies, were seen with increasing duration of oral contraceptive use. Reduced relative risk estimates were observed for ovarian and uterine body cancer many years after stopping oral contraception, although some were not statistically significant. The estimated absolute rate reduction of any cancer among ever users was 45 or 10 per 100 000 woman years, depending on whether the main or general practitioner observation dataset was used. In this UK cohort, oral contraception was not associated with an overall increased risk of cancer; indeed it may even produce a net public health gain. The balance of cancer risks and benefits, however, may vary internationally, depending on patterns of oral contraception usage and the incidence of different cancers.
HIV/AIDS and STIs RESEARCH
Reducing the risk of mother-to-child human immunodeficiency virus transmission: Past successes, current progress and challenges, and future directions
(http://dx.doi.org/10.1016/j.ajog.2007.06.048)
American Journal of Obstetrics and Gynecology. 2007 Sep;197(3 Suppl 1):S3-S9.
Fowler MG | Lampe MA | Jamieson DJ | Kourtis AP | Rogers MF
Prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) in the United States and Europe has been a tremendous success, such that transmission rates of less than 2% have been achieved. Some key successes have also been demonstrated in resource-poor countries; however, the translation of successful interventions into public health policy has been slow because of a variety of factors such as inadequate funding and cultural, social, and institutional barriers. The issue of HIV and infant feeding in settings that lack culturally acceptable, feasible, affordable, safe, and sustainable nutritional substitutes for breast milk is a continuing dilemma. An effective preventive infant HIV vaccine would be an optimal approach to reduce HIV acquisition in the first year of life among breast-feeding infants. The challenges to eliminate new perinatal HIV infections worldwide will depend on both sustaining and expanding PMTCT interventions and effective primary HIV prevention for women, adolescents, and young adults.
GENDER and HEALTH RESEARCH
Human papillomavirus and HPV vaccines: A review
(http://www.who.int/bulletin/volumes/85/9/06-038414/en/index.html)
Bulletin of the World Health Organization. 2007 Sep;85(9):719-726.
Cutts FT | Franceschi S | Goldie S | Castellsague X | de Sanjose S | Garnett G
Cervical cancer, the most common cancer affecting women in developing countries, is caused by persistent infection with "high-risk" genotypes of human papillomaviruses (HPV). The most common oncogenic HPV genotypes are 16 and 18, causing approximately 70% of all cervical cancers. Types 6 and 11 do not contribute to the incidence of high-grade dysplasias (precancerous lesions) or cervical cancer, but do cause laryngeal papillomas and most genital warts. HPV is highly transmissible, with peak incidence soon after the onset of sexual activity. A quadrivalent (types 6, 11, 16 and 18) HPV vaccine has recently been licensed in several countries following the determination that it has an acceptable benefit/risk profile. In large phase III trials, the vaccine prevented 100% of moderate and severe precancerous cervical lesions associated with types 16 or 18 among women with no previous infection with these types. A bivalent (types 16 and 18) vaccine has also undergone extensive evaluation and been licensed in at least one country. Both vaccines are prepared from non-infectious, DNA-free virus-like particles produced by recombinant technology and combined with an adjuvant. With three doses administered, they induce high levels of serum antibodies in virtually all vaccinated individuals. In women who have no evidence of past or current infection with the HPV genotypes in the vaccine, both vaccines show greater than 90% protection against persistent HPV infection for up to 5 years after vaccination, which is the longest reported follow-up so far. Vaccinating at an age before females are exposed to HPV would have the greatest impact. Since HPV vaccines do not eliminate the risk of cervical cancer, cervical screening will still be required to minimize cancer incidence. Tiered pricing for HPV vaccines, innovative financing mechanisms and multidisciplinary partnerships will be essential in order for the vaccines to reach populations in greatest need.
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Theresa Norton
Associate Editor
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