The HPV Vaccine and Pap Results
A dear friend of mine, Sarah Stern, recently had an abnormal Pap test result showing precancerous cells. She submitted to all the requisite follow-up: a colposcopy, or microscopic examination of the cervix; a biopsy of the suspicious-looking area; and treatment with cryosurgery to freeze and destroy the abnormal cells. Plus, she endured plenty of fear and anxiety. Very few women in this country now die of the cancer that killed Eva Perón in the 1950s, but 1 in 3 will, like Sarah, have an abnormal Pap at some point in her life. It appears that you can reduce the odds of being the one, however, by getting vaccinated against the cervical cancer-causing virus known as HPV. The Gardasil vaccine cuts the rate of Pap abnormalities by 43 percent, researchers announced today at the meeting of the Society of Gynecologic Oncologists.
Let's qualify this a bit: The women in the vaccine study were ages 16 to 26, not infected with HPV, and followed for just three to four years—not the two or three decades it can take for precancerous lesions to develop. Still, this certainly adds to the reasons for getting vaccinated. Gardasil, the only vaccine currently available in the United States, protects against four HPV types, two of which cause genital warts and two of which are responsible for 70 percent of cervical cancers. A new vaccine called Cervarix could be approved by the Food and Drug Administration later this year.
"We saw significant reductions in the most severely abnormal Pap smears," says study leader Warner Huh, associate professor of gynecologic oncology at the University of Alabama-Birmingham. The vaccine protection translated into about a 20 percent reduction in colposcopies and a 22 percent drop in cervical biopsies. Considering that $3.6 billion is spent every year on the treatment and evaluation of abnormal Pap smears, Huh adds, vaccination could yield a big cost savings. (The current study was funded by Merck, manufacturer of Gardasil, and Huh also serves as a paid consultant for both Merck and GlaxoSmithKline, manufacturer of Cervarix.)
One reality that gets lost in all the enthusiasm over the HPV vaccine is that it can't completely guarantee a woman won't get cervical cancer. So women still need to go in for regular Pap smears. Moreover, older women like my friend Sarah, 55, usually aren't vaccinated, since Gardasil is currently approved only for women up to age 27; most who wind up with Pap abnormalities were infected with HPV decades ago, well before Gardasil was invented. As the founder of a Mideast think tank called Emet, she's used to getting her message out, and this time she has two. The vaccination might save young women from both cervical cancer and unnecessary torment. And "surgery and early detection saved my life," she tells me. "I want to remind every woman to go for that regular Pap smear."
Tags: human papillomavirus | cervical cancer
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Reader Comments
Gardasil does harm
Gardasil was tested in a population which was much older than the target population
Gardasil was not associated with decreased cervical cancer risk
Gardasil safety testing was inadequate in the target population
Young women no longer even need paps because the risk of not completely clearing HPV infection on their own is zero ; check the new recommendations online for paps in women under 20
At best we're going to "protect" these vaccinated girls for 5-10 years , after the vaccine wears off, we'll either have to give expensive boosters or we'll just see a spike in new vaccine associated HPV infections in their 20s
It'll be decades before we know how many extra cases we'll have caused with Gardasil
the ads should say "one less with natural life-long immunity"
And serotype replacement, like what happened with Prevnar, will be a wild card in all this
we very well may unleash a relatively rare cancer causing strain by knocking down temporarily these 2 strains
just research the specifics of the trials that got the shot approved FUTURE 1 and FUTURE 2 trials and look at the numbers
the number of women, WOMEN, studied and the lack of effect on the overall chance of getting HPV changes and precancerous changes
Re: To Nancy of New York--
Nancy,
Your comment "A person is only considered 'positive' for HPV if they have one of the 13 strains." is untrue.
What do mean "considered positive"? there isn't any consideration about it. Positive means that the test probes for you were tested reacted in adequate amounts of detection above the cutoff level (5,000 HPV DNA copies).
Most people beleive that HPV tests only for high-risk strains--NOT TRUE, don't take my word for it, from Qiagen's website, maker of the Digene Cpature 2: digene HPV hc2 Test For 40 cervical samples (96 tests); Probe Diluent, Low-Risk HPV Probe, High-Risk HPV Probe, Quality Controls, Calibrators, Capture Microplate, Reagents and Buffers Part #5196-1330.
The real problem is that most Dr's (and insurance companies) are not concerned with affiramative testing for low-risk strains.
You're so concerned with promoting this vaccine; maybe you should do a little research before regurgitating what the drive-by media and Merck would have you and everyone else believe.
Follow the Money!
For the moment, forget the fact the Gardasil's FDA approval was based upon short-term "junk-science", and forget the fact that Dr. Huh held a significant role in those test, and forget the fact that Dr Huh is a paid consultant for Merck (among many other pharma companies), and forget the fact there is no long-term efficacy study of safety analysis, this vaccine is now suspected of as many as 10 deaths!!!! Deaths! Through the Freedon of information act, Judicial Watch, a governmental watchdog and oversight group obtained a list of reported side effects (judicialwatch.org). I urge anyone considering this vaccine to read their report and consider the dangers associated with this drug and compare the real benefit..is death or paralysis a side effect you accept?? and for what benefit? You still need annual pap and there are still another 100 strains of the HPV virus for which you would not be protected. This is all about making this vaccine as standard and making money.
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