According to Kaiser News today:
The "real" reason that "[t]oo many women still die of cervical cancer" is the "lack of access to preventive medical care for low-income women and not the lack of a vaccine," Wall Street Journal columnist and Illinois-based physician Benjamin Brewer writes in an opinion piece.
According to Brewer, the "decision to vaccinate a child" with a human papillomavirus vaccine, such as Merck's HPV vaccine Gardasil, "should be made by the patient, her parents and their doctor" and not states (Brewer, Wall Street Journal, 3/8)....
Brewer writes that Gardasil will not stop the need for annual Pap tests, adding that the "real usefulness" of the vaccine is its protection against genital warts.
Cervical cancer thus has become a "rare disease" in the U.S. in part because "newer versions of the [Pap] test have cut down on false positives and improved cancer screening," Brewer writes, adding, "There are not millions of women in the U.S. that we're going to save with a mass vaccination program. The developing world is another story."
He concludes, "[A]s a personal choice, spending $360 of disposable income on a vaccine is one thing. Mandating a vaccine with limited clinical usefulness at taxpayers' expense ... is another."
Comments:
Someone asked this question on a message board I visit, and I did not know the answer. I am hoping as a nurse you will be able to explain this. The poster is a married woman who has never had sex with anyone but her husband, who has never had sex with anyone but her. If cervical cancer is caused by HPV, and HPV is an STD, does that mean she can stop getting Pap smears?
Posted by: Michelle Potter at March 9, 2007 6:58 PMMichelle, there are rare, unexplained cases of HPV. For instance, a poster on this blog has HPV and is sure neither she nor her husband have had pre- or extra-marital sex. I looked it up, and there is that phenomenon.
Posted by: Jill Stanek at March 10, 2007 7:58 AMMichelle
HPV can be transmitted through ANY sexual contact, not just sexual intercourse. Penetration is not required. For example, you can transmit HPV just through heavy petting. There are theories that it can be transmitted though unclean towels, but you will also hear people say it can be transmitted from a toilet seat, which is a myth.
and that absolutely DOES NOT mean you should stop having regular Pap smears. Pap smears and pelvic exams are used to identify many other health issues - not just Cervical cancer. It can identify benign cells in the vagina or cervix that could lead to a growth or discomfort, it identifies precancerous cells that could be in that area. Also, while more than 70% of cervical cancer cases are attributed to HPV, that still leaves 30% of cases NOT caused by HPV, so it is very important that women not think that having the vaccine or knowing they dont have HPV means they dont need pap smears anymore.
Posted by: Amanda at March 10, 2007 9:44 AMAnd now shall we compare Amanda's answer and Jill's answer? Amanda 100, Jill 0.
Posted by: Danielle at March 10, 2007 8:20 PMYes, thank you, Amanda. I would just correct your statement, "more than 70% of cervical cancer cases are attributed to HPV, that still leaves 30% of cases NOT caused by HPV."
Virtually all cervical cancer (99%) is caused by HPV. You may have been confused by the fact that the HPV vaccine only guards against 70% of cervical cancers, which leaves 30% of cervical cancer cases not treated by the vaccine.
Also, to add to your first point, HPV can be transmitted via oral-genital sex.
Posted by: Jill Stanek at March 11, 2007 2:49 PM