From Pap Smears to HPV Vaccines: Evolution of the Cervical Cancer Prevention Industry (Obstetrics and Gynecology Advances)

This book provides a comprehensive analysis of how the HPV industry has invaded and eroded the women's health care system in the field of cervical cancer prevention. The analysis based on currently available science and public records provides the readers interested in cervical cytopathology, HPV molecular diagnostics and HPV vaccination with a clear understanding of issues and solutions to cervical cancer prevention. Pap smear screening in the United States was first implemented as an annual test in the late 1940s. Its widespread use for early detection of precancerous cells destined to proceed to invasive carcinoma for timely ablative treatment markedly reduced the morbidity and mortality rates of cervical cancer. No one should die of cervical cancer if every woman continued receiving proper annual Pap smear screening carried out by a team of cytology technologist, pathologist and gynecologist. However, this teamwork broke down when cytology samples were sent to geographically distant centralized commercial laboratories for screening. Under such business atmosphere, cytology screeners, pathologists and gynecologists hardly speak to one another to discuss any potential diagnostic problems. Overwhelming numbers of unnecessary colposcopic biopsies have been performed on essentially healthy women when "false positive" cytology reports are sent to their gynecologists. However, it is the false-negative results which draw public attention while stories about Pap smear litigation cases are circulated around social media sites when follow-up tests unexpectedly reveal an invasive cancer during the patient's annual screening. Further chaos was created after human papillomavirus (HPV) infections were discovered by Dr. Harald zur Hausen to be one of the most important risk factors for developing cervical cancer. A handful of opportunists successfully persuaded the Food and Drug Administration to regulate their HPV assays as cancer tests and anti-HPV vaccines as cancer vaccines so that they can market these products by tapping into the public's fear of cancer. Commercial HPV tests detect many reversible cytopathology changes with high viral loads per cell, but are not sensitive enough to detect high-grade precancerous cells with low viral loads per cell. Without performing DNA sequencing, none of these test kits can provide an accurate genotyping for follow-up of persistent HPV infections, a true cancer risk. This book points out there is no factual evidence that HPV vaccination has prevented a single case of cervical cancer. Using reversible precancerous histologic changes as surrogate endpoints in clinical trials to support the claim of efficacy of HPV vaccination in prevention of cervical cancer is flawed. Since the HPV vaccine Gardasil relies on using residual HPV L1 gene DNA fragments bound to aluminum salt as the toll-like receptor 9 agonist to boost innate immune response, high levels of pro-inflammatory cytokines are generated in the vaccinees. These pro-inflammatory cytokines may cause serious adverse events in genetically and physically predisposed individuals. Women consumers are advised to read this book before choosing the modalities for cervical cancer prevention to protect their own health and lives as well as those of their loved ones.