More on the Cervical Cancer Vaccine

Dr. Benjamin Brewer, who writes "The Doctor's Office" column in the Wall Street Journal (subscription required), takes a skeptical look at Merck's new cervical cancer vaccine, and comes down against states requiring vaccination. Here's the crucial paragraphs:

How much health care can we afford?

A lot of the costs associated with human papillomavirus are not due to cancer. The costs are associated with annual exams and for evaluation of abnormal pap smears. The Gardasil vaccine isn't going to eliminate the annual pap smear.

Thanks to the development and availability of the low-cost Pap smear, cervical cancer has become a rare disease in the U.S. Newer versions of the test have cut down on false positive results and improved cancer screening.

Despite the fear induced by diagnosis of an abnormal pap smear, only a minority of women with high-risk HPV ever develop cervical cancer. It often takes years to develop and happens mainly to women who don't have access to annual exams. I've seen one case of cervical cancer in my practice in nine years and it was treated successfully with surgery.

Too many women still die of cervical cancer; however, the real problem is lack of access to preventive medical care for low-income women and not the lack of a vaccine.