Guest Editorial in The Daily Iowan
Harper: Gather information and make your own choice
Direct communication and full information are necessary to make health-related decisions.
As a physician who routinely treats women and men with HPV-diseases, my experience includes having sat at the bedside of women dying of cervical cancer; having performed tens of thousands of colposcopies; having surgically treated pre-invasive HPV-related disease; having been actively involved in HPV cancer-prevention research for more than 20 years at the National Cancer Institute, Dartmouth, and University of Missouri-Kansas City; having served as the state director for the CDC Breast and Cervical Cancer Early Detection Programs; having served as a consultant to both Merck (which manufactures the HPV vaccine Gardasil, the one used by University of Iowa Hospitals and Clinics) and GSK (which manufactures the HPV vaccine Cervarix) on the vaccine trial designs as well as the phase-II and phase-III trials for FDA approval of both Gardasil and Cervarix; having served as a consultant to the World Health Organization; and having been an invited visiting professor to more than 70 countries about cervical cancer-prevention and HPV-associated diseases. So it’s refreshing to see an editorial (“Recommend Pap smears, not vaccines” Nov. 29 The Daily Iowan) that does not shame or fear people into being vaccinated with Gardasil.
The current Pap-screening program in the United States has resulted in an average incidence of 8 per 100,000 cases of cervical cancer per annum. Black and Latina women have higher rates at 11.1 per 100,000 and 12.8 per 100,000. The very best that Pap screening can do is to reduce the incidence of cervical cancer to 2 to 3 per 100,000 women because of false-negative testing.
Ignoring Pap screening and making generous assumptions that Gardasil will last your whole life (for which there is no proof, only speculation), that the efficacy will remain at 100 percent for your whole life (again no proof, only speculation), that Gardasil will provide complete protection from HPV-16 and -18 and partial protection from HPV-31, and that every single female receives three doses on time, the lowest incidence of cervical cancer that Gardasil can achieve is 14 per 100,000 after 60 years of Gardasil use.
Making similar assumptions about Cervarix, but with the difference being protection against six of the cancer causing HPV types, the lowest incidence Cervarix can achieve is 9.35 per 100,000. Making similar assumptions about the monovalent Gardasil+5 vaccine that is being tested on women at the UI, the lowest incidence of cervical cancer achievable is 9.3 per 100,000 women.
Clearly, if one has to choose between Pap screening and vaccination, Pap screening is the way to detect early lesions so that these lesions caused by all 15 of the cancer causing HPV types can be treated and thus, cervical cancer prevented. Clearly, there is also a choice in which vaccine a woman may want if she chooses to add vaccination to her Pap screening program.
Read the entire article here.
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