The Human Papilloma vaccination to suppress cervical cancer

[sophiecentaur]

TL;DR Summary

Things have changed, I heard

Not long ago, Cervical Cancer was linked to 'the' human papilloma virus (HPV). There was a big drive for vaccinating teenage girls against 'the' virus in an attempt to protect them from the risk of CC due to sexual contact. I think the statistics showed a benefit from a program of vaccinations.

I was listening to Radio Four today and I heard two things. One is that there are several strains that the present vaccination doesn't suppress and the other is that there has been an increase in unprotected sex (and hence HPV and CC) because girls (and their mums) feel that they are protected without condoms so cases of other STIs are increasing. You can't win!

 

[russ_watters]

Color me skeptical. Any sources provided? Cause-effect in the data or assumed?

Teens/young people are having less sex and fewer pregnancies, implying there has not been a contra-indicated increase in unprotected sex:

https://www.psychologytoday.com/us/.../why-todays-teens-are-having-so-much-less-sex

https://opa.hhs.gov/adolescent-heal...-on-adolescent-sexual-and-reproductive-health

 

[sophiecentaur]

Color me skeptical.

You should be; it's healthy.

I posted this because BBC R4 has less rubbish than most radio stations and I thought this issue might be well known about in the right circles. The sources provided by the interviewee were standard (and not memorable by me) government. There's loads of info and links here. HPV is pretty ubiquitous and just two(?) strains (the most likely culprits for Cervical Cancer) are vaccinated against. The term "strain replacement" describes how vaccination can (not unreasonably) reduce a target strain and allow others to increase. The radio item suggested that some of them cause an increased risk of CC so similar risks could exist unless new vaccinations are used.

The (other) issue of sexual activity in young people and 'protection' against HPV can't be ignored. Perceived risk of CC is lower due to vaccination (no question there) and is reducing the use of condoms (was the story).

As you say, the reduction in sexual activity for many other reasons has probably helped the situation but the data in your citations refers to a certain 'privileged' portion of the world population. But this opens further factors - like the anti-vax movements which are largely prevalent in societies where unprotected sex is more common.
You are right to bring up 'cause and effect' questions but it seems to me that it's an issue that justifies study despite the journalist's questionable interest in a good story.

 

[russ_watters]

HPV is pretty ubiquitous and just two(?) strains (the most likely culprits for Cervical Cancer) are vaccinated against.

[Googles] The CDC says that used to be true in the US but now the vaccine given in the US protects against 9 strains.

Also:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6042675/

"Human papillomavirus vaccination has not been associated with increased sexual risk behaviour among young females."

 

[sophiecentaur]

"Human papillomavirus vaccination has not been associated with increased sexual risk behaviour among young females."

That study seems to use Canada for the data. The takeup of vaccination varies a lot around the world so any correlation could be less clear. But there's a real need to promote more responsible behaviour in the face of serious ignorance of STI risks in general - not least the reluctance to take on board the need for protection against HIV.

it would be good to get some info and opinions from others on PF too.

 

[pinball1970]

That study seems to use Canada for the data. The takeup of vaccination varies a lot around the world so any correlation could be less clear. But there's a real need to promote more responsible behaviour in the face of serious ignorance of STI risks in general - not least the reluctance to take on board the need for protection against HIV.

it would be good to get some info and opinions from others on PF too.

This from the BMJ https://www.bmj.com/content/385/bmj-2023-077341

"Conclusions The high effectiveness of the national HPV vaccination programme previously seen in England continued during the additional 12 months of follow-up. HPV vaccination was associated with a substantially reduced incidence of cervical cancer and CIN3 across all five deprivation groups, especially in women offered routine vaccination."

and this from the UKHSA

https://researchportal.ukhsa.gov.uk...en-years-of-hpv-vaccination-in-england-survei

From the abstract.

"More than ten years of high coverage HPV vaccination in adolescent females in England has delivered dramatic declines in the prevalence of HPV vaccine-types and closely related HPV types in females in the vaccine eligible age group, and no indication of type replacement. These findings should enable confidence in planning for cervical screening of these females, and in predicting declines in HPV-related cancers."

 

[sophiecentaur]

This from the BMJ https://www.bmj.com/content/385/bmj-2023-077341

Perhaps the upbeat message of that link could be due to the fact that the data would have been from information pre-2023. The radio item I was referring to was last week and probably refers to more recent reports of a 'new' trend.
I wasn't looking for an argument - just a reaction to an up to date bit of information which is obviously not to be relied on totally. It was only on the level of chat about a bit of journalism which may or may not stand scrutiny over time
The world of vaccination in general is full of controversy and a lot of input is total nonsense. I wouldn't base my actions on a radio broadcast - usually.

 

[Cepacia]

Consider not only change in frequency of sexual encounters but also willingness to admit sexual encounters.

 

[sophiecentaur]

Consider not only change in frequency of sexual encounters but also willingness to admit sexual encounters.

Yes. Social convention of the time would play a part but we're not in a particularly repressed age so you might expect a more frank response to questions about social and sexual mores these days. In most cases it wouldn't be an 'admission'; just information.

 

[Cepacia]

That requires control, as with any confounding factor of a study. Not a "but" and a self serving excuse - "In most cases it wouldn't be an 'admission'; just information."

 

[sophiecentaur]

a self serving excuse

What did you mean by that? Am I "self serving" or is it just that you disagree with my attitude to these things?Opinions and attitudes are not the same for everybody and one's sexual behaviour is not always a matter of personal shame. You seem to imply that it is.

Why would you suggest that a study on this topic would not be able to work reliably and with appropriate controls?

 

[Cepacia]

One does not dismiss a confounding factor by making up a self serving excuse that defends conclusions. It is not my job - I'm offering neither data nor conclusions - it is the basis of scientific rigor.

 

[russ_watters]

One does not dismiss a confounding factor by making up a self serving excuse that defends conclusions. It is not my job - I'm offering neither data nor conclusions - it is the basis of scientific rigor.

*Potential confounding factor. Not only are you not providing any data, you're not even providing any logic to suggest this potential confounding factor even exists. Yes, it is your job to provide something better than pure speculation.

And no, logic that suggests it does not exist is not automatically self-serving. Logic is logic. Heck, I'm not even sure you have the bias leaning in the right direction for that!

 

[sophiecentaur]

One does not dismiss a confounding factor by making up a self serving excuse that defends conclusions. It is not my job - I'm offering neither data nor conclusions - it is the basis of scientific rigor.

You seem to be out for a pointless argument. What have I been trying to defend? You introduced a "confounding factor" by suggesting that sexual behaviour would always be treated as private or embarrassing; I suggested it may be less significant than you implied. Argue with those who conducted any such study and not with me. Would they really be that naive as that?

 

[Cepacia]

This IS an uncontrolled confound factor - not dismissed by the suggestion it has limited significance or judgement of "potential". Agree - it is the responsibility of those reporting the study and offer their interpretation of significance.
I "imply" nothing - just note thel lack of rigor .

 

[sophiecentaur]

I "imply" nothing - just note thel lack of rigor .

And you have evidence of this, in particular? Did you read an in depth description about the survey? Is your suggested example an isolated factor? Why just pick on that one?
If you want accurate information then why not post on a more specialised forum or discussion?

 

[Cepacia]

Scientific rigor is not a specialized study.

 

[sophiecentaur]

Scientific rigor is not a specialized study.

Have you evidence of lack of rigour? Do you actually know whether or not they considered the possible (or measured?) effect of social sensitivities? Who or what are you complaining about? Apart from making one unsubstantiated comment you seem to offer no proper argument as to its possible effect on their results.

Like I said earlier, you seem just to want an argument. Why? Are you playing the moral policeman?

 

[phyzguy]

Changing the subject, I have also heard that it is beneficial for males to be vaccinated against HPV as well to reduce the probability of spread. Are there any studies on that?

 

[pinball1970]

Changing the subject, I have also heard that it is beneficial for males to be vaccinated against HPV as well to reduce the probability of spread. Are there any studies on that?

Females and males, this from the CDC

https://www.cdc.gov/hpv/hcp/vaccina.../www.cdc.gov/hpv/hcp/vaccine-safety-data.html

And this for males

https://pubmed.ncbi.nlm.nih.gov/37376472/#:~:text=Five studies showed an efficacy,, beyond HPV-naïve males.

"Five studies showed an efficacy against genital condyloma of 89.9% in HPV-naïve males, varying between 66.7% and 67.2% in intention-to-treat populations. Studies reporting no efficacy have included older participants. These results support vaccination of young men previously infected, beyond HPV-naïve males."

https://www.sciencedirect.com/science/article/abs/pii/S0749208122000377?via=ihub

"global uptake of HPV vaccine in males is low and depends on country, funding, and public awareness. Nurses, doctors, and other health care providers play an important role in recommending HPV vaccination and raising community"

 

[Kevin the Crackpot]

TL;DR Summary: Things have changed, I heard

Not long ago, Cervical Cancer was linked to 'the' human papilloma virus (HPV). There was a big drive for vaccinating teenage girls against 'the' virus in an attempt to protect them from the risk of CC due to sexual contact. I think the statistics showed a benefit from a program of vaccinations.

I was listening to Radio Four today and I heard two things. One is that there are several strains that the present vaccination doesn't suppress and the other is that there has been an increase in unprotected sex (and hence HPV and CC) because girls (and their mums) feel that they are protected without condoms so cases of other STIs are increasing. You can't win!

I am currently a registered nurse and a former paramedic, and I disagree with this reasoning.

Even if STIs are on the rise, the cancer rate from papilloma virus is still way down.

There are over a hundred different strains of papilloma virus, and only some are considered as having a high risk of causing cancer (and not just cervical cancers, but mouth cancers and rectal cancers).

Boys should be vaccinated as well, because even if they can't get cervcal cancer, they won't spread the virus to their sex partners.

Vaccination with the papilloma vaccine can reduce cervical cancer by over 95% regardless of how "promiscuous" (a word that I utterly hate because of its misogynistic and patriarchal associations) a woman chooses to be.

Please see link below for further clarification:

https://www.google.com/url?sa=t&sou...oQFnoECBcQAQ&usg=AOvVaw132yw0JT0IJGHip4sve477