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HPV vaccine cuts risk of dying from cervical cancer before 30

theguardian.com

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Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#171

Post by rzzzt »

tialaramex wrote: post #158
durkie wrote: post #151

Earlier quoted context omitted.

Why does that seem important? The “in mice” one makes sense (such results might not be the same in humans), but is there a reason to think that results achieved here in England couldn’t happen elsewhere?

Basically it's definitely possible that you could get cervical cancer without HPV. There's a scientific disagreement about whether in some populations that's say 5% prevalent while others it's more like 0.1% prevalent, or whether they're more similar, but it clearly can happen. Outside science this can turn into "England is very, very white, so, this is basically only a study of white women" which as you observe isn'…

This didn't even occur to me. The title in the submission is cut short; most outlets including this article includes a "close to zero", "near zero" at the end, which has this overly cheery feeling (at least to me) that we can pat ourselves on the back, it's not just done but done-done, on to the next disease, huzzah. Whereas this whole thing is the result of a systematic nation-wide vaccination program that has been going on for quite a while (2008) and a study looked into its effectiveness and found that yes, this concerted campaign may have moved the needle on that population-level gauge.

It can happen elsewhere but it hasn't happened yet! Or who knows!

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#172

Post by pyuser583 »

lolc wrote: post #157
pyuser583 wrote: post #139

Every-time the HPV vaccine stuff comes up there’s a ton of old guys bragging about how they got it AMA. This doesn’t make you seem like a good person. It makes you seem like you don’t trust public health officials. I had this conversation with my doc. He said dont get it. Going around that doesn’t make me a good person, it makes me dumb. Don’t listen to what a forum says. Listen to your doctor.

I was lucky my pharmacist didn't listen to my doctor when I showed up with a prescription for a misdiagnosed disease. Would have delayed getting effective treatment for a life threatening disease. If I'd read forums I could've spotted it too. Don't just listen to your doctor.

Was your doctor following clearly and rigorously established medical guidelines?

If you think your doctor has screwed up talk to another doctor or the pharmacist. That’s legit.

But deciding you need a vaccine the guidelines say you don’t is a different matter. That’s just drug seeking.

People close to me have died from cervical cancer, so I’d love to be part of abolishing it. And by following vaccine guidelines that’s exactly what I’m doing.

I encourage everyone else to follow the guidelines too - don’t home brew this shit!

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#173

Post by apparent »

kstrauser wrote: post #167
apparent wrote: post #14

Earlier quoted context omitted.

They could do that, but given how low the base rate is, the reduction in number of procedures (and the resulting negative impacts on the women) would be incredibly low. It seems the base rate for cervical cancer deaths under 30 was already near zero.

I don’t think that’s right. I know 2 women well enough that they shared with me having been diagnosed with cervical dysplasia, diagnosed via Pap smear, in their late 20s. Both had a procedure to freeze off the affected cells and were later declared cured. My understanding of it is that this is extremely freaking common as far as medical issues go, because women, much more so than men, are more likely to go in for rou…

The base rate of deaths is different from the base rate of diagnosed illness. Dying before 30 is obviously less common than being diagnosed before 30.

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#174

Post by somenameforme »

pfdietz wrote: post #169
somenameforme wrote: post #156

Earlier quoted context omitted.

Do you understand the problem I'm describing? You are saying that women who got cervical cancer essentially died at birth. You need to look at years of life lost. Cervical cancer has a low frequency, high survivability, and disproportionately effects women in later age. You also need to factor in the efficacy of the vaccines, which will not be 100%. The years of life lost/saved will end up most likely being in the da…

Let me shoot right back and ask if you understand what I was saying. Yes, I understood what you are saying. I was making a crude argument, but the crude argument showed benefit something like 18-36x the cost. The points you are making would reduce the benefit, but not by a factor anywhere close to 18.

I think it certainly will. We can test it fairly easily by getting some real numbers.

- Years of life lost per death = 17 [1]

- Mortality rate = 2.2/100k

- Life lost per person per year = ~3.3 hours (derived from 17 years * 2.2 cases / 100k people)

- Total change in life expectancy if completely eliminated = ~3.3 hours/year for ~50 years = 1 week

My argument is lowballing everything (or in other words working against me) since you used extreme ends for your argument, and I'm simply accepting them. I also used years of life lost data from 2000 when cancer survival rates have significantly improved since then, assumed 100% perfect efficacy and so on. It doesn't matter, because it's not even remotely close.

From these data we can see that your argument implies implies that a person would be willing to pay about $20,000 (midpoint of your 18-36 = 27 x $750 cost of vaccine) for an increase of 7 days of life expectancy. That's nonsensical, by orders of magnitude, unless you're only polling multi millionaires to determine a statistical value of life.

[1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#175

Post by somenameforme »

kstrauser wrote: post #167
apparent wrote: post #14

Earlier quoted context omitted.

They could do that, but given how low the base rate is, the reduction in number of procedures (and the resulting negative impacts on the women) would be incredibly low. It seems the base rate for cervical cancer deaths under 30 was already near zero.

I don’t think that’s right. I know 2 women well enough that they shared with me having been diagnosed with cervical dysplasia, diagnosed via Pap smear, in their late 20s. Both had a procedure to freeze off the affected cells and were later declared cured. My understanding of it is that this is extremely freaking common as far as medical issues go, because women, much more so than men, are more likely to go in for rou…

Those are precancerous lesions, it's not the same as being diagnosed with cervical cancer. In young people these are not that uncommon, yet the majority do not progress onto cancer. This is part of the reason there's been a major shift in recommended testing timelines for cervical cancer for younger people. The treatment may be unnecessary and can cause both physical and emotional trauma.

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#176

Post by pfdietz »

somenameforme wrote: post #174
pfdietz wrote: post #169

Earlier quoted context omitted.

Let me shoot right back and ask if you understand what I was saying. Yes, I understood what you are saying. I was making a crude argument, but the crude argument showed benefit something like 18-36x the cost. The points you are making would reduce the benefit, but not by a factor anywhere close to 18.

I think it certainly will. We can test it fairly easily by getting some real numbers. - Years of life lost per death = 17 [1] - Mortality rate = 2.2/100k - Life lost per person per year = ~3.3 hours (derived from 17 years * 2.2 cases / 100k people) - Total change in life expectancy if completely eliminated = ~3.3 hours/year for ~50 years = 1 week My argument is lowballing everything (or in other words working against…

That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#177

Post by somenameforme »

pfdietz wrote: post #176
somenameforme wrote: post #174

Earlier quoted context omitted.

I think it certainly will. We can test it fairly easily by getting some real numbers. - Years of life lost per death = 17 [1] - Mortality rate = 2.2/100k - Life lost per person per year = ~3.3 hours (derived from 17 years * 2.2 cases / 100k people) - Total change in life expectancy if completely eliminated = ~3.3 hours/year for ~50 years = 1 week My argument is lowballing everything (or in other words working against…

That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.

That is why I multiplied the change per year by 50, exactly as you did.

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#178

Post by toomuchtodo »

toomuchtodo wrote: post #166
pyuser583 wrote: post #146

Earlier quoted context omitted.

What age do you recommend they be vaccinated?

Lower age bound for Gardasil 9 is nine years old. That is when I had my kids vaccinated for it at their pediatrician. https://www.gardasil9.com/

Additional resource:

https://www.cdc.gov/hpv/vaccines/index.html

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#179

Post by toomuchtodo »

apparent wrote: post #115
toomuchtodo wrote: post #89

Earlier quoted context omitted.

Married ~20 years and ethically non monogamous. My partner and I date women together and solo. ~$1k to protect other people is cheap and is looked upon favorably by potential partners (I am able to provide vaccination and most recent STI test results on demand when asked). Even if you’re monogamous, life is long and divorce common. I walk through cheap optionality doors whenever possible, and recommend others do to.…

I thought it was not effective if you had previously been exposed. Did you make it into your 40s as a non monogamous person without any exposure?

https://www.acog.org/womens-health/experts-and-stories/the-l...

> The vaccine is still helpful even if you have already tested positive for HPV or have been sexually active for a while. Most HPV transmission happens when people first become sexually active. But women who have already tested positive for HPV usually aren’t positive for all nine types that we vaccinate for. So in some cases, we’ll recommend those patients get the vaccine if they haven’t already. And if you’re older – midlife age, and new on the dating scene and sexually active – you should ask your doctor about the vaccine too.

>[Note: The HPV vaccine can also be an important part of treatment for the cell changes caused by HPV infection. After the abnormal cells have been removed or destroyed, the HPV vaccine may help prevent abnormal cells from coming back. Read Human Papillomavirus (HPV): Infection and Vaccination for more information.]

https://www.acog.org/womens-health/faqs/hpv-vaccination

Re: HPV vaccine cuts risk of dying from cervical cancer before 30

#180

Post by pfdietz »

somenameforme wrote: post #177
pfdietz wrote: post #176

Earlier quoted context omitted.

That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.

That is why I multiplied the change per year by 50, exactly as you did.

OK. If a life is worth $12M, that's $3300/week (assuming a 70 year lifespan). The shots cost $500-1000, a 3-6x ROI.
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