Tag Archives: mortality

STD Awareness: HPV Testing vs. the Pap Test

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I love writing about health and medicine, but I hate going to the doctor. I don’t like taking my clothes off for a dermatological exam, I don’t like rolling my sleeve up for a shot, and I don’t like opening my mouth for a dentist. I don’t even like having my blood pressure taken — it gives me the heebie-jeebies, and probably a case of white-coat hypertension too.

For now, pelvic exams are a mainstay — and an important part of cancer prevention.

So when it comes to something even more invasive, like the Pap test to screen for cervical cancer, I’m one of those people pining for a magic wand — a tool that a health care provider can wave over your fully clothed body to detect disease. The Pap test may have transformed a scourge like cervical cancer into one of the most easily detected and treated cancers — and for that I love it — but I still fervently wish for its demise. As long as it’s replaced by something better, of course.

Last month, an article in JAMA inspired a burst of headlines. “HPV test more effective than Pap smear in cancer screening,” said CNN. Or as WebMD put it more succinctly, “HPV Test Beats Pap.” Then, last week, the U.S. Preventive Services Task Force updated their guidelines to recommend that patients 30 and older can forgo the Pap test in favor of HPV testing alone. This news might be welcome to anyone who dislikes regular Pap tests and wishes to avoid stirrups and speculums. Unfortunately, HPV tests aren’t the noninvasive “magic wand” so many of us hope for. From the patient’s perspective, the experience of undergoing an HPV test is no different from the experience of undergoing a Pap test. They both require a pelvic exam — the stuff of stirrups and speculums. Continue reading →

STD Awareness: Does Gardasil Have Side Effects?

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Teen_GroupIn 2006, a vaccine called Gardasil made its debut. Its ability to protect against two of the most widespread strains of human papillomavirus (HPV) means that it doesn’t just protect against an infectious disease — it protects against cancer, too. A persistent HPV infection can trigger cell changes that could lead to cancers of the mouth, throat, cervix, vulva, anus, or penis. Gardasil also protects against two additional strains of HPV that cause most genital warts.

The most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site.

Cervical cancer is not as common in the developed world as it once was, thanks to an effective screening test. The Pap test catches “precancerous” cell changes, allowing the precancer to be treated before it develops into full-fledged cancer. So, while HPV vaccines have the potential to save hundreds of thousands of lives if they can be distributed in countries without widespread access to Pap testing, they have utility in the United States, too. Gardasil has spurred declines in high-risk HPV infections and genital wart incidence among American girls — which means less “precancer” and all the invasive, possibly expensive or painful, treatments that they entail, and a lot fewer genital warts. What’s not to like about that?

Despite this, a lot of people are curious about Gardasil’s side effects. If you enter a few key search terms into Google, you can easily find all kinds of websites warning you of Gardasil’s alleged dangers. So, you might be wondering: Is Gardasil safe?

What are Gardasil’s side effects?

Despite Gardasil’s relatively recent debut, many studies have already been conducted to evaluate its safety — and research continues so that we can consistently reassess its risks and benefits. So far, the consensus is that Gardasil is safe, with very few side effects. According to the Centers for Disease Control and Prevention, the most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site. These reactions are not considered to be serious, some people don’t experience any of them, and they are only temporary. Continue reading →

Gardasil and Mortality

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womenVaccination is one of public health’s greatest achievements, but today’s sociopolitical climate promotes unfounded fears. In turn, this fear-mongering has led to outbreaks of otherwise rare infectious diseases, such as measles and whooping cough. Human papillomavirus (HPV) vaccines protect against two HPV strains that cause 70 percent of cervical cancers, which itself is the second-most common type of cancer in women worldwide. Immunization has the potential to eliminate these viral strains, which would save lives and reduce health care costs — but, unfortunately, vaccine horror stories are a dime a dozen on the Internet, and HPV vaccines like Gardasil are popular targets for vaccine opponents.

Of 57 million Gardasil doses given in the United States, 40 confirmed deaths have occurred in recipients. However, these deaths were not caused by vaccination.

There are many claims flying around that Gardasil causes serious side effects, including death. However, claims that Gardasil can lead to death aren’t supported by good evidence. Generally speaking, people who make these accusations obtain their information from a publicly accessible database called the Vaccine Adverse Event Reporting System (VAERS), which collects claims of adverse events from anyone — including health care providers, patients, or family members.

What is an adverse event?

Most people don’t realize that the phrase “adverse event” cannot be used interchangeably with the term “side effect.” An adverse event is something that occurs after a vaccination — such as a headache, seizure, depression, or death. It could happen one second after being injected with a vaccine or more than a year afterward. It could be a coincidence, or it might be caused by vaccination. For example, if two weeks after receiving a flu shot I get a headache, I could legitimately claim it is an “adverse event,” even if my headache had nothing to do with the shot. An adverse event is only called a side effect if it is found to have been caused by vaccination.

What is VAERS?

Despite its occasional misrepresentation in print media, social media, and the blogosphere, VAERS is not a source of information about verified side effects — it is a database of adverse events that have been self-reported by the public. Anyone can submit a report to VAERS — heck, I could claim that the flu shot gave me telekinetic powers in addition to that headache, and it would be recorded in the database. That doesn’t mean that you should worry about coming down with a nasty case of telekinesis after getting a flu shot at the corner drug store. Continue reading →

STD Awareness: Sexually Transmitted Diseases and Pregnancy

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Every month since January 2011, we’ve been sharing installments of our STD Awareness series, and each month, we’ve encouraged you to protect yourself from sexually transmitted diseases (STDs) by using dental dams and condoms. But what if you’re trying to get pregnant? In that case, you’re probably not using condoms! However, it is very important that partners know their STD status — being screened and treated for STDs prior to pregnancy is a good idea for your health, and can protect your future baby.

If you and a partner are trying to get pregnant, you might consider being screened for STDs together.

When present during pregnancy, certain STDs can have negative health effects for you or your future baby (including preterm labor, stillbirth, low birth weight, pneumonia, certain infections, blindness, and liver disease), especially if they are not cured or treated in time. Receiving prenatal care can help prevent these problems, so it is important to be screened and treated for STDs prior to or early in your pregnancy.

During pregnancy, the immune system undergoes changes, which are probably necessary to ensure that the body doesn’t reject the fetus — normally, the immune system recognizes non-self cells as potential pathogens and attacks. These immune system changes might make a pregnant person more susceptible to disease. Latent viral infections, like genital warts or herpes, might come out of dormancy. Additionally, anatomical changes lead to a larger exposed area of the cervix, which is potentially more vulnerable to initial infections. Continue reading →