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.
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.
The estimated number of deaths from cervical cancer in the US in 2026 is 4,200. The death rate is 2.2 per 100,000 people down from 3.1 per 100,000 in 1992.
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.
It's not reasonable to use the rates from 30+ years ago because survival rates for all cancers have been sharply increasing for decades. You also need to consider years of life lost if you're going to look at things economically, because you're formulating things as if somebody who died of cervical cancer never existed.
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...
So use the current rate, which is 2.2 per 100,000. The argument is basically the same. The cost/benefit ratio is so good that your quibbles don't change the conclusion.
Do you understand the problem I'm describing? You are saying that women who got cervical cancer essentially died at birth. You need to look at years of life lost. Cervical cancer has a low frequency, high survivability, and disproportionately effects women in later age.
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...
Let me shoot right back and ask if you understand what I was saying.
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.
I think it certainly will. We can test it fairly easily by getting some real numbers.
- 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.
[1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4167424/
That 2.2 per 100,000 is deaths PER YEAR, not PER LIFETIME. The vaccine is protecting against death each year over the person's life, not just in one year.
That is why I multiplied the change per year by 50, exactly as you did.
OK. If a life is worth $12M, that's $3300/week (assuming a 70 year lifespan). The shots cost $500-1000, a 3-6x ROI.
You're again playing very fast and loose with numbers there. The average female life expectancy is 81. 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. 50 was already pushing the limits there, but I accepted it because even with that exaggeration, it's not close. But at some point you've got to start being remotely reasonable. And this is again before we even get into real efficacy, side effects, and other issues which matter quite a lot with diseases that have as low an impact as cervical cancer. E.g. a quick search shows a rate of severe side effects from the vaccines at 1.8 per 100k (which you need to multiply for a multi-shot regime). That matters quite a lot when the death rate from cervical cancer is 2.2 per 100k.
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.
Even if you just consider all of those 4000 + survivors would have got treatment for the cancer after getting it which costs far more than a vaccine.
Yep and significantly more than the death count would have needed expensive treatment and be out of the workforce for a time or permanently. Also the charged price isn't real cost to the economy. If they have a big margin on it after fixed research/approval expenses lots of it feeds back into the economy through taxes and dividends/reinvestment in other drug development.
Beyond death, it can also cause sterility and people may end up with extremely expensive IVF surrogacy pregnancies etc.
Good calc, here's some other benefits.
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
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> From what risk level without them?
“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
Thanks for the data.
4,462 out of the whole population (of women etc.).
Would you subjectively describe that number as "almost zero"?
> 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.
Looking at healthcare stuff globally is misleading because of Africa. The ongoing HIV/AIDS epidemic there makes death rates for anything that HIV/AIDS can contribute to highly malinformative. For instance in southern Africa, more than 60% of women with cervical cancer also have HIV. [1]
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...
Very fair. These are UK data, and I’m unfortunately not well versed in their sources. Our American sources don’t seem to measure by age consistently enough for me to gather an estimate. If there is a comorbidity irrelevant outside Africa and rural Southeasr Asia, that will mess up the numbers.
>Zero deaths
It's not zero deaths though, it's "almost zero".
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So 5 deaths across 3 years? Doesn't seem worth a headline, especially since it could literally just be noise in the data.
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.
Absolutely is - this is such a no-brainer of a public health intervention. We're not touching on the cost of treatment (including inability to have future children! very much something a State should be interested in avoiding).
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The linked chart shows that there were none in the 20-24 age range during the during the recent few years. Is the entire population vaccinated? If not (the article doesn't claim this), then the fact that no one in that age range died (and only 5 in the entire under-30 cohort) tends to indicate that it was not a very high base rate.
Are there other sources that show data going back to the 1970s? Probably! I didn't go searching for them. I looked at what was linked above and saw there were very few. As I said, the Guardian journalist didn't include a base rate, which surely would have been included if it bolstered the argument.
EDIT: I just scrolled down further and saw that even the chart that shows trends over time (which I hadn't seen before, having stopped scrolling earlier) doesn't support your point. It shows there were roughly .2 deaths per year per 100k. Not having any deaths in 20-24 for 3 years is not a statistically significant difference, I would imagine, than the .2 figure. Also, there are undoubtedly other cancer-related advances that have made it less likely that a young woman would die of any kind of cancer.
And the data regarding under-30 deaths is muddled because the next bucket up is 25-34, and we don't know what it is up to 29.
Lastly, at the bottom there's this disclaimer, which makes it even harder to tell what's going on with small numbers:
> Note: Non-zero counts of 5 or less are suppressed and presented as 5.
If you have another source, please feel free to share. What we've seen so far (nothing in TFA, nothing of import in the commenter's linked data) isn't remotely compelling.
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Your source doesn't say what you think it says, as evidenced by your other mistaken comments in this thread. I was referring to other sources (other than the one you posted, which doesn't say what you think it does) because I wanted to know if anything supported your claims.
Please stop with the ad hominem business, which is frowned upon by the HN guidelines (I see you're new here).
I see you didn't go down the page to "trends by age".
It is not ad hominem to point out you don't search and you don't understand.
> You are not a serious person. Please stop being noise.
This is specifically against the guidelines, notably these lines:
Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes.
Comments should get more thoughtful and substantive, not less, as a topic gets more divisive.
When disagreeing, please reply to the argument instead of calling names. "That is idiotic; 1 + 1 is 2, not 3" can be shortened to "1 + 1 is 2, not 3."
Please stop registering accounts to break the guidelines with. You know what is expected here.
Your questions are sort-of answered in the article. 3300 die each year of cervical cancer in the uk. So at 0% it saves 3300 lives per year. However the vaccination is fairly new so they have to wait longer to see if it applies 20-years, 30-years, etc later. I assume it would though.
Parent's question isn't answered in the article - no figure is given for how many deaths under 30 there are as a baseline.
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.
The BBC article had that more comparable information: https://www.bbc.com/news/articles/c621z28z138o
> 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.
Out of curiosity, have there been any other advances in medicine that would make it less likely that women would die from cervical cancer before hitting 30? I don't keep up on oncology developments, but I assume that this particular shot is not the only thing that has reduced cervical cancer deaths in women under 30. If they were looking at rates of acquiring cancer, that would be more focused on this intervention.
I'm not a doctor and certainly not an oncologist.
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...
> 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?
Because cancer interventions have moved forward in general?
>From what risk level without them? How many people actually die of cervical cancer before age 30??
They will downplay that number or exaggerate it.
They?
I had no idea HN had so many cookers.