By: Norma Erickson
31 August 2010
The following is a direct quote from a recently revised copy of “Cervical Cancer Prevention, Health Professional Version,” published by the National Cancer Institute (NCI):
“The finding of HPV viral DNA integrated in most cellular genomes of cervical carcinomas supports epidemiologic data linking this agent to cervical cancer however, direct causation has not been demonstrated.”
The next paragraph states HPV infections dropped by 42% with no precancerous lesions being demonstrated during an eight month study of women whose partners consistently used condoms.
After that, the guidance being offered is a little confusing. Even though HPV has not been demonstrated to cause cervical cancer, the paper states vaccines to prevent HPV infections would offer a “primary prevention strategy for prevention of cervical cancer.”
The article goes on to state other controllable factors which can increase the risk of cervical cancer such as smoking, use of oral contraceptives, number of children born and dietary factors.
Now, move to a companion article, also published by NCI, called “Cervical Cancer Screening, Health Professional Version.” This document states:
“Based on solid evidence, regular screening with the Pap test leads to additional diagnostic procedures (e.g., colposcopy) and treatment for low-grade squamous intraepithelial lesions (LSIL), with long-term consequences for fertility and pregnancy. These harms are greatest for younger women, who have a higher prevalence of LSIL, lesions that often regress without treatment. Harms are also increased in younger women because they have a higher rate of false-positive results.”
“Based on solid evidence?” Where is the ‘solid evidence’ that shows a Pap test ever harmed anyone? The ‘harms’ for younger women are caused by additional diagnostic procedures (colposcopy/biopsy) and treatment for LSIL, which is commonly known to be a reversible lesion, certainly not caused by a Pap test.
Now, look at the reference to ‘false positive results.’ The reasons for these so-called false-positive results are not mentioned. According to Dr. Sin Hang Lee, professional pathologist with over 50 years’ experience, the reasons are two-fold.
Number one: “Currently almost all Pap smears are analyzed in commercial labs, where cytologists work in an assembly-line fashion. Due to the trend toward commercial labs instead of in-hospital labs, most of these cytologists are overworked to the point where it is almost impossible for them not to make errors.”
(This information is more than adequately confirmed by visiting this forum where working cytologists discuss their jobs. Read through just a few of the posts and you will understand why there is a problem with accuracy. No one should have to work under the conditions these dedicated health professionals are dealing with.)
Number two: “The current HPV testing in the U.S. is in chaos. One of the two FDA-approved HPV tests has been found to generate 2 to 4 times more positive results than the other FDA-approved HPV test.”
(reference: Kinney W. Stoler MH, Castle PE. Special commentary: patient safety and the next generation of HPV DNA tests. Am J Clin Path. 2010;134:193-9)
Please note, the currently approved HPV DNA tests do not employ the extremely accurate PCR (polymerase chain reaction) DNA sequencing. The two FDA-approved tests employ a technology that is 25 years old, hence the unreliability.
In a letter rejected for publication by the Editor of the New England Journal of Medicine, Dr. Lee pointed out that the increasing number of excessive colposcopic biopsies with the associated unnecessary harm done to young American women is largely caused by the ASCUS (atypical squamous cells of undetermined significance)/LSIL Pap cytology classification, the liquid-based cytology system, and the non-reliable HPV test, all initiated and promoted by the NCI, as is the HPV vaccination program.
The product insert of the Gardasil vaccine clearly advises women to “continue to undergo recommended cervical cancer screening.” Now, the NCI states that continued Pap tests in women who qualify to receive Gardasil will cause them harm. What should women do after vaccination, rely on a non-reliable NCI-endorsed HPV test for cancer screening?
All in all, it appears that the NCI either does not know what they are talking about; or they have an agenda other than a woman’s health in mind.
So, what is a woman to do to avoid cervical cancer?
- Get regular Pap smears.
- If a Pap test comes back negative, look at the cytology report. If it does not state, ‘endocervical cells present,’ have another one done.
- Agree to an immediate biopsy only if the cytology report has a diagnosis of HSIL, cancer, or suggestive of cancer, not a diagnosis of LSIL alone.
- If you have a positive HPV test, demand to see a DNA sequence.
- Agree to HPV vaccination only if you know you have not been exposed to vaccine-relevant strains of HPV. (see above)
Women, your health and the health of your daughters remains your responsibility. Be informed. Be engaged. Be safe.