Posted by on May 27, 2013 - 9:06am

A significant number of parents are not allowing their daughters to receive the HPV (human papilloma virus) vaccine, despite an increase in doctors recommending it. The HPV vaccine is a series of three shots given to pre-teen and teen girls and boys over the course of six months to prevent HPV and related conditions, most notably, cervical cancer in women.

Between 2008 and 2010, the percentage of doctors recommending the HPV vaccine rose from 48% to 52%. However, the CDC reports that only around one-third of eligible girls have received the HPV vaccine. In a study of parents not planning on having their daughters receive the vaccine, the percentage of those concerned about its safety increased from 5% to 16% over the course of three years. Another 17% cited the lack of necessity of the vaccine as the reason their daughters won’t receive it.

In response to concerns over the safety of the HPV vaccine, Dr. Joseph Bocchini, a pediatrician on the CDC’s Advisory Committee on Immunization Practices has stated that “we have not identified a significant likelihood of serious adverse events following vaccine” and that it “is a very safe vaccine.” Claims that the vaccine is not necessary appear weak after identifying what results from HPV. Nearly all instances of cervical cancer are caused by HPV, and many cases of vulvar and vaginal cancer are linked to it. This doesn’t mean men are exempt from HPV. 95% of anal cancers and 60% of oropharyngeal cancers (cancers in back of the throat, base of the tongue and tonsils) are caused by HPV. Vaccinating both boys and girls significantly reduces the risk of them having several forms of cancer in the future.

Increasing education efforts may help increase the rate in which children receive the HPV vaccine. Currently, there is a strong correlation between receiving a doctor’s recommendation and receiving the vaccine. However, many teens do not see a primary care provider regularly in the years they can be vaccinated. Additionally, parents may not know about the vaccine, or feel they don’t know enough about it and how it can help their children. To tackle these problems, education programs that target the general public are necessary.

For more information on the HPV vaccine, click here.



Hensley, Scott. "Worried Parents Balk at HPV Vaccine for Daughters." NPR. 18 March 2013.
"HPV and Cancer." Centers for Disease Control and Prevention. 5 February 2013. 

Posted by on February 3, 2013 - 9:20am

According to recent studies, many women are receiving unnecessary Pap tests, or smears, to screen for cervical cancer, while others are not receiving the appropriate tests. The guidelines for how often women should receive Pap tests were recently changed. Previously, physicians typically administered Pap tests to women 3 years after they became sexually active, or when they turned 21. After that, women were advised to receive a Pap test once every one or two years.

In March 2012, physicians’ groups released new Pap test guidelines. These recommend that most women do not need a Pap test before age 21, and that between ages 21 and 65, women should typically be tested once every 3 years. However, some women ages 30 to 65 may receive a Pap test in intervals of 5 years, as long as they are being tested for the human papillomavirus (HPV) as well. After age 65, women do not need to receive a Pap test unless they are at a high risk of cervical cancer. Additionally, testing is not recommended for women who have received a hysterectomy and have no history of cervical cancer or abnormal test results. These changes were made because cervical cancer is rare for young women, and grows at such a slow rate, that longer intervals between tests is not harmful.

Recent data shows that although some of these guidelines are being followed, others are not. Looking at positive trends first, the percentage of women aged 18 to 21 who have not received a Pap test has increased from 26% in 2000 to 48% in 2010. Additionally, the percentage of women over age 65 (who have not had a hysterectomy) that have recieved a Pap test has gone down slightly, from about three-quarters in 2000 to two-thirds in 2010.

However, there are also several negative trends visible. The percentage of women between ages 21 and 30 who have never received a Pap test has increased from 7% in 2000 to 10% in 2010. Another shocking statistic indicates that about 60% of women who have had a total hysterectomy, which means they no longer have a cervix, are still receiving Pap tests. While unnecessary tests cost money, they can also produce false results, anxiety, and additional tests and procedures. With increased dissemination and awareness of Pap test guidelines, physicians can work with their patients to provide appropriate care.



Posted by on November 9, 2011 - 9:58am

Consumers are often frustrated when they hear the results of research studies that indicate a "maybe" rather than a definitive answer.  Here's an interesting study that demonstrates the long road researchers often have to take.  On the other hand, trial and error sometimes leads to surprising results and are worth it.  This example also demonstrates how different medical disciplines can learn from each other.

A new study suggests that a common sexually transmitted virus already linked to cancer may also cause cardiovascular disease.

Women infected with the human papillomavirus, or HPV, are two to three times as likely as uninfected women to have had a heart attack or stroke, according to a report published recently in The Journal of the American College of Cardiology.

HPV is known to cause cancer of the cervix, vulva, penis, anus and throat, but the new study is the first to connect the virus to heart disease. The heart findings are not definitive: They show the virus may be associated with heart disease, but do not prove it caused the disease.

The senior author of the study, Dr. Kenichi Fujise, a cardiologist at the University of Texas Medical Branch in Galveston, said the research grew out of his quest to find out why some people have heart attacks even though they have none of the usual risk factors, like high cholesterol or high blood pressure. About 20 percent of patients with heart disease lack obvious risk factors, and researchers think those people must have other underlying problems that science has not yet figured out.

Dr. Fujise decided to study HPV because the virus can sabotage a gene called p53, which normally protects the body from cancer and may also help prevent artery disease. Inactivation of p53 occurs in a variety of cancers, and the gene is considered to be a sort of guardian of the genome. Disabling p53 may also lead to inflammation and thickening in the walls of arteries.  HPV is the most common sexually transmitted infection in the United States. Scientists estimate that half of sexually active men and women have been infected and that 80 percent of women have had it by age 50. The virus has many strains, only some of which cause cancer. In most people, the immune system fights off the virus.  The infection persists and causes cancer in only a small minority. Two vaccines are approved to prevent HPV infection and are recommended for young people before they become sexually active. The vaccine does not work in people who are already infected.

Dr. Fujise studied 2,450 women, ages 20 to 59, who took part in a national health survey from 2003 to 2006. The women used vaginal swabs to provide specimens for HPV testing and reported whether they had heart disease, which was defined in this study as ever having suffered a heart attack or stroke.

In all, 1,141 women had HPV. Sixty women had heart disease; of those, 39 also had HPV. When the researchers analyzed the data and adjusted for heart risks like smoking, blood pressure and weight, they found that women with HPV were 2.3 times as likely as those without the virus to have heart disease. The risk was even higher, 2.86 times that of uninfected women, in those who had HPV strains known to cause cancer.

Dr. Fujise said the results surprised him. “I was thinking maybe there would be just a weak link or no link, but this is a strong link,” he said.   Even if further research confirms the connection, most people who contract HPV would not be at special risk for heart disease. Dr. Fujise said that if the link is real, heart disease, like cancer, would be likely to develop only in people with lingering HPV infection.

A researcher not involved with the study, Dr. Lori Mosca, director of preventive cardiology at NewYork-Presbyterian Hospital/Columbia University Medical Center, said: “I’m definitely intrigued by this. The biological argument is highly plausible and deserves further investigation.”

But she emphasized that plausibility is not enough; the history of medicine is full of ideas that made sense and turned out to be wrong. The type of study that Dr. Fujise did, in which scientists look for associations in a mass of data, is good for generating ideas for more research, but it does not prove cause and effect.

Finding an association does not even tell which condition came first. In theory, heart disease could have come first and made the women more vulnerable to HPV. Or some other unknown factor could have predisposed some women to both HPV and heart disease.

“We need to proceed with caution,” Dr. Mosca said. “We need to go on and do more rigorous kinds of research that would answer the question more definitively.”She said that many researchers were studying possible links among cancer, infections and heart disease, but that so far no infection had been proved to cause artery disease.

Dr. Fujise’s work, she said, “has the potential, if it does pan out, to further inform the public about the potential benefits of vaccination for HPV.” But she added that the findings were too preliminary to be used as evidence in favor of vaccination.

Posted by on September 20, 2011 - 10:42am

Where do you get your health information?   Doctors are often too busy to spend much time on preventive care.   The internet is alive with personal and commercial  blogs on the latest health fads. And most recently, politicians are getting into the act.

The latest bruhaha about the HPV vaccine has been front and center in the presidential debate and has hit the airwaves.   In case you are not following this case, one presidential candidate has raised concerns about the safety of the HPV vaccine given to teenage girls to prevent cervical cancer.  And her source:   a woman she met on the campaign trail who said her daughter is mentally retarded due to the vaccine.   Even though this presidential candidate admits that she personally is not a "doctor" or a "scientist",  she still cites this mother's concern in the media as evidence that this HPV vaccine is dangerous!  There was no followup to see if there was any truth to the mother's assertion.   In my mind, what this candidate is doing IS  dangerous because she is using her celebrity status to spread unsubstantiated information about a serious women's health issue!

The Institute for Women's Health Research at Northwestern U. has created this blog site as an authoritative resource for women (and men) around the globe to learn about the latest (evidence-based) research in women's health.   Our sources include the leading scientific institutions around the world.   We also try to put risks and benefits into perspective based on the LATEST EVIDENCE so that you can decide what is best for you.  We acknowledge that science constantly evolves making it even more important the we continue to monitor the latest findings.  And the internet is certainly a good way to keep up.....if you use it wisely.

The good news about this latest political gaffe, is that even the talk shows are pointing out how absurd this candidate's assumptions are.  Maybe it will shed light on how important it is to find credible source for your health information.     By the way, please check out our recent blog on the HPV vaccine by clicking HERE.

Posted by on September 3, 2011 - 7:41am

Protect your daughter from cervical cancer by getting her the HPV vaccine. It takes 3 shots to complete the series, so make sure she gets them all to be protected.
It's easy to get very busy with school, activities, work, and all of the juggling that parents of preteens and teens do every day. For the sake of your daughter's health, take the time to get her the life-saving HPV vaccine to protect against cervical cancer. Every year in the U.S., about 12,000 women are diagnosed with cervical cancer, and 4,000 die. If we protect girls now, we could reduce disease and cancer due to HPV.   About 20 million people, most in their late teens and early 20s, are infected with HPV, the type of virus that causes cervical cancer. That's why it's important to protect preteen and teen girls early through vaccination.

The HPV vaccine is safe and effective and is given in a series of 3 shots over about a six-month period. The second shot is given 1 or 2 months after the first, and the third shot is given 6 months after the first shot. It is very important to complete all of the shots to be fully protected. 35 million doses of HPV vaccine have been safely given to girls across the country.

If your daughter is age 11 years or older, the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the Society for Adolescent Health and Medicine (SAHM) recommend you vaccinate now to protect her against cervical cancer.    If your daughter is older than 11 or 12 and has not started these shots, it's not too late.

Posted by on July 6, 2010 - 10:28am

A survey of more than 1,200 primary care physicians indicates that many are not following clinical practice guidelines on recommended screening intervals for cervical cancer, both with regard to traditional Pap testing as well as a newer screening method, a DNA test for the human papillomavirus (HPV). The FDA has approved HPV DNA testing for use in conjunction with Pap testing, a process called co-testing, for women age 30 and older.

At the time the survey was conducted, guidelines from the American Cancer Society and those from the American Congress of Obstetricians and Gynecologists advised extending the interval between screenings to 3 years for low-risk women over the age of 30 after three consecutive normal Pap tests or a single normal co-test (a normal Pap test plus a negative HPV DNA test). Guidelines from the U.S. Preventive Services Task Force also are consistent with a longer interval between screening tests.

In the survey, based on a hypothetical clinical vignette of a 35-year-old, low-risk woman with three prior normal Pap tests, only 32 percent of respondents reported that they would comply with guideline recommendations, researchers from the CDC and NCI reported in the June 14 Archives of Internal Medicine. Even fewer respondents, 19 percent, would comply when, during a single visit, the low-risk woman had a normal co-test result. Approximately 60 percent of those surveyed—which included general internal medicine physicians, family practice doctors, and obstetrician-gynecologists—said they would still recommend that the woman undergo annual Pap screening.

Although the Pap test is the most commonly used cervical cancer screening method, a number of studies have shown that the DNA test for HPV—the cause of the vast majority of cervical cancer cases—is more sensitive than the Pap test in detecting high-grade precancerous lesions, spurring discusions about the optimal approach to cervical cancer screening in the United States.

This new study, however, suggests that guidelines for extending screening intervals have not influenced current clinical practice, wrote Dr. Mona Saraiya of the CDC’s Division of Cancer Prevention and Control and her colleagues. “When offered the choice for HPV testing,” they wrote, “many physicians deferred to the same pattern they used for Pap testing,” annual screening with both tests or no recommendation for HPV testing.

“These practice patterns are not likely to lead to much improvement in cervical cancer outcomes, but may result in unnecessary follow-up testing, increased risk of colposcopy-associated morbidities, and distress for patients,” said Dr. Robin Yabroff, a study co-author from NCI’s Division of Cancer Control and Population Sciences.

“New HPV infections are extremely common but overwhelmingly benign; they almost always go away by themselves,” said Dr. Mark Schiffman of NCI’sDivision of Cancer Epidemiology and Genetics. “Only persistent infections are a risk factor for cancer. If you screen for HPV too often, you will detect new infections rather than persistent infections, and this poses the risk of overtreatment.”

Posted by on January 29, 2010 - 11:45am

New information from the Kaiser Family Foundation and the George Washington University School of Public Health and Health Services on family planning services covered under Medicaid has been added and is available for 2009 for all states. The number of states that cover over-the-counter emergency contraception is 26; sterilization (36 +DC); Infertility testing (4); Infertility treatment (0); STD Testing  (11) and Treatment (9); HPV Vaccine for ages 21-26 (29). The report also contains information about family planning eligibility service waivers for each state. The map below demonstrates the emergency contraception coverage.

Coverage for Emergency Contraception

To view the entire report visit

Posted by on July 24, 2009 - 11:36am
Sharon Green, Dr. Marie Savard, Susan Scanlan, Sarah Bristol-Gould, and Michelle Desjardins at the luncheon

Sharon Green, Dr. Marie Savard, Susan Scanlan, Sarah Bristol-Gould, and Michelle Desjardins at the luncheon

Yesterday, the Institute for Women’s Health Research co-hosted a luncheon with the Chicago Foundation for Women and the National Council of Women’s Organizations featuring the Pearl of Wisdom™ campaign to promote awareness and prevention of cervical cancer.   Speakers included Dr. Marie Savard, ABC News Medical Contributor; Susan Scanlan, Chair of the National Council of Women’s Organizations; Michelle Whitlock, Cervical Cancer Survivor and Women’s Health Advocate; and Lanise Sanders, Certified School Nurse in the Chicago Public School system.  The luncheon was extremely well received with many important Chicago organizations in attendance, including Sen. Jacqueline Collins, Rep. Constance Howard, Rep. Mary Flowers, and a representative from Congresswoman Debbie Halvorson.  One idea that was stressed by speaker Dr. Savard is that cervical cancer is treatable when detected early with the tools that we have including the Pap test, HPV test, and HPV vaccine.

The vaccine, Gardasil®, has been the subject of controversy since its release in 2006.  Part of the issue is the fact that the vaccine is recommended for girls starting as early as age 9.  Because HPV is a sexually transmitted infection, many parents (who must give consent for the vaccine) are uncomfortable with the suggestion that their young daughters might engage in sexual activity.  While it is unlikely that a 9 year old will be exposed to the virus, it is important that the vaccine is

Dr. Marie Savard, ABC News Medical Contributor

Dr. Marie Savard, ABC News Medical Contributor

administered before sexual activity commences.  The vaccine is meant to protect women who may be exposed to the virus in the future, and realistically, that’s pretty much all of us.

Cervical Cancer Survivor Michelle Whitlock mentioned that at the time of her diagnosis she was not afraid to admit to and talk to friends and peers about her cervical cancer, but she felt ashamed to mention the HPV infection.  Sexually transmitted infections have a stigma; women often feel ashamed and afraid they will be labeled as promiscuous.  The fact is it takes only one sexual encounter to become infected with an HPV virus.  In addition, HPV is transmitted by skin-to-skin contact, not just by fluid exchange.  This means that condoms cannot offer complete protection.

So what can we do?  We can talk about it.  We can attempt to remove the stigma and make sure we encourage the women in our lives to get routine Pap tests and HPV tests as necessary.  Early detection is key.

For more information on the Pearl of Wisdom™ campaign, visit their webpage at:

For more information on HPV and the Gardasil® vaccine visit:

To learn about Cervical Cancer visit: