Dying of ignorance

Women are dying of cancer because medical research is not being shared,
argues Dorothy King

The Guardian
Monday June 20, 2005

In archaeology although there are facts, much published research is conjecture and opinion. Science is assumed to be different, with studies providing "proof" definitively. But science is a constantly evolving field, and publication of research has become so important that competition, not collaboration, is becoming the norm. Research by other teams is routinely ignored, even though the mechanisms for sharing are there. If someone ignores an obscure academic article on archaeology, the worst that can happen is a bruised ego. Ignoring medical research leads to death.

Many of my friends are involved with the new vaccine against HPV (human papillomavirus), the development of which has been largely funded by pharmaceutical companies. The vaccine has gained a lot of press attention. HPV 16 and 18 are linked to 78% of squamous cell cervical cancer and pre-cervical cells (CIN). In the long-term this vaccine and its successors will hopefully consign the many cancers associated with HPV to the history books.

There are only two problems with the vaccine. The first is that it needs to be administered before women catch HPV, so we need to know how and when papilloma is acquired.

The second is an image issue, because HPV is seen as being sexually transmitted. Condoms do not stop its spread, so certain Christian groups in the US, such as the American Family Association, see HPV as demonstrating that safe sex does not work. They use it as an argument for abstinence, and now they are opposed to the new vaccine. These groups are very powerful in the US, and have managed to get warning stickers put on school textbooks stating that Darwinism was only one of many theories. Creationism is the one they prefer.

The logic of their anti-HPV vaccine argument is based on "facts" that many doctors and scientists, including the World Health Organisation, repeat as gospel truth. The problem is that these facts are based on long out of date research, because scientists are not keeping up with developments in the field. Cures bring glory. Asking about the background to the virus, and how it is spread, is of less interest to the men in white coats.

The theory of papillomavirus being a sexually transmitted disease (STD) should have been consigned to the history books long ago. Numerous studies have shown that papilloma can be contracted in many non-sexual ways, but for some reason those studies are being ignored.

Scientists made the link between HPV and the main type of cervical cancer about 15 years ago. Two types of HPV (six and 11) are sexually transmitted, so they assumed that other types of HPV were too. That assumption has become axiom, despite numerous studies that contradict this assumption.

When a non-governmental organisation asked me to come on board and help with fundraising for HPV research, I wanted to support them, but I also wanted to know more about the issue. Their research material stated that HPV was sexually transmitted. A nun friend has had cervical cancer, so sexual transmission of HPV struck me as unlikely. I also wanted to know why it went through condoms. The scientists may be doing brilliant research, but they seemed to know only about their limited field: how to vaccinate against HPV, but not how we acquire it. They couldn't answer many questions, and if their message in one area is so out of date, one has to question their overall message.

A quick search of www.pubmed.gov for "HPV transmission vertical" turned up many studies. Fortunately, a few scientists had asked the same questions, and then done studies showing quite clearly that papilloma is not just caught through sex.

One 1995 study in China had 30% of newborns testing positive for HPV; another study in Colombia recorded similar levels among primary school children. Almost 52% of three to 11-year-olds in a large study in south London had signs of exposure to HPV 16 infection. Children tend to touch themselves, transmitting the infection around their bodies, which accounts for the prepubescent girls with cervical cancer. The Wellcome Trust - which gives money only to the most reputable researchers - has funded many studies that have yielded similar results. They are not after the financial rewards of a pharmaceutical cure, and can instead afford to investigate areas of interest.

Condoms do not prevent the spread of HPV, because condoms only stop semen, and HPV 16 and 18 are not typical STDs. HPV 16 is passed by skin to skin contact, not through semen, so kissing, sharing spoons, breastfeeding, playing sports will all pass it on.

The bottom line is that papillomavirus is everywhere. Some studies show that 90% of all adults have or have had the virus. It's like the flu, and most of the time we fight it off without realising we ever had it.

The research studies are conclusive - now we need to work on getting that information across to women, many of whom are being told information that is obscenely out of date.

Medical researchers working on HPV rarely issue press releases, so we tend to ignore their work.

One scientist I spoke to asked me why an archaeologist was interested in his HPV research. I don't understand why every woman doesn't know about it. Yet if many internationally renowned scientists working on HPV 16 tell me that we know very little about its transmission, because they have not bothered to read the studies, it is little surprise that GPs have not been informed about new research.

A leading UK cancer charity told me, off the record, that it had given up on cervical cancer as a "minority cancer". More than a third of British women will have an unclear smear test as a result of HPV at some point in their lives, which can potentially lead to cancer.

Cervical cancer is the easiest cancer to detect, but 1,400 women in the UK are still dying from it each year because we are not sharing and publicising research. Many of those women are dying because they didn't get a smear test out of embarrassment or ignorance. If we can get the new research across, we can make women realise that HPV is normal and encourage them to go for smear tests.

Cervical cancer need not be a battle; the treatment, if caught early, is swift and relatively painless. The real battle with cervical cancer is to get the facts about HPV across. The bottom line is that women are dying of ignorance because basic medical research is being ignored.

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