HPV shots might save thousands of lives

Vaccines, screenings, treatments could severely cut deaths from cervical cancer, N.Y. Times says

Cervical cancer last year killed more than 311,000 women, one every two minutes, but early detection might have prevented thousands of those deaths around the world.

Such detection, it's believed, could have resulted in expanded screenings and treatments.

In addition, an increase in HPV vaccinations for teenage girls may have helped a great deal.

At least those are the conclusion drawn by Mia Armstrong in a recent story in The New York Times. 

Dr. Kirsten Austad

Armstrong quotes Dr. Kirsten Austad, director of women's health for the Maya Health Alliance, as saying, "Almost no one needs to die of cervical cancer."

Of the more than 300,000 annual deaths from cervical cancer, the fourth most common cancer for women globally, the Times piece notes, more than 85 percent were in low- and middle-income countries.

The story also mentions a World Health Organization estimate of 570,000 new cases in 2018, the same year that Dr. Tedros Adhanom Ghebreyesus, director general of WHO, "called for coordinated global action" to eliminate the disease.

Armstrong cites, too, the words of Dr. Silvia de Sanjosé, director of women's cancer for PATH, a nonprofit focused on global health, to the effect that such a coordinated effort "was crucial to elevating the issue," which had previously received little attention.

"I would not say that that's enough," she said, the story continues. "But it's clearly a turning point." 

She also told the Times about a couple of big challenges: The vaccine needs to be given after age nine, which is later than most routine vaccines, and the price tag, which in the lowest-income countries costs approximately $4.50, jumps to $150 in some places.

WHO recommends that 9- to 14-year-old girls receive two does of the [HPV vaccine, which protects] against HPV infections responsible for 70 to 90 percent of cervical cancers."

The difficulty is, however, that, according to the story, WHO estimates indicate that "only around 25 percent of 10-year-olds live in counties that have introduced the HPV vaccine."

Other calls to action about diseases can be found in "Rollercoaster: How a man can survive his wife's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

600 old medical tests, treatments still used

Physicians have big trouble unlearning outmoded practices, New York Times writer claims

The public is paying more because it's hard for physicians to unlearn what they were taught long ago.

That — along with the notion that "procedures live on even after they've been proved ineffective," which "can lead to harms and wasted resources" — is the contention of a recent story in The New York Times by Dr. Aaron E. Carroll, a pediatrician.

The article leans on a review in JAMA Pediatrics magazine of "medical literature related to overuse in pediatric care" — finding "that we still recommend that children consume commercial rehydration drinks [that] cost more, when their drink of choice would do," that we "give antidepressants to children too often," that "we induce deliveries too early, instead of waiting for labor to kick in naturally," and that "we get X-rays of ankles looking for injuries we almost never find."

Overuse, the article maintains succinctly, "is rampant. And it can harm patients."

The Times specifically cites an initiative of the American Board of Internal Medicine Foundation, "Choosing Wisely," which it says is "entirely focused on the identification of care that physicians routinely recommend but shouldn't."

Almost 600 tests, procedures or treatments collected over six years, it claims, "are currently listed on their website. Almost all the recommendations basically say 'don't do' them."

But the public "shares some culpability," Carroll's story says: "Americans often seem to prefer more care than less."

Professional organizations are also to blame, the piece contends, because they "seem better at telling physicians about new practices than about abandoning old ones."

David Niven

Carroll asks David Niven, lead author of an earlier study, why it's so tough for docs to "discontinue certain practices. The researcher says "physicians have a hard time unlearning what they have learned, even when there's newer and better science available [in part] because they work within a system that doesn't adapt well to changing evidence."

More details on medical community attitudes toward treatments and tests can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.