From what risk level without them? How many people actually die of cervical cancer before age 30??
I mean, vaccinations and cancer prevention are both great, but this headline is ridiculous.
I mean, vaccinations and cancer prevention are both great, but this headline is ridiculous.
If we multiply 3.1e-5 by 50 years that's about a 0.15% chance of dying of this cancer. The HPV shots cost $500-1000 for the three shots, so the cost per life saved is about $650K. With the statistical value of a human life being about $12M this is quite cost effective.
I'm assuming the reduction in death continues to later in life after 30, but that's a reasonable assumption, IMO.
Cervical cancer disproportionately affects older women, even moreso than other cancers. The average age of diagnosis is 50 [1] and so the years of lost life due to cervical cancer is both going to be extremely low and going to disproportionately be very late life years lost. Rates in U30 are already near zero with an extremely high survival rate for those that do get it.
[1] - https://www.cancer.org/cancer/types/cervical-cancer/about/ke...
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 days or weeks at most, and so the $12 million figure you pulled out of thin air, for a full lifetime, is highly inappropriate.
This also generalizes to many medical issues. For instance, contrary to what most people think, early cancer screening achieves very little in terms of life extension. Prostate cancer screening, for example, adds about 37 days to one's life expectancy. [1]
[1] - https://jamanetwork.com/journals/jamainternalmedicine/fullar...
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.
- 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.
And more generally, I think converting this issue into weeks starts to emphasize how broken a metric statistical value of life is. Nobody, again outside of millionaires, is paying thousands or even hundreds of dollars for one more week of life expectancy. Even if they wanted to, the overwhelming majority of people just don't have that degree of disposable wealth. It's akin to you ask people how much they'd be willing to pay to e.g. deal with climate change, and they give some ridiculously large number. But then when it comes time to really pay, and not hypothetically pay, that number suddenly becomes quite close to $0.
This is a quibble that does not substantially alter the conclusion.
> And the shots only matter during the window of your life where cervical cancer is remotely relevant, which is during a typical sexual window where somebody may have multiple partners.
Already taken into account in your "save 1 week" conclusion. No double counting please.
> And this is again before we even get into real efficacy, side effects, and other issues which matter quite a lot
This argues in favor of the shots, as I have been ignoring the real cost of cancers to those who don't die of them, or who suffer before they die.
> And more generally, I think converting this issue into weeks starts to emphasize how broken a metric statistical value of life is.
You're calling it broken because it's showing you're wrong.
Something like the statistical value of a life is necessary because tradeoffs between different options must be made. If those tradeoffs are made consistently, a value of life naturally falls out.
Beyond death, it can also cause sterility and people may end up with extremely expensive IVF surrogacy pregnancies etc.
herd immunity: Vaccines benefit even those that don't take the vaccine now. eradication effects: vaccines benefit those that don't take the vaccine in the future.
fertility increase: non lethal cervical cancer can cause inability to get pregnant or carry a pregnancy to term. I don't know if it can cause birth defects.
Life Years: Early deaths save more Life Years than diseases that protect against later disease.
Quality Adjusted Life Years: Very nuanced, and I don't know how HPV cancers compare against the baseline of QALY. But being a vaccine that prevents, the Quality of life gained should be 100%, which would compare positively to treatments that do not cure completely
“Approximately 0.6 percent of women will be diagnosed with cervical cancer at some point during their lifetime, based on 2021–2023 data” [1].
Given “reports of serious health issues after HPV vaccination were consistently rare—around 1.8 per 100,000 HPV vaccine doses, or 0.0018%” [2], a woman suffers a 300x higher hazard (assuming we measure a serious vaccine reaction as being equivalent to cancer, which is silly) from going unvaccinated.
> How many people actually die of cervical cancer before age 30?
4,462 young women under the age of 30 died of cervical cancer in 2022 worldwide [3].
[1] https://seer.cancer.gov/statfacts/html/cervix.html
[2] https://www.cancer.gov/news-events/cancer-currents-blog/2021...
[3] https://gco.iarc.who.int/today/en/dataviz/pie?mode=populatio... Mortality, cervix uteri, females, 0 to 29
4,462 out of the whole population (of women etc.).
Would you subjectively describe that number as "almost zero"?
Sure. If the only effect were on under-30s, this wouldn’t be a great vaccine. What 5,000 people is good for, however, is confidently measuring decline in a cohort. Zero deaths, even against a baseline of tens, strongly implies this should cross into the tend or hundreds of thousands over the next decades in populations that keep vaccination rates up.
Oddly enough I can't find exact death rates from cervical cancer paired amongst those who had HIV/AIDS but this [2] hints at it, with 90% of all cervical cancer deaths coming in low/middle income countries, and with the "highest burden" (plurality I guess?) coming from sub-Saharan Africa where rates of HIV are the highest. [2]
[1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC7815633/
[2] - hhttps://www.unaids.org/en/resources/presscentre/featurestori...
It's not zero deaths though, it's "almost zero".
From the article:
“We estimate that since its introduction [in 2008], HPV vaccination has prevented nearly 200 young women from dying from cervical cancer in England.”
This is an estimate of 200 total of any age total across 18 years. The article doesn't say 3300 die each year, 3300 are diagnosed each year.
> Between 2020 and 2024, no cervical cancer deaths were recorded in women aged 20 to 24 - the first time that had happened over a five-year period.
> Without vaccination, around 23 deaths would have been expected.
Note the first chart in the link showing the historical trend for the 20-24 cohort since 2000 plumetting from 25 to 0.
The CDC mentions that not smoking and wearing condoms also lower the risk.
https://www.cdc.gov/cervical-cancer/prevention/index.html
Anecdotally people smoke less thant they uses to. Don't know what condom usage rates have done in the past quarter century.
> I assume that this particular shot is not the only thing that has reduced cervical cancer deaths in women under 30.
Why would you assume that when presented with a study that tracks with long standing belief in the medical community that the HPV vaccine works?
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
Because cancer interventions have moved forward in general?
They will downplay that number or exaggerate it.
I had no idea HN had so many cookers.
Also, no need to post snarkily about LMGTFY. TFA should have included the base rate, and the fact that it didn't signals that it's not much of a reduction. It also signals that the journalist who wrote it is more in it for clicks than conveying accurate information.