Ottawa has provided the country a whopping 300 million dollars to buy Gardisil to vaccinate young girls against HPV. The last time a Prime Minister made a decision like this was in the 1950s, during the polio epidemic. There is no epidemic of cervical cancer! In fact, according to the Canadian Cancer Statistics, approximately 400 women were anticipated to die of the disease in 2006, making it not even fall within the top 10 cancers that kill women.
The following are the percentage of estimated deaths from selected cancers in Canada, female, 2008:
Lung 26.3
Breast 15.2
Colorectal 11.6
Pancreas 5.6
Ovary 4.9
Non-Hodgkin Lymphoma 4.0
Leukemia 2.9
Body of Uterus 2.3
Brain 2.1
Stomach 2.1
Multiple Myeloma 1.8
Kidney 1.7
Bladder 1.5
Esophagus 1.2
Oral 1.1
Cervix 1.1
To see a chart showing incidence and deaths of cancer in women please go to http://www.cancer.ca/British%20Columbia-Yukon/About%20cancer/Cancer%20statistics/~/media/CCS/Canada%20wide/Files%20List/English%20files%20heading/pdf%20not%20in%20publications%20section/Canadian%20Cancer%20Society%20Statistics%20PDF%202008_614137951.ashx ( Page 15)
Cervical cancer can be deadly, but this is rare and uncommon in Canada. Invasive cervical cancer takes a progressive course that can be halted at one of various stages (CWHN).
Cervical cancer is often first detected by abnormalities by routine Pap smears (rarely do women experience obvious symptoms). If detected early, and the abnormal cells (dysplasias) are removed entirely, cervical cancer will not develop. Repeat testing and treatment is recommended for cervical cancer screening, as are smoking cessation and safer sex practices.
It takes on average 10 years for an untreated cervical dysplasia to progress and become progressive, invasive cervical cancer (CWHN). Cervical cancer is preventable and deaths from it can be avoided through detection and treatment at an early stage. Those women who do die from cervical cancer often either:
-Don’t have access to primary care and discover the disease at a later state or
-Are not given proper follow up after the discovery of an abnormal Pap result.
Women who lack access to regular Pap screens are often those women living in poverty, immigrant and refugee women, women living with disabilities, women who have experienced sexual trauma/abuse, Aboriginal women, and women living in remote areas. According to CWHN, women who have sex with women also tend to be under screened (health care providers incorrectly assume they do not need to be tested. Other barriers to access to PAP screens are the lack of female health care providers, time constraints, costs, childcare, language and literacy differences, lack of knowledge, cultural differences, safety concerns etc.
“Missed opportunities” should not be a reason for developing cervical cancer, or not catching it early enough. A vaccine cannot fill the gap that has been created for those who are not regularly screened for cervical cancer through Paps. Those who are vaccinated will still need routine Pap testing; and if Pap testing is what can identify and prevent cervical cancer, is this not something we should be promoting at the same level we are promoting the HPV vaccine??
Are young girls who are receiving the vaccine going to think they are fully protected against cervical cancer (when really they are protected from only 4 strains of HPV)? Will they then decide it is not necessary for them to get Paps, which can not only detect cervical cancer but numerous other STIs, diseases and abnormalities?
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2 comments:
I don't see why so much money has been put into this vaccine when it confers such a small (in the grand scheme of things) amount of protection. Wouldn't the money be better spent improving access and information to those with the most barriers to access? It seems like the women with the most barriers to pap tests are also some of the least likely to get the vaccine. Personally, I'm having trouble seeing the justification for such wide scale support of a vaccine that seems to be a sub-par solution to the problem.
A lot of money has been put towards not only implementing this vaccine but also advertising for it on a large scale! This is a lot of effort and creating a lot of awareness for a very small issue in the grand scope of sexual health.
The vaccine being available for free in schools was meant to provide access for women who may be the least likely to be able to afford the vaccine were it not publicly funded. The problem here is that it is only free for grade 8 females... what about the barriers that women other than those in grade 8 face in affording and accessing the vaccine?
Making it available in schools as a "one time" offering almost puts the pressure on young women and their parents to make a decision before it is too late and they have to pay for it themselves. Sneaky, I think.
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