Commentary Sexual Health

How to End Cervical Cancer? We Must Refocus on Common Sense, Medical Evidence and Love for Our Children

Sinsi Hernández-Cancio

No woman should die from cervical cancer. Medical science has finally given us the tools to prevent the deaths of women living with it.

This article is cross-posted from and in partnership with the National Latina Institute for Reproductive Healthand is published as part of a series on cervical cancer.

See all our coverage of Cervical Cancer Awareness Month 2012 here.

No woman should die from cervical cancer. Medical science has finally given us the tools to prevent the deaths of women living with it. Yet in the United States, this highly preventable and treatable disease kills more than 4,000 women every year. What’s more, the disease is not spread equally across society – Hispanic women are 1.5 times more likely than white women to be diagnosed with, and eventually die from, cervical cancer.

Experts have pointed to a number of factors contributing to this alarming disparity. In general, Latinas have faced greater barriers to getting the care that is necessary to prevent, detect, and treat cervical cancer in its early stages. Some of these obstacles are the ones typical to Latinos in general, such as uninsurance, lack of a regular source of care, and language and geographic barriers. Yet there is another, overarching impediment that, while not exclusive to the Latino community, may be hitting us particularly hard. An argument can be made that there is a critical cultural and social barrier that is interfering with our ability to make cervical cancer a thing of the past: the baggage that the disease carries because it is primarily caused by a sexually transmitted virus, the Human Papilloma Virus, better known as HPV (which also causes other forms of cancer in women and men).

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Thanks to the new health care law, we are in a better place than ever before to tackle the usual barriers to care. As the law is implemented, many more Latinas will have access to coverage, primary care providers will be better supported, and community health centers will grow, all which will help Latinas get the care they need. And on top of all this, preventive benefits – including pap smears and HPV tests – will be available to women free of charge, and HPV vaccinations for boys, girls, women, and men in the recommended age ranges will also be free.

However, the best technology in the world is useless if it isn’t implemented – and there is a real danger that this is exactly what may happen in our community. Just a few years ago, science produced a true game changer in the fight against cancer: the HPV vaccine. Imagine: a cancer vaccine! The Holy Grail of cancer researchers for decades! You’d think that the public would be clamoring to make sure everyone got it. Instead, this public health breakthrough is being undermined by a dangerous and misguided debate about the social and moral implications of vaccinating pre-teen girls against exposure to a sexually transmitted virus.

It is vitally important that we change the framing of this issue, especially in the Latino community, where we clearly have more to lose. This is a matter of health and safety, not of sex and stigma. Just as is true for other vaccines, the HPV vaccine is meant to protect individuals against unexpected health risks in the future. We must clarify for our community that the scientific basis for vaccinating our girls and boys at age 11 and 12 is not because we expect them to have sex when they reach 13, but because the vaccine needs time to become effective, and younger immune systems produce stronger antibodies that will protect them their whole lives. Moreover, although it is difficult for us to accept, especially those of us who are parents, we need to understand that we live in a society where young people face a clear and present risk of being exposed to life-threatening sexually transmitted diseases completely against their will. Recent coverage of child sexual abuse scandals in the news have made this clear-whether it is at Penn State, Hollywood, or a community closer to home. We can’t afford to let stigma and our squeamishness keep us from protecting our kids.

Many of our young people are still in that golden window of opportunity to get the vaccine: women and girls between the ages of 13 and 26, and men and boys between the ages of 13 and 21. It is our responsibility to make sure that our young people take full advantage of this extraordinary shield against a deadly disease – whether that means parents taking their teenagers to get their shots or empowered young adults taking control of their health on their own.

We need to banish our discomfort, forget the taboo, and let common sense, love for our children, and medical science lead the way to a future without cervical cancer.

Commentary Family

Here We Go Again: Republican Candidates ‘Debate’ the Settled Science of Vaccines 

Martha Kempner

Republican candidates took on vaccines in Wednesday night's debate. They failed to clarify falsehoods, spouted misinformation, and put their own political aspirations ahead of the needs of young people in this country.

Vaccines were one of the many subjects batted around by the crowded field of Republican presidential hopefuls in the second debate of primary season held on Wednesday night. Those candidates who took on this topic failed to clarify falsehoods, spouted misinformation, and put their own political aspirations ahead of the needs of young people in this country.

Moderator Jake Tapper began the discussion with a question aimed at Ben Carson: “Dr. Carson, Donald Trump has publicly and repeatedly linked vaccines, childhood vaccines, to autism, which, as you know, the medical community adamantly disputes. You’re a pediatric neurosurgeon. Should Mr. Trump stop saying this?”

It was an easy question with an easy answer. Carson should have said, “Yes, it’s inaccurate and, as such, dangerous to repeat. Trump should stop saying it.”

But Carson, who is indeed a brain surgeon, did not take that strong of a stance. At first, he said, although with less conviction than the statement warranted, “There has—there have been numerous studies, and they have not demonstrated that there is any correlation between vaccinations and autism.”

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Then he undercut that statement immediately by adding that the vaccine-autism connection “was something that was spread widely 15 or 20 years ago and it has not been adequately, you know, revealed to the public what’s actually going on.” And even worse: “Vaccines are very important. Certain ones. The ones that would prevent death or crippling. There are others, there are a multitude of vaccines which probably don’t fit in that category, and there should be some discretion.” And, finally, despite the damage he’d already done, he added: “A lot of this is pushed by Big Government.”

Essentially, Dr. Carson took a topic that has a simple answer—”Vaccines have been proven not to cause autism”—and made it so murky that debate viewers might walk away thinking that there is something the public hasn’t been told about the link between autism and vaccines, that only some vaccines are lifesaving and therefore necessary, and that there’s been some sort of government conspiracy to push vaccines on unsuspecting parents and their children.

Donald Trump’s message was much clearer, though entirely inaccurate. He claimed, as he has in the past, that he knows someone who “just the other day” took a beautiful 2 or 2-and-a-half-year old to the doctor, the child got shot full of vaccines, spiked a terrible fever, and now has autism. Trump, who has no medical background, then explained that he is “in favor of vaccines,” he just thinks we bunch them together too much and they should be spaced out over a longer period of time. If we do this, Trump said, “I think you’re going to see a big impact on autism.”

Rand Paul—also a medical doctor—could have helped clarify the situation by explaining that there is no science to support the connection between vaccines and autism and that there is no science to support spacing vaccines over time. But he sat firmly on the fence instead, saying, “I’m all for vaccines, but I’m also for freedom. I’m also a little concerned about how they’re bunched up. My kids had all of their vaccines, and even if the science doesn’t say bunching them up is a problem, I ought to have the right to spread my vaccines out a little bit, at the very least.”

The deliberate confusion, misinformation, and sacrifice of science for politics is reminiscent of the 2012 Republican presidential primaries, when Michele Bachmann went after Rick Perry for his support of HPV vaccines and suggested they caused “mental retardation.” As Rewire did then, it appears to be time to play another round of “pointing out how the candidates are wrong about vaccines.”

First and foremost, there is no link between vaccines and autism. This should have been the beginning and end of the discussion. The false connection between these two unrelated issues started with a 1998 study in which British researcher Andrew Wakefield studied the records of about a dozen autism patients and concluded that the MMR shot—the vaccine for measles, mumps, and rubella—was the source of their problems. It was later revealed that Wakefield had fabricated his data, possibly for financial gain. He has been stripped of his medical license and his research has been retracted by the journal that published it.

Not surprisingly, all efforts to recreate his results have failed. Study after study has looked for this connection and concluded that it simply does not exist. The most recent of these, published in the Journal of the American Medical Associationexamined the records of 95,000 children with older siblings. Those whose siblings had been diagnosed with autism were considered at a high risk for getting that diagnosis themselves. As Rewire reported, researchers found that vaccination did not affect the rate of autism diagnosis, even in these higher-risk kids.

As for Trump’s claim that spacing vaccines out over time will lead to a reduction in the autism “epidemic”—it, too, is totally bogus. First, there is no autism epidemic. In fact, science shows that autism has existed at its current rate in the general public throughout our history. Changes in how we diagnose it and a willingness to talk about it are likely behind false assumptions that it is on the rise.

Second, logic tells us that if vaccines don’t cause autism, changing the timing of when they are given will have no impact. As the Centers for Disease Control and Prevention (CDC) notes, the schedule currently suggested for routine vaccinations is recommended for a reason:

Administering all needed vaccines at the recommended ages, even if it means giving multiple doses during the same visit, is important because it increases the likelihood that children will be fully immunized as recommended. Studies have shown that vaccines are as effective when administered simultaneously as they are individually and carry no greater risk for adverse side effects.

No one, however, is forced to vaccinate on this schedule, so long as children have had the vaccines required to attend school in their state by the time they reach kindergarten. Rand Paul’s rhetoric on parental freedom, therefore, was mere pandering.

Which brings us to Ben Carson’s insinuation that kids are given too many vaccines and some—those for diseases that don’t kill or maim—might be unnecessary. Either he was trying to appeal to those who think vaccinations are a moneymaking scam for pharmaceutical companies, or he has his facts wrong.

The list of potential outcomes of the diseases we vaccinate against—from measles and rubella to tetanus and pertussis—almost always ends with “death.” And those children who do not die may end up deaf (from mumps), with an intellectual disability (from measles), or paralyzed (from polio). Even the flu, which healthy adults sometimes think of as no big deal, can kill children. Fifteen children in nine states died of the flu in 2014.

If, by chance, Dr. Carson was talking about the HPV vaccine—which has been controversial and often dismissed as unnecessary because it protects against a sexually transmitted infection—he would do well to remember that HPV causes cervical cancer. About 4,000 women die from cervical cancer each year in this country.

Earlier this year, there was a measles outbreak on the West Coast that should serve to remind us how quickly these diseases can spread when too few people are vaccinated. One person with measles visited an amusement park in California in December and ultimately sickened more than 115 people in numerous states. The CDC notes that the majority of people who got measles were unvaccinated. In 2014, there were 23 outbreaks of measles—one occurred in unvaccinated Amish communities in Ohio and sickened 383 individuals.

Such outbreaks are absurd in a country that has the knowledge and resources to prevent diseases that killed so many children in the past. Vaccines represented a major step forward for science and medicine, but the rhetoric around them is a giant step back. Hearing this nonsense from a group of people who want to lead our country—people who could end up in charge of public health agencies like the CDC—is truly frightening.

It seems that the candidates can’t think beyond their immediate goal of winning the primary nod and, as such, are working really hard not to offend those misinformed parents who are skeptical of vaccines. There are many issues in which voters have legitimate differences of opinions—and candidates can knock themselves out trying to stay in the exact middle of the road on those. But there is no debate on vaccines and autism. There is just fact. The candidates should be ashamed of themselves for trying to pretend otherwise.

News Health Systems

Study: States With Low HPV Vaccination Rates See Higher Cervical Cancer Rates

Martha Kempner

A new study finds that cervical cancer rates and HPV vaccination rates tend to move up and down together, suggesting once again that if more young women get vaccinated there will be fewer cases of cervical cancer.

More proof that vaccinating young people against human papillomavirus (HPV) can prevent cervical cancer was presented this week at a health disparities conference, as a national study found that there are fewer cases of cervical cancer in states in which HPV vaccines are more common.

Distrust of vaccines—based largely on dubious information—and fear that the vaccine might encourage promiscuous sexual behavior among teenage girls could be factors in states with the lowest HPV vaccination rates and the highest cervical cancer occurrences. Numerous studies have shown that the vaccine does not encourage promiscuity.

The study, presented at a conference organized by the American Cancer Research Association, pointed to a number of states on opposite ends of the spectrum. In Massachusetts, for example, 69 percent of girls ages 13 to 17 receive at least one dose of the vaccine, which is given as a series of three shots six months apart, and only six out of 100,000 women are diagnosed with cervical cancer each year.

Sixty-six percent of young women in Vermont have received at least one dose of the vaccine and 5.4 women out of 100,000 are diagnosed each year.

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In contrast, 41 percent of girls in Arkansas have received one dose of the vaccine and 10.2 out of 100,000 women are diagnosed with cervical cancer each year. In Mississippi, only 40 percent of girls received one dose of the vaccine and the cervical cancer rate is 9.2 per 100,000 women.

Fifty-seven percent of girls nationally have received one does of the vaccine and the national cervical cancer rate is 8.2 per 100,000 women.

This new study confirms research showing that vaccine rates are much lower in the South than in other parts of the country.  A 2013 study of older women, ages 18 to 26, found that between 2008 and 2010, 37.2 percent of young women in the Northeast had received at least one shot compared to 28.7 percent the Midwest and West, and just 14 percent in the South.

The newest study shows that cervical cancer rates and HPV vaccination rates tend to move up and down together. Though the authors could not prove causality, their finding suggest that increasing the uptake of the vaccine in a state could have a direct impact on cervical cancer rates and could help even out existing disparities between states.

Cervical cancer affects about 12,000 women each year in the United States, and about 4,000 women die from the disease.

Worldwide, the numbers are much higher. The clear majority of cervical cancers (91 percent) are caused by HPV, a highly contagious sexually transmitted disease (STD) that is spread from infected skin to uninfected skin. Around 79 million Americans are currently infected with HPV, and about 14 million people become infected each year.

Though the HPV vaccine has been shown to be safe and effective, it has been a tough sell since it came onto the market in 2006. Low vaccination rates reflect a general distrust of vaccines that stems from disproven data released in the late 1990s linking vaccines to the rise in autism.

This explains only part of the problem, because other vaccines are more readily accepted. In fact, the Centers for Disease Control and Prevention estimated in August that if 13-year-old girls had been given the vaccine at the same time they were given the other vaccines recommended for that age, 91.3 percent of them would have received at least one dose.

Some parents seem worried that vaccinating against as sexually transmitted disease would encourage sexual behavior in young girls. Others have said that the recommended age of 11 is too young to even discuss sexual behavior, despite lack of evidence that the vaccine changes a teen’s sexual behavior.

There is a lack of understanding among parents about the HPV vaccine and many parents don’t realize that it can actually prevent cancer.

Perhaps the most important research on the vaccine thus far are studies that show it is working. Despite the low vaccination rates, the proportion of teen girls infected with the strains of HPV that the vaccine addresses has dropped by 56 percent.

This applies to all teens, whether or not they were vaccinated. This may be a result of what public health experts refer to as “herd immunity”—if enough of the population is protected by a vaccine, that protection extends to the un-vaccinated as well. Among girls who had gotten the vaccine, however, the drop in HPV infections was even higher, at 88 percent.

Jennifer Moss, a doctoral student at the University of North Carolina Gillings School of Global Public Health and the author of the new study, told TIME, “These states could really use some interventions to increase the rates of HPV vaccination now, and hopefully there will be big dividends in the coming decades in terms of cancer mortality.”

Moss added that pediatricians play a critically important role.

“The factor that’s most strongly associated with HPV vaccination is whether a child’s health care provider recommends it,” she said. “We really need strong recommendations from health care providers to adolescent patients and their parents to get the vaccine.”