Although the vaccine represents a major medical breakthrough, there is reason to be cautious. The benefits and risks of the new HPV vaccine aren't fully known, reports the August 2007 issue of Harvard Women's Health Watch .

Gardasil, the new vaccine, has been shown to protect against four types of HPV that are sexually transmitted and thought to cause most cases of cervical cancer and genital warts. But it won't protect against the nearly one dozen other types of HPV associated with cervical cancer, and it won't protect against any type that a girl or young woman has encountered before vaccination. So women will still be at some risk even after they've been vaccinated, and they'll still need regular cervical cancer screening with Pap smear testing. Moreover, they will still need to take precautions against other sexually transmitted diseases.

The HPV vaccine is a medical achievement that could save thousands of lives annually worldwide, but it is not a perfect answer to cervical cancer. There are still questions about the vaccine's safety and effectiveness beyond five years, especially in girls ages 11 and 12 ”the age group targeted for vaccination by health officials.

The bottom line: Certainly the new HPV vaccine shows great promise. But given the many unanswered questions about its effectiveness and safety, the Harvard Women's Health Watch suggests its use should be more a matter of individual choice than government mandate.

Also in this issue:

Hysterectomy and sexual function Simple steps to ease heel pain Concerns about the diabetes drug Avandia By the way, doctor: Can strontium help treat osteoporosis? How much should I limit my salt intake:

Harvard Women's Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $24 per year. Subscribe at www.health.harvard/women or by calling 1-877-649-9457 (toll free).

health.harvard/

Chinnaiyan and his team have received numerous awards and honors, including the American Association for Cancer Research Team Science Award for their previously published work on gene fusions, and the Specialized Program of Research Excellence Outstanding Investigator award. The new Center for Translational Pathology supported in part by the Prostate Cancer Foundation, which has offered to match up to $1 million dollars in donations to support work related to developing therapies against prostate cancer gene fusions at the university.

Mapping of the human genome was only the beginning. Equipped with the comprehensive analysis of the human genome, we can now systematically examine the blueprint of disease at the molecular level. This essential knowledge may lead to better diagnostic tests and promising new treatments for cancer, cardiovascular disease, diabetes and other illnesses, Chinnaiyan says.

For information about the Michigan Center for Translational Pathology, go to med.umich/mctp.

About 218,890 men will be diagnosed with prostate cancer this year, and 27,050 will die from the disease, according to the American Cancer Society. The gene fusion work is not currently available for treatment or diagnosis, and no clinical trials are currently recruiting. For information about prostate cancer and currently available treatments, go to www.mcancer or call the U-M Cancer AnswerLine at 800-865-1125.

In addition to Chinnaiyan, U-M study authors were Scott Tomlins; Saravana Dhanasekaran, Ph.D.; Bharathi Laxman; Qi Cao; Beth Helgeson; Xuhong Cao; David Morris, M.D.; Anjana Menon; Xiaojun Jing; Bo Han; James Montie, M.D.; Kenneth Pienta, M.D.; Diane Roulston; Rajal Shah, M.D.; Sooryanarayana Varambally, Ph.D.; and Rohit Mehra, M.D. Mark Rubin, M.D., from Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School is also a study author.

Funding for the study came from the U.S. Department of Defense, the National Institutes of Health, the Early Detection Research Network, the Prostate Cancer Foundation and Gen-Probe Inc.

The University of Michigan has filed for a patent on the detection of gene fusions in prostate cancer, on which Tomlins, Mehra, Rubin and Chinnaiyan are co-inventors. The diagnostic field of use has been licensed to Gen-Probe Inc. Chinnaiyan also has a sponsored research agreement with Gen-Probe; however, GenProbe has had no role in the design or experimentation of this study, nor has it participated in the writing of the manuscript.

med.umich/