How Our Societal Norms are Interfering with Cancer Prevention

by Erika Nakajima, '21

     As the second leading cause of cancer-related deaths in women, cervical cancer is primarily caused by the contraction of HPV (human papillomavirus), a sexually-transmitted virus that causes genital warts and abnormal growth in the cervical region. 2006 marked a breakthrough in cancer research when a three-step vaccine was developed to protect the population against these genital wart infections, and more importantly, cervical cancer. Despite this revolutionary advancement, much of the population has responded adversely to the HPV vaccination, primarily because of ethical and safety reasons. However, these concerns can be alleviated by revisiting the scientific basis of the vaccine. A better understanding will reveal that the HPV vaccine should be administered at a young age for both girls and boys to increase the efficacy and normalcy of the vaccine.

     Before discussing reasons to vaccinate against HPV, let’s first look at some statistics. According to the Center for Disease Control and Prevention, nine out of ten people, on average, will get an HPV infection at some point in their lives. Since more than 20 types of HPV (out of 120 types) are known to cause genital warts and cervical intraepithelial neoplasia (abnormal growth in cervical region), the likelihood of developing cervical cancer is too high to ignore. Based on the National Cancer Institute’s data, in 2015, an estimated 257,542 women were living with cervical cancer and about 4,170 women die each year because of this cancer. These statistics demonstrate that despite not being the most talked about cancer, cervical cancer is a serious matter that the population as a whole should start taking more seriously.
     One of the primary reasons parents choose to deny their children of the HPV vaccine falls upon the sexual implications of the vaccine. The human papillomavirus is generally transmitted via sexual intercourse, so many parents assume that vaccination against the virus implies allowance of sexual activity. Because most children are vaccinated between the ages of nine and fourteen, it is understandable that parents are concerned about such implications at an early age. However, this age range is not arbitrary. The HPV vaccine is effective only against HPV strains that the vaccinated individual has not already been exposed to. Clinical trials conducted on women who have already been exposed to HPV have shown diminishing efficacy of the vaccine. In other words, to guarantee protection against HPV, vaccines should be administered before the age of sexual activity. Furthermore, it has been demonstrated that when the vaccine is administered between the ages of nine and fourteen, the antibody titre-- the amount of antibodies generated by the body to protect against the virus--is maximized, ensuring the highest level of protection against the virus. Thus, parents who want their children to be fully protected against HPV come the age of sexual activity should permit the vaccination of their children at early ages, despite the ethical concerns it may raise in a non-scientific context.
     Although cervical cancer only affects females, males are still capable of transmitting HPV and should thus be vaccinated to amplify the benefits of herd immunity. There are many individuals who cannot be vaccinated because of compromised immune systems, religious beliefs, etc. and it is important that those of us who can be vaccinated do what’s in our power to protect those around us. In 2010, the FDA approved Gardasil for men because research has shown that similar to females, males also run the risk of developing cancers (specifically, invasive penile cancers) from HPV infections. Vaccinating males will not only increase the efficacy rate of the HPV vaccination by lowering the transmission rate of the virus, but it will also help protect males against genital warts, which have shown to last longer and cost more for males compared to females. As with other vaccines, the health impact of the vaccine is highly dependent on the rate of vaccination because herd immunity, which requires the participation of both males and females, is what ultimately protects the population.
     Administration of the HPV vaccine has been considered a widely controversial topic, as often happens with other novel advancements in medicine. However, this is no excuse for a wide range of the population to disregard it. Because the HPV vaccine is relatively new, it is imperative that physicians and those knowledgeable about the vaccine share their insight on the benefits of vaccination to help alleviate the concerns that individuals have about vaccinating themselves or their children. The more people are aware of the benefits of the vaccine and the safety measurements that have been put into place, the more they will be willing to accept the vaccine as the mean of fighting cervical (and other various) cancers. Informing is not only encouraged but vital to save the lives of the thousands of women that die from HPV every year due to a stigma that can be easily erased through societal effort.

Sources:

1. Intlekofer, Karlie A., et al. “The HPV Vaccine Controversy.” Journal of Ethics | American Medical Association, American Medical            Association, 1 Jan. 2012, journalofethics.ama-assn.org/article/hpv-vaccine-controversy/2012-01
2. Navarro-Illana, Pedro et al. “Ethical considerations of universal vaccination against human papilloma virus” BMC medical ethics vol. 15 29. 7 Apr. 2014, doi:10.1186/1472-6939-15-29