The Politics and PR of Cervical Cancer

Many women, including the author, have been affected by cervical cancer or Human Papillomavirus (HPV) at some point in their lives. Part one of a series of articles examining HPV and Gardasil -- the facts, the hype, and what Merck stands to gain.
HPV is rampant throughout the world, and the U.S. is no exception. It is estimated that up to 20 million people in the U.S. are currently infected with HPV -- men as well as women. It is not surprising, therefore, that Gardasil has burst onto the national stage as the latest 'wonder' vaccine. Manufactured by Merck, Gardasil is the first vaccine available that can prevent 4 strains of HPV, which is a leading cause of cervical cancer and pre-cancerous cervical conditions.

In nearly every state in the U.S. there is a legislative push to make the HPV vaccine mandatory for middle school aged girls, with catch-up clauses to cover girls that have passed that age but are not yet sexually active. Given the anxiety of most people about cancer and the number of people infected with HPV, it is not surprising that what is touted as the first vaccine against cancer has been largely greeted with acclaim. But despite having been affected personally, I became concerned by the headlong rush to not only approve the vaccine, but to mandate it for middle-school aged girls. It is also worrisome that a vaccine may give a false sense of security, which could lead to a decline in the very reliable and proven diagnostic tools available, including Pap tests. Decisions affecting millions of young women should not be made lightly, and certainly not without examining the marketing, PR, and profit motives of a corporation like Merck.

HPV and Cervical Cancer: Just the facts, Ma'am

According to the Centers for Disease Control and Prevention, as many as 50 percent of sexually active men and women become infected with Human Papillomavirus (HPV) at some point in their lives. Because the virus is so pervasive, by age 50, at least 80 percent of women will have acquired genital HPV infection. It is estimated that each year an additional 6.2 million Americans becomes infected by one of the strains of HPV. It is important to note, however, that only a few strains of HPV actually cause cervical cancer.

Despite how ubiquitous the virus is, basic knowledge about HPV and its link to cervical cancer is sadly lacking in the U.S. population. According to the 2005 National Cancer Institute's Health Information National Trends survey, only 38.3% of U.S. women surveyed said that they had heard of Human Papillomavirus or HPV. In addition, less than 50% thought that HPV caused cervical cancer.

HPV is significant not only because of the high infection rates among the population. HPV infection can affect fertility, can cause the sexually transmitted disease (STD) genital warts, and some strains can lead, in rare cases according to the Centers for Disease Control and Prevention, to cervical cancer. The CDC goes on to say that "Most people who become infected with HPV will not have any symptoms and will clear the infection on their own." That is to say, without any treatment, many infections are addressed by the body's own immune system. (The National Cancer Institute's survey noted that nearly 80% of women mistakenly believed that the body could not resolve the infection without treatment.)

For those whose bodies are unable to counter the infection without assistance, a Pap test provides a reliable method of detection, which, coupled with appropriate treatment, has drastically reduced the mortality rate of cervical cancer patients. The National Institutes of Health points out that HPV does not lead directly to cervical cancer but causes cell abnormalities, or dysplasia, which can over time develop into cancer. It is a slow progression, and "this pre-cancerous condition can be detected by a Pap smear and is 100% treatable." In addition, 92% of women are alive 5 years after a cervical cancer diagnosis if the cancer was kept from spreading outside of the cervical area.

So why is cervical cancer still an issue for women? In the developing world, lack of access to healthcare and routine tests like the Pap smear means that infections and early pre-cancerous conditions are not detected, and if and when women are diagnosed, it is with advanced, invasive cervical cancer that may have metastasized to other parts of the body. In addition, other cervical cancer risk factors, such as becoming sexually active at an early age and giving birth to several children, are more common for women in developing countries.

source : www.alternet.org