Preventing Cervical Cancer–We Can Do Better!

three preteen girls smilingThis post has been updated:

Only about 60% of American teens (13 through 17) have been vaccinated against HPV. The HPV (human papilloma virus) vaccine provides protection against certain viruses that are known to cause cervical cancer. Here in Alabama, the statistics are slightly worse. We remind you that–regardless of whether you have received the HPV vaccine–you should continue to be screened for cervical cancer after age 21 (Pap test/HPV test).

Recently the CDC has added additional guidance for adults over age 26 who have not yet been vaccinated against HPV as follows:

“…some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.”

As an obstetrician, I assist families to achieve healthy pregnancy outcomes. I place precious newborns into the arms of caring, loving parents every day. These parents who followed my advice so carefully before their baby’s birth have not lost their determination to protect that child. So how have we missed the target so badly for this important vaccination?

As a mother of two, I understand the anxiety that all parents feel about the decisions they make for their children. Like all moms, I have struggled to calm my child and myself as the nurse laid the little needles down on the exam table, sometimes 3 or more at a time. I understand how parents can worry that it may be too much. But I have confidence in the scientific evidence that has recommended these immunizations.  The HPV vaccine is now recommended for boys as well, since they too can develop certain cancers caused by HPV or pass the virus to their partners.

Some parents have very strong personal beliefs about vaccinations, and some of these are faith related. But for most moms and dads whose uncertainty about immunizations comes from myths and mistrust, I’d like to offer some reassurance.

Myth: the vaccine isn’t safe or it isn’t effective. The media bring us more information and misinformation than a busy parent can hope to sort out. Misinformation sometimes grows out of the fact that “scare-mongers” make better headlines than doctors and scientists. Solid scientific evidence assures us that the HPV vaccine provides long-term protection against future HPV-related cancers, and it does this safely. If you have time to read it, the CDC website offers thorough, reliable information But here is where trust comes in. Develop a relationship with a physician/pediatrician in whom you have confidence. Then trust that he or she advises you relying on the best available medical information.

Myth: If my teen is not sexually active, there is no reason to vaccinate at such a young age.  As a gynecologist, I hope to convince you that even the most vigilant parent will be challenged to know for sure when a child chooses to have sex. By age 18, over half of teens (little difference between boys and girls) have become sexually active [2]. Furthermore, HPV is so common that nearly all sexually active adults will be exposed to the virus. Another important advantage to early vaccination:  a pre-teen develops a better immune response to the vaccine than an older teen or adult and, therefore, gets more protection. Because so many adults have been exposed to HPV by their mid-twenties, the HPV vaccine (Gardasil) is less likely to provide effective protection after that age.

Finally, parents know how quickly childhood passes.  Teens come to the doctor’s office much less frequently, so immunizations can easily slip out of our minds. Don’t let this important window of opportunity pass by.

These days a general mistrust of the institutions of government and society has spilled over into healthcare. Scientific progress has added much to what medicine can offer. But treatment options are no longer simple measures that a lay person can easily grasp. And the physician who recommends them is no longer the old family doctor who cared for your granny, delivered your mom and you, and stitched up your knee a couple times. As a modern physician, as well as a mom, I understand this very well. But avoiding these important vaccinations because of fear and misinformation is much like saying “I don’t trust a car seat.”

Note: We do have Gardasil in the office for our young patients who did not receive it as pre-teens or teens. This vaccine is not given during pregnancy.

With best wishes for your family’s health,

Wendy Gregory, MD


[1] 2012 statistics from the U.S. Centers for Disease Control and Prevention

[2] In Brief: Fact Sheet, June 2013, Guttmacher Institute.