Among humans’ greatest achievements is the ability to control and even eradicate diseases that for centuries caused wide suffering and death. Thanks to medical advances, the ancient scourge of smallpox has been eradicated. In much of the world, vaccinations are available that protect children from measles, polio and diphtheria.
A remarkable, though under-reported, study published recently in The Lancet medical journal suggests that we have ability to eliminate in much of the world another fearsome disease — cervical cancer. Worldwide, this is the fourth most common cancer in women, with 570,000 new cases reported in 2018 and more than 311,000 deaths.
But the study findings also generated a troubling question the authors don’t answer: Does the will exist to vanquish this disease? The answer ought to be yes, but it’s frustratingly unclear. Unlike other public health challenges, this is less about access to medical care than about embracing a preventive treatment that is already widely available in developed countries.
A vaccine that’s highly effective against human papilloma virus (HPV), which causes cervical cancer, has been in use since the mid-2000s. The shot series is generally recommended for adolescents and young adults. The problem is that patients and their families aren’t taking advantage of it in the same way they do shots for measles, diphtheria and other childhood diseases.
While HPV vaccination rates are increasing in the United States, “51 percent of adolescents have not completed the HPV vaccine series,” according to a 2018 report from the U.S. Centers for Disease Control and Prevention. Also of concern: “Fewer adolescents in rural areas are vaccinated, compared with adolescents in urban areas.”
The HPV vaccination rate must go much higher to consign cervical cancer to history. Policy strategies are needed, such as adding the HPV vaccine to the list of required school-aged immunizations.
But medical providers also have an important role to play. They need to better communicate how vital the vaccine is.
Important ground to cover includes HPV’s other benefits. The sexually transmitted virus it guards against doesn’t just cause cervical cancer. It is also linked to cancers of the vagina, vulva, penis, anus and throat. Getting boys vaccinated protects them in addition to preventing HPV’s spread to sexual partners.
The vaccine’s safety has also been extensively evaluated, according to the National Cancer Institute.
How a medical provider talks about the vaccine may be as important as what is said. Annie-Laurie McRee, an associate professor in the University of Minnesota’s Department of Pediatrics, has written multiple papers about clinical communication concerning vaccines and other preventive care.
Although the HPV vaccine has been in use for over a decade, it’s too often presented as a new option or less important, McRee said. That it guards against a sexually transmitted virus may also lead to tentativeness from providers if they think parents might be uncomfortable.
What’s needed instead is clear guidance from doctors that these shots are routine and vital, McRee said. Providers should acknowledge concerns but also work to steer the conversation toward common ground: the desire for young people to grow up healthy and strong.
The Lancet article suggests something else we all have an interest: a future free of cervical cancer and the other fearsome diseases HPV can cause. The vaccine, along with better screening for early cancer signs, can make this a reality. There’s no good reason the will to do so should be lacking.