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Week of 2.23.07

Lance Armstrong on the HPV Debate

Reprinted with permission from Armstrong's blog at

Let's talk about the real issues here...

I've been talking a lot about the need for scientific innovation and medical breakthroughs in the fight against cancer. It has become a more prominent issue lately with the budget cuts at NCI and I think it is a good sign that we are now discussing it.

There is still so much we don't know about what causes cancer or how to stop it.

That is not the case with cervical cancer. We now know that human papillomavirus (HPV) - which causes a sexually transmitted infection that affects at least half of all sexually active men and women - causes most cases of cervical cancer. An HPV vaccine is now available and recommended by the CDC for girls before they become sexually active. The vaccine is one of only two that protect against cancer.

I bring this up today because the Texas Legislature is hosting a public hearing at which cancer survivors, doctors, public health experts and parents are expected to testify about Texas Governor Rick Perry's executive order requiring all girls age 11 and 12 to receive the HPV vaccine prior to entering sixth grade starting in September 2008. Texas is the first state to do this, though similar laws are being considered in about 20 different states.

You are probably aware that the mandate has caused debate between religious groups and public health experts about a range of issues, including abstinence and parental rights.

I won't dismiss these concerns, but the controversy makes me wonder if we are talking about this in the wrong terms. Maybe the current debate is missing the point. It's a cancer vaccine. And it should be considered in the context of other realities in Texas.

For example, NCI reports that cervical cancer rates remain high for Hispanic women, for whom advanced cervical cancer diagnoses are more common and the use of screening more rare. Elderly, African-American and low-income women are also less likely to get screened. Cervical cancer deaths are most common among women who are uninsured, underinsured or who live in rural areas.

We think this is because of lack of insurance coverage, access to care and information.

Texas currently has the second-highest number of women with cervical cancer, including 1,169 new cases and nearly 400 deaths last year. Texas also has the highest number of insured citizens of any state.

"Maybe the current debate is missing the point. It's a cancer vaccine."
It seems that the same barriers that prevent access to screening for low-income, rural and uninsured women will also keep them from receiving the vaccine unless a school-based program is implemented. Experts say that school-based mandates are the most effective way to ensure widespread vaccination.

It would seem unfair if only girls with insurance and informed parents benefit for a life-saving vaccine.

My friend Dr. Harold Freeman says, "We need public, scientific and medical policies that allow people at the highest risk for cervical cancer to receive the vaccine."

I'm a parent, too, and I agree parents deserve information and must ultimately decide what's best for their kids. I know these issues can be uncomfortable and no parent needs reminding that our kids will grow up and they will be vulnerable to a range of life's realities.

So I welcome the debate today. But, with all the talk about abstinence and parents rights and mandates - let's not forget to talk about the part I think matters most...CANCER.

For all of you out there who want to know more about HPV and the vaccine, there is a pretty good overview in the Austin American-Statesman today.



Related Links:

» Lance Armstrong's blog

» The Lance Armstrong Foundation Website

Cervical Cancer Survivor Stories:

» Tamika's Story and Video

» Wendy's Story and Video

» Navita's Story and Video