Risk of cervical cancer distorted, causes alarm

Special to the Star
The recent headlines and political posturing about the HPV vaccine program to protect girls from cervical cancer might imply that there’s an epidemic of this type of cancer.

But that’s not the case, according to statistics and experts on both sides of the controversy.

At about 1,350 cases and 400 deaths a year, cervical cancer rates 13th on the list of cancers most frequently suffered by women, based on Canadian Cancer Society statistics for 2007.

That’s way behind breast cancer, at 22,300 cases and 5,300 deaths, lung cancer, at 10,900 cases and 8,900 deaths, and cancer of the pancreas, with 1,850 cases – all fatal.

“It’s not an epidemic because we have a relatively good screening program (Pap tests),” says Dr. Joan Murphy, head of gynecologic oncology at Princess Margaret Hospital and chair of the Society of Gynecologic Oncologists of Canada.

“All the hype is causing people to be worked up and needlessly worried,” says Anne Rochon Ford, co-ordinator for Women and Health Protection, a national working group that monitors drug regulation at Health Canada. “There was no crisis, so why did we have to rush ahead (with the vaccine program)?”

“We need some balance here,” agrees Dr. Abby Lippman, at epidemiologist at McGill University who has been outspoken against Ottawa’s support for the vaccine program.

But Murphy supports the vaccine program because she says “there is an epidemic of HPV” (human papillomavirus). As many as 80 per cent of Canadian women contract the virus each year, although the immune systems of 80 per cent of those who contract it manage to fight it off, she says.

There are 30 strains of HPV and the Gardasil vaccine can prevent HPV types 16 and 18, which are responsible for 70 per cent of cervical cancer cases, says Murphy.

All three women stress that the vaccination program is not a substitute for regular Pap tests, which help detect cervical cancer and other conditions.

In a Pap test, cells are scraped from the cervix and examined under a microscope.

“We need to educate young girls who have been vaccinated that they are still at risk. Pap tests remain vital,” says Lippman.

The Canadian Cancer Society has been advocating for the vaccine, which costs about $400 for the three-shot treatment, to be made more available and affordable since its approval by Health Canada in July 2006, says society spokesperson Heather Chappell.

The society supports the Ontario government’s decision to make the vaccine available to Grade 8 girls, and is now advocating for funding and surveillance programs and more followup, says Chappell.

“We need to keep track of who has received the vaccine so that we get a clearer picture,” she says.

Although records are kept on the number of cases of cervical cancer, there is little data on pre-cancerous conditions such as dysplasia, which is not cancer but may develop into cancer if it is not treated.

The vaccine can be effective against dysplasia, which requires painful treatments, says Chappell.

“So cervical cancer is not the whole story,” she says.

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