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Recommend Pap smears, not vaccines

BY DI EDITORIAL BOARD | NOVEMBER 29, 2011 7:20 AM

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Controversy continually surrounds the prospect of administering vaccines to America's youth. Recent efforts to combat the human papillomavirus, and ultimately cervical cancer, through vaccination have only fueled such debates. But in the case of cervical cancer, only one method is statistically proven to prevent the disease, and it's 100 percent safe: regular Pap smears.

Before vaccination, doctors should be mandated to provide such information to patients and parents, as well as disclose the known risks and actual benefits of Gardasil and Cervarix, the vaccines most commonly used.

HPV is the most prevalent sexually transmitted disease. There are an estimated 6 million new cases diagnosed each year. According to the American Social Health Administration, 80 percent of sexually active people — those who have had sex even once — will contract the virus over the course of their lives.

Fortunately, HPV is effectively harmless and is not accompanied by any symptoms in the vast majority of cases. Most who test positive will then test negative after six to 12 months. However, though most cases of HPV are nothing to worry about, some are very serious — every instance of cervical cancer is caused by some form of HPV.

By the end of 2011, approximately 12,000 people will have been diagnosed with cervical cancer, and 4,000 will die because of it. The deaths due to cervical cancer make up 18 percent of deaths from gynecologic cancers and 2 percent of all cancer deaths in women, according to data from the Oral Cancer Foundation.

If the numbers are consistent with one another, there is a 0.436 percent chance a woman diagnosed with HPV will be diagnosed with cervical cancer in the future — a figure too high to continue without initiating preventive measures.

In late October, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention once again recommended HPV immunization in young girls and boys. Mary Larew, a UI clinical associate professor of pediatrics, recently told The Daily Iowan that she presents the vaccine as cancer-preventory and estimates that more than 75 percent of her patients (or their parents) choose to take the vaccine.

But do these vaccinations prevent cervical cancer?

"We don't know yet," responded Dr. Diane Harper, one of the lead researchers of the two vaccines. She has successfully published nine such studies, some even being funded by the manufacturer of Gardasil, Merck & Co. Inc.

So what does it do? Harper said all the vaccine has been proven to provide is a reduction in the chance of an abnormal Pap smear.

"It won't protect you from very much at all," she said. "The whole question with Gardasil is, 'How long will that protection last?' It will only be effective five to seven years, then anyone who gets vaccinated at 11 to 12 years old will not have protection when their sexual activity is probably at its highest — so anyone who takes it still has a whole lot of HPV exposure the vaccine won't be protecting against."

There are many health concerns regarding the vaccines. An FDA report showed that 73 percent reported new medical conditions after receiving the drug. According to the National Vaccine Information Center, one in 1,855 result in a bad outcome. Side effects include seizures, blood clots, and heart problems.

The cost-to-benefit ratio of vaccination is much more costly in developed communities such as Iowa City. Of the 4,000 cervical cancer deaths, many came from communities in which Pap smears were largely unavailable to low-income families — in inner-city communities, Appalachia, and along the U.S.-Mexican border. Worldwide, 80 percent of cervical-cancer deaths are reported from developing countries.

After all of the information she has gathered, Harper has found only one method proven to effectively prevent cervical cancer.

She said, "I think it's incredibly important for doctors to tell their patients that the only way to prevent cervical cancer is to stay in a regular Pap-smear program.

"If doctors tell patients that this vaccination will prevent cancer, they're telling them a lie."

At this point in time, not enough is known about HPV vaccinations to be recommended to the general public by medical professionals. Even when an HPV vaccine that does indisputably causes more harm than good exists, regular Pap smears should be stressed to exhaustion to women locally and worldwide.


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