GlaxoSmithKline distorts the facts on cervical cancer
Last year, the FDA approved another cervical cancer vaccine, a product from GlaxoSmithKline. It's no wonder then that I'm now seeing ads on TV, but they're not for the product, they're fearmongering about cervical cancer and distort the facts.
The commercial I've seen multiple times in the last few days has a woman on the phone with a friend "how's she doing" "she has cervical cancer, she's not sure she can have kids" "but she's only 25"
Then it mentions prevention and flashes the GSK logo.
No, no, and no. If a woman has cervical cancer that early in life it is likely not going to be prevented with the HPV-targeted vaccine, it is likely due to genetics and can be triggered by a number of other environmental factors, besides HPV (which is the viral instigator of cervical cancer affected by the vaccines on the market). HPV-induced neoplastic changes take time to develop to an extent to which they can be diagnosed, sometimes decades. (Edit: a doctor has pointed out that it is accepted in practice that all cervical cancer is caused by HPV; however, there are published cases of non-HPV female reproductive cancers, including that 5% of cervical carcinomas are non-HPV cancers. e.g., literature reference 1, 2, 3 After discussion with the doctor I admit that this idea itself may be controversial, but I stand by the idea that the commercial did not explain the risk appropriately or what the vaccine is meant to protect against)
The average age of cervical cancer patients is 48 years!! Only ~15% of cervical cancer patients are diganosed under the age of 34 years. Making the woman in the ad so young is misleading about who is actually affected by cervical cancer. Very few women die in their 20s or 30s from cervical cancer. The most important thing is diagnosis, which is via pap smears, to catch it early and treat it. The vaccine does not eliminate the need for this screening, and it will not eliminate all kinds of cervical cancer, only those caused by consistent HPV infection (which only occurs in ~5% of women according to studies in promiscuous populations).
The ad does not even mention HPV, which is another misleading aspect.
This is just one of the surprising ads in GSK's marketing arsenal currently assaulting young women into beng afraid for all the wrong reasons.
Overall, I'm surprised the FDA is allowing this advertising campaign that is blatantly ignoring the facts about cervical cancer, misconstruing what the vaccine can do (it only prevents certain types of cervical cancer), and attempting to scare women into buying GSK's product (the vaccine). If it's as good as it's supposed to be, it would be attractive to practitioners without the fear mongering to consumers.
The truth is, cervical cancer is serious business, and it kills women yearly, so it does need appropriate surveillance, diagnosis, and treatment. A vaccine against HPV-induced neoplasia would be a boon to the 5% of women who are at risk due to persistant infection, unfortunately there isn't a way to tell who that is until they're already infected. So they want to vaccinate everyone not already exposed. Ok, I get that, and Merck's Gardasil would be a good vaccine against genital warts, an increasing health problem (though GSK's hasn't been shown to be). So then say that!
Why lie to me and every other woman out there? Health is about making informed decisions, not buying into the latest marketing campaign. So give us the information and make the vaccine available. Don't put on the boogey mask and distort the facts just to sell more.
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Comments
I mean who can be informed of something false unless they themselves allow it.
Its just like seeing a 350 hp car on television doing 110 mph. Now the stupid ass buys the car because of what he sees on television. Now where in the hell in the US can you do 110 Mph in a 350 hp car. Yet instill the idiot will go out and buy one. Ironic isn't it ?
Now that is false advertisement at its best. And they fail to say, "Do Not Try This On Any Highway in the US".
Or for that fact a label on the car stating "Warning The Surgeon General Advises Using This Product At Above Highway Speed Limits Might Kill You". Get where I"m coming from ?
By Burgess Dillard 03/17/2010
It is true that there are many co-factors in cervical cancer, as listed on the ACS link you give, but generally speaking, HPV infection is necessary for the development of cervical cancer. This is a well established fact. It's close to 100%, in fact. It is also true that having a 25 yr old girl with cervical cancer is unlikely- she'd be more likely to have LGSIL (an abnormal Pap). It's possible, though, for her to have cancer if she started having sex at 15. 10 yrs is long enough to progress from infection with HPV to cancer. Also, the GSK vaccine protects only against the high risk strains of HPV for cervical cancer, not for genital warts. Gardasil does both. The 5% you quote as getting persistent infection with HPV is accurate, but the way you wrote it implies that only 5% of women with cervical cancer get it from HPV (wrong denominator). It is correct that the vaccine does not eliminate the need for Pap smears. I am giving these corrections because people need to understand that it is important to protect girls from HPV with the vaccine, as well as to continue to get Pap smears. I'll agree with Alicia that Pharma advertising can be terribly misleading.
I think the worst part of the advertising is that they don't clarify the limitations of the vaccine and make it seem like the likely person with cervical cancer is 25 and will never have kids. They should've shown a 40 something single mother without health insurance, and then laid out the exact purpose of the vaccine (dysplasia instigated by high-risk HPV strains).
The public is generally underinformed and so, yes, a simple commercial can affect their health decisions, and the marketing preys on that. The commercial is blatantly preying on women's fears rather than educating them or helping them.
Direct-to-consumer marketing in the guise of "education" is one of the biggest jokes in the health field. It's nothing but profiteering.
Your statement: "Health is about making informed decisions, not buying into the latest marketing campaign." is exactly true in reverse. There was a recent study of doctors that showed that over half of the patients requesting a drug seen in an ad were prescribed that drug by the doctor, without further testing. This study focused on anti-depressants, but the findings will likely be similar for other drugs. We are being fed only information that the pharmaceutical companies want, but that isn't news. If Craze Czar is actually involved in pharma marketing, he will likely know that most medical research is underwritten by a drug company with a vested interest in the outcome. I was a graphic designer doing brochures for GSK and believe me, those doctors and I were paid damn well to make their case for them.
[Reference Clark, LR et. al. Adolescent Knowledge About Sexually Transmitted Diseases. Sexually Transmitted Diseases:
August 2002 - Volume 29 - Issue 8 - pp 436-443]
Parental knowledge about STIs, including HPV was equivalent.
[Reference: L.Clark, K.Barnes-Harper. Who knows more about sexually transmitted diseases (STDs)? parents or adolescents?
Journal of Adolescent Health, Volume 34, Issue 2, Pages 149-150]
If you don't know about an STI (not to mention it's relationship to cervical, anal and penile cancer), how can one truly make informed choices when it comes to sexual decision making, especially when there is no screening test for some of those STIs (and most people don't realize that).
[Reference: L. Clark, M. Kahn, P. Gallagher, D. Schwarz. “The everything test:” Understanding what adolescents know about sexually transmitted disease testing. Journal of Adolescent Health, Volume 36, Issue 2, Pages 129-130]
So since my entire career as an adolescent medicine researcher/practitioner was devoted to educating about this particular area of health and raising awareness, I'm going to have to vehemently disagree with you.
If people have no knowledge about a particular subject, it is important to raise awareness.
And as for your wanting to parse out the risk for cervical cancer...sure you can join the camp of those who say that poor minorities should be the ones targeted for the vaccine (And you can guess how I feel about any targeting, risk based strategies that have never worked, or any other attempt to "other" certain populations because of their increased risk of cervical cancer. But what about those at increased risk of cervical precancer? You know, the 330,000 cases in the US each year? It ain't *just* the poor minorities in this group.
How about the number of abnormal PAPs caused by HPV types 6, 11, 16 & 18? Again, not just the poor minorities.
*THAT'S* why the CDC/ACIP chose not to employ a doomed to fail risk based strategy for an infection that is an equal opportunity abuser.
I get that you hate pharma. Not a surprise. But sometimes in addition to the presumed never ending quest for profit (like the Ferengi in Star Trek), sometimes pharma can create a vaccine to help prevent a scourge that we've had no way to treat (short of taking off pieces of the cervix, or perhaps the entire uterus) before.
Yeah, let's bash pharma for developing the 15th erectile dysfunction drug, but heaven forbid they come up with something to decrease cervical cancer, precancers, vaginal and vulval cancers and precancers, anal cancer and precancers, penile cancer and precancers, and more likely than not, tonsillar and laryngeal cancers caused by HPV 16.
I'm a doctor. The health of the public is paramount in my mind. I cannot roll like that.
And yes, as I have said before, I do currently work for Pharma on the other HPV vaccine after 15 years as an adolescent medicine physician at Children's Hospital of Philadelphia. I wanted to do more to stem the tide of STIs that I saw regularly in my adolescent patients from throughout the tri-state area.
Another thing I think they'd have to do is decrease the cost of the vaccination. Necessary public health benefits (the elimination of genital warts and decreased female reproductive cancers) shouldn't cost parents hundreds of dollars, especially since the length of coverage by the vaccines isn't yet fully determined. Boosters will likely be necessary, and since HPV is something that a person can be infected with at any point in their sexual lives, it will likely be like tetanus, with an update required every so many years thereafter to continue coverage (though that research is still being worked on according to the CDC).
a general note: I'm just of the mind that a good medical intervention doesn't require fear mongering. Stating the facts, educating without marketing (honestly and forthrightly), and making the intervention available to practitioners should accomplish the aims while maintaining the trust.
Personally I do not want to be inundated with pharmaceutical advertisments on every channel I watch or for that matter on every website or news page I am reading on the internet or in print.
Seems to me that this advertisement is comparable to the tobacco adverstisements that were eventually banned.
I would rather see Joe Camel on a commercial then Bob Dole talking about erectile dysfunction.
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107170.htm
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm143562.htm
The FDA needs to make some changes to the DTC ads... sooner, rather then later and most definitely before I diagnose myself with something dreadful .. umm like Restless Leg Syndrome.
The median age at diagnosis of cervical cancer has been dropping. I just pulled out my GYN oncology book from residency (1985, I really have to clean out my old books) and it lists the median age at diagnosis as 51.4 years old. Data from 2002-2006 shows a median age at diagnosis of 48, and data from 2006 alone shows a median age at diagnosis of 47. In addition, more than 15% of invasive cervical cancers are diagnosed before age 35. And that doesn't even count the pre-cancerous lesions found in women in their teens and twenties.
The primary (some people believe the only) cause of cervical cancer is HPV; that's certainly consistent with the preponderance of the evidence. In other word, cervical cancer is essentially a sexually transmitted disease.
The assumption about Gardasil is that by preventing HPV infection, the risk of cervical cancer will be reduced. Gardasil does prevent HPV infection; only time will tell if it will prevent cancer, too.
The epidemiology of cervical cancer has changed over the last decades with a decreased median age at the time of diagnosis. It is important that women understand the risk and take steps to protect themselves.
There is no reason in the world why the taxpayers should have to pay for the drug companies' advertising budgets.