Last modified: Tuesday, August 22, 2006 12:43 AM EDT Experts tout vaccine as frontline in fight against cervical cancer By Rebecca Keister/Sun Chronicle Staff Nicole Boss' daughter, Emma, is just 2 1/2, but like any adoring parent, she's always looking for ways to protect Emma's future health. That's why she's been paying close attention to the newly approved cervical cancer vaccine. `` Why wouldn't you want the life of your daughters protected,'' Boss, 26, of Attleboro, said. `` My dad died of cancer, and now I take any and all measures to help prevent it.'' The vaccine, Gardasil, was approved in June by the Federal Drug Administration and subsequently recommended by the Advisory Committee on Immunization Practices for 11- and 12-year-old girls. The panel also supported recommending the vaccine, which protects against the Human Papillomavirus (HPV), a sexually transmitted disease that can lead to cervical cancer, to females ages 9 to 26. The American Cancer Society estimates that about 3,700 women will die from cervical cancer this year. Another 9,710 cases of invasive cervical cancer will be diagnosed. Since the panel recommendation, arguments against the vaccine's necessity have centered around the fear that it will increase sexual activity among vaccinated teenagers. It also has brought attention to the fact that many women might not know of the link between HPV and cervical cancer. `` You could assess cervical cancer to be an STD,'' said Dr. Elizabeth J. Terry, who has a master's degree in public health and whose practice is in the Foxboro Center for Women's and Family Health. `` (HPV) is easily the most common STD. People have an 80 percent lifetime risk of exposure.'' Gardasil vaccinates against the four most dangerous strains of HPV, out of dozens of types, that most commonly lead to cervical cancer or genital warts. Boss and Cassie Ketchum, 28, and a mother of two, both said they didn't know much about the risk factors for HPV, including the chance of cervical cancer, until reading about the vaccine this year. `` I had no idea. No one ever told me,'' Boss said. `` I knew it was something to think about, as with any STD. It must be more common than I thought.'' Ketchum's first thought when she learned about the 80-percent lifetime risk was, `` Wow.'' `` That's a big percentage,'' Ketchum, of Attleboro, said. `` That opened up a lot of other things for me to think about.'' Many women might not hear much about HPV until they've already contracted it. That's because most women aren't tested for HPV unless they specifically ask for it, or unless they have an abnormal pap smear, an annual gynecological test that detects pre-cancerous changes in the cervix. The Centers for Disease Control reports on its Web site that most HPV infections have no signs or symptoms, and that most infected persons are not aware they are infected. The strains that cause cervical cancer are distinct from those that cause genital warts, which also can appear on the cervix. Not everyone who contracts HPV will develop cervical cancer. The CDC reports that most people will clear the infection on their own. `` But when it comes to your children, you should definitely go beyond, `Oh, it's not going to happen to me','' Ketchum said. Terry is hoping that increased awareness will dampen the stigma around HPV. `` It's truly just a part of being sexually active. It's extremely infectious, and truly, it's just prevention,'' Terry said. `` We want to treat people before they have the exposure.'' If Boss gets her daughter vaccinated, several years down the road, she plans to tell her what the vaccine prevents. `` She has the right to know,'' Boss said. `` The vaccine doesn't protect from all STDs, so there is still plenty for her to worry and be cautious about.'' The CDC also reports that there are 10 strains of the 30 identified genital HPV types that can lead to cervical cancer. The vaccine only targets two of those, and even those who are vaccinated still will need regular pap smears, Terry said. Vaccinated females also will have a reduced risk of genital warts. `` It's certainly not life threatening, but it's a huge cost to health care,'' she said. `` And no patient wants to have genital warts.'' Other factors to consider are that there is no cure for HPV (though there is for genital warts), that women can become infected more than once in their lifetime and that there is no HPV test available for men. The CDC reports that HPV infection can occur in both male and female genital areas that are not covered by a condom during intercourse. Dr. Bradford Germain, assistant chief of pediatrics for Sturdy Memorial Hospital, said the vaccine is so new that doctors affiliated with Sturdy do not currently stock it. But he expects it will be available soon. Germain said that people have expressed an interest in the vaccine and that, at this point, it's an issue of cost. At $130 per dose, with three doses, many insurance companies are still processing the information. `` Will people be willing to pay for it if their health insurance doesn't,'' is one of the questions remaining to be answered, Germain said. Almost $400 for a series of vaccinations to prevent cervical cancer, he said, is far less than the cost to treat cervical cancer. `` Everyone has a different feeling, but I think people should know they will be able to (protect) their daughters,'' Terry said. `` This is probably one of the biggest breakthroughs for public health with an STD in decades.''