Lack of preventive care, not HPV vaccine, 'real' reason 'too many women still die of cervical cancer'

Mar 11 2007

The "real" reason that "[t]oo many women still die of cervical cancer" is the "lack of access to preventive medical care for low-income women and not the lack of a vaccine," Wall Street Journal columnist and Illinois-based physician Benjamin Brewer writes in an opinion piece.

According to Brewer, the "decision to vaccinate a child" with a human papillomavirus vaccine, such as Merck's HPV vaccine Gardasil, "should be made by the patient, her parents and their doctor" and not states (Brewer, Wall Street Journal, 3/8).

Gardasil, approved by FDA in July 2006, has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases.

The vaccine, which costs $360, also is about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases (Kaiser Daily Women's Health Policy Report, 2/28).

Brewer writes that Gardasil will not stop the need for annual Pap tests, adding that the "real usefulness" of the vaccine is its protection against genital warts.

Cervical cancer thus has become a "rare disease" in the U.S. in part because "newer versions of the [Pap] test have cut down on false positives and improved cancer screening," Brewer writes, adding, "There are not millions of women in the U.S. that we're going to save with a mass vaccination program.

The developing world is another story." He concludes, "[A]s a personal choice, spending $360 of disposable income on a vaccine is one thing.

Mandating a vaccine with limited clinical usefulness at taxpayers' expense ... is another" (Wall Street Journal, 3/8).