In the past, cervical cancer screening has been recommended starting at age 21 or within three years of a female's first sexual experience, whichever comes first. Now, the American College of Obstetricians and Gynecologists (ACOG) says women can start getting screened at the age of 21, regardless of when they began having sex, and that women older than 30 who have three consecutive normal Paps can get screened every three years instead of every year. ACOG also says some women can put screening on hold between ages 65 and 70, and that women with no history of abnormalities who have their cervix removed through hysterectomy can stop screening entirely.

Like the mammogram guidelines, these new Pap smear recommendations are meant to reduce the harm caused by false positives. But doctors say the risks of Pap smears are greater than those of mammograms — they often detect cervical lesions in young women that would go away on their own without ever progressing to cancer. Removing these lesions can damage the cervix and increase the chances of premature birth.

Dr. Cheryl B. Iglesia, chairwoman of the panel that developed the new Pap smear recommendations, calls their timing — coinciding with debates on mammograms and on healthcare reform overall — "an unfortunate perfect storm." And cervical cancer survivor Patricia Juirc told the Washington Post,

It seems a little bit of a week where women's health is taking a beating, considering the suggested guideline changes for mammography and all. Like they no longer want to be proactive and only see or treat us when we get sick.

But Cindy Pearson of the National Women's Health Network says,

There's something about health reform and guidelines that makes people think they're telling women to do less screening to save money. But we don't have any concerns that women are being asked to give up something that is helpful. These recommendations are sound.

And Thomas Herzog, a gynecological oncologist and spokesman for ACOG, adds, "in this case, if anything, we're taking money out of our own pockets." Part of the skepticism about screening guidelines is no doubt caused by fears surrounding the health care debate. But in part, these guidelines have been so controversial because they go against the prevailing medical culture. The Times's Kevin Sack writes,

For decades, the medical establishment, the government and the news media have preached the mantra of early detection, spending untold millions of dollars to spread the word. Now, the hypothesis that screening is vital to health and longevity is being turned on its head, with researchers asserting that mammograms and Pap smears can cause more harm than good for women of certain ages.

Are we about to see a shift in the way we think about our health, in which the benefits of early detection are weighed against the risks of detecting and treating something that never would have harmed us? This shift might be beneficial — especially if we believe ACOG — but it's not going to happen overnight. And a healthcare debate in which phrases like "death panel" get thrown around isn't going to make it happen any faster. In addition, the new Pap smear recommendations may seem strange to women who take birth control, given that doctors often require yearly Pap smears as a condition for such prescriptions. Girls and young women who want the Pill have long had to submit to screening before even the more conservative three-year recommendation, and the new guidelines are unlikely to change this practice. Beneficial as screening can be, using birth control as a carrot to lure women into the stirrups is a little paternalistic, and reflects an approach to women's health in which the women themselves don't have much power. This approach is evident in the debate over reproductive rights as well — over the years, so many people have tried to exert control over women's bodies that it's no wonder we've become a bit suspicious.

Cervical Cancer Screening Can Wait Till 21, Group Says [Washington Post]
Medical Science And Practice In Conflict [NYT]
Guidelines Push Back Age For Cervical Cancer Tests [NYT]

• On the heels of reports that Going Rogue confirms there was tension between Sarah Palin and John McCain's aides during the 2008 campaign, Ann Coulter says, "Wow, I hope she pays them back in this book, and I can't wait to read it. No, I mean, McCain — he was the media's favorite Republican. So, any criticism his side made of Palin was instantly printed, and now we finally get the payback. And I'm looking forward to it." • Palin will visit Fort Hood next month as part of her book tour for Going Rogue. She planned the visit before last week's shooting, and a representative from the base called her and said she should still make her planned appearance on December 4. • The British government has proposed a ban on people under the age of 18 using tanning beds to reduce the risk of young people developing skin cancer. It was reported today that in some areas of the U.K. up to half of all girls aged 15-17 are tanning, which doctors say significantly increases the risk of malignant melanoma. • In February, Jen Ivers will become the first female student to participate in the Mr. Yale contest. Ivers prefers to dress as a man, is openly gay, and doesn't identify as a man or a woman. Her residential college overwhelmingly voted for her to represent them, but initially the college rejected her application. Yale claims it was a miscommunication and a rep says, "It'll be really cool and unique to have her compete." • Scientists from the University of California tested the pain threshold of 25 women in various situations and found that they didn't hurt as much when their romantic partner was holding their hand, and experienced even less pain when just looking at his picture. Researchers say the person's picture brings up pleasant thoughts, but when they're actually in the room they may be upset that their partner is worried about them. They recommend patients bring loved ones' pictures to painful procedures. • Jill Berry, president of the Girls' Schools Association, says that schools should tell teenage girls that they don't need to beat themselves up if they decide to take time off from their future careers to raise children. ''They will need to realise that there may be times when they might not want to work, or they might want to take a lesser job because their priorities have changed. It is important that they leave school at 18 with their eyes open," she said. • Kirsty Moore, who became the first woman admitted to Britain's Royal Air Force display team, says she hopes her position will make girls "think that this is something they could be part of and they should go for it." • Caster Semenya says after the international controversy over her gender, "People want to stare at me now. They want to touch me. I'm supposed to be famous but I don't think I like it so much." • Oreo, the dog who was nursed back to health after her owner threw her off the roof of his six-floor Brooklyn apartment building, was killed today by lethal injection. After Oreo's owner was convicted of animal cruelty many people offered to adopt her and pay for her medical care, but the A.S.P.C.A. said she was a danger to the public because she was "unpredictably aggressive." Supporters had requested that the organization delay the euthanization and negotiate the dog's transfer to an animal sanctuary. • No African country has developed a program to give the cervical cancer vaccines to girls, even though 71,000 of the 500,000 who are diagnosed with cervical cancer every year are from Africa, and 78 percent of cases result in death. Professor Lutz Gissman, one of the researchers who discovered the virus said, "If you can persuade [African] girls to get a vaccine shot, the problem will be drastically reduced in the next 10, 20 years." • Police are hunting for a Brazilian blogger they say posted the names of 300 people who are cheating on their partner in the small rural town of Lagoa da Prata on Orkut. "This is not a very nice joke – for people to say that your boyfriend or your husband is a cuckold," says one woman whose boyfriend's name was on the list. "I don't really know what to say to people." • Police arrested a Florida man who repeatedly called 911 and made sexual comments to the dispatcher, asking to come to her house. There's a perfectly reasonable explanation: He told police that he'd run out of cell phone minutes and 911 was the only number he could call. •

• A recent poll found that Russians are the most snap-happy - and possibly the most vain - people in Europe. Russians are also more likely to post pictures of themselves online than any other group studied. • Several schools in the UK have halted HPV vaccination following the death of a young girl. Although officials say the vaccine is safe, the batch that was administered to Natalie Morton is under investigation. • The U.S. Food and Drug Administration has temporarily shelved the approval of Cervarix, another HPV vaccine marketed as an alternative to Gardasil. Officials state that this is unrelated to the recent death in Britain, but the vaccine is under review. • And in other cervical cancer news, a HPV vaccine will be available in Japan by year's end, according to a government panel. • The Detroit City Council are considering an amendment that would ban lap dances and require club workers to get certified for their positions. • Lawmakers across the pond have announced that starting today, police will have the power to ban anyone arrested for domestic violence from their home for up to 14 days. They hope that the new domestic violence protection orders - known as "go orders" - will give victims some much-needed "breathing space." • New research indicates that elderly men are more likely than elderly women to attempt suicide. Researchers also report that women who attempt suicide multiple times are likely to "complete suicide." • Maoist activists gathered on Thursday to protest the "Miss Nepal" pageant. "The contest is a forum where women are used by companies to popularize and sell their products," said protest leader Manu Humagain. "It is a blow to the dignity of the women. We oppose it." •

• And to make it even better, his tagline is "What? I like variety," which is an odd choice for the man notorious for sticking to his "type." Related: Hugh is finally getting a divorce. • The Australian government has announced plans to widen protection for women fleeing their home countries out of fear for possible genital mutilation and honor killings. Women at risk will now be covered by the "Refugees Convention." • Four women from Wisconsin have been charged with being party to felony false imprisonment after they held a 37-year-old man captive and super-glued his penis to his stomach as a twisted punishment for his philandering ways. The woman who did the gluing, Therese Ziemann, is also charged with misdemeanor fourth-degree sexual assault. • An increase in availability of sex-determination and sex-selection technology has lead to a huge disparity between the number of male and female babies born in Vietnam (112.1 male babies per 100 female babies). The U.N. says they fear the widening gap may lead to a greater demand for sex work, and increased gender-based violence. • Iranian video artist Shirin Neshat has premiered her first feature film about women's rights in 1953 Iran, titled "Women Without Men" at the Venice film festival. Neshat says that much of the material she explores in the film can be applied to the situation today in Iran. • Michelle Obama has given her support to a request from the Freshfarm Markets to close a section of Vermont Avenue for a weekly farmers' market. If the request goes through, the busy street would be blocked off every Thursday between 1 p.m. and 8 p.m. • 16-year-old Jessica Watson had hoped to become the youngest person to sail around the world, but just days before she was about to sail, she crashed her boat, the Pink Lady, into a 63,000-ton cargo carrier of the coast of Australia. • Lynndie England is suing writer Gary S. Winkler for seizing control of her biography, which she had hoped would help salvage her image. The book, Tortured: Lynndie England, Abu Ghraib and the Photographs That Shocked the World, is apparently not selling very well. "Nobody's getting rich here. I'm in the hole," said Winkler. • A Portuguese judge has banned further sales of a book written by a former policeman on the grounds that it hampers the search for Madeleine McCann. The book in question claims that McCann, who has been missing since May 2007, is dead. • In attempts to change his reputation as a "closed, brutal dictator," Iranian President Mahoud Ahmadinejad has already appointed one woman to his cabinet and is pushing for a second. However, women's rights activists recognize that the women appointed will probably not further their cause. "These women that Mr. Ahmadinejad selected are anti-woman," said Aida Qajar. • Attorneys for NFL player Ben Roethlisberger have rejected a "bizarre" offer to settle a lawsuit accusing Roethlisberger of rape. The so-called "bizarre" deal asks that the quarterback admit he raped Andrea McNulty and donate $100,000 to a women's advocacy group. Roethlisberger's lawyers claim her proposal "insults women who have legitimately suffered from sexual misconduct." Say what? • A panel of medical experts have voted to approve HPV vaccine Cervarix. The FDA will review the application and make a decision by September 29th. • According to a recent survey, one in every 33 women who regularly attend religious services has been the target of sexual advances by religious leader. • The Australian government said Wednesday that they are willing to allow women to serve in frontline combat units. American women are currently barred from combat roles. However, according to this article (and photograph) Australian women already serve on the frontline. • A British coroner failed to determine whether the LighterLife diet contributed to the death of 34-year-old bride-to-be Samantha Clowe. • IAAF spokesman Nick Davies said on Tuesday that even if Caster Semenya's gender tests show that she has had an "unfair advantage" due to a medical condition, she will most likely get to keep her gold medal. "This is not a doping case at present so it shouldn't be considered as one where you have a retroactive stripping of results," he explained. •

Yesterday, CDC and FDA researchers published an analysis of the side effects associated with the human papillomavirus vaccine - which has been linked to 32 deaths since 2006 - in the Journal of the American Medical Association (JAMA). As of June 1, 23 million doses of Gardasil have been distributed, and there was an average of 53.9 complaints filed with the government for every 100,000 vaccine doses, which ABC News reports is similar to the number of complaints filed for other vaccines.

Experts say the complaint data is limited because anyone can file one and the reports are not verified, but only 6.2 percent of the reported complaints were considered serious and lead to hospitalization, permanent disability or death. Compared to other vaccines, users of Gardasil were more likely to report fainting or blood clots, but the JAMA study showed 90 percent of the 56 women who reported developing blood clots had other risk factors like smoking, being overweight, or using oral contraceptives. "Although the number of serious adverse events is small and rare, they are real and cannot be overlooked or dismissed without disclosing the possibility to all other possible vaccine recipients," Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research Group at University of Missouri told ABC News, "The rate of serious adverse events is greater than the incidence rate of cervical cancer."

The FDA and CDC continue to recommend the vaccine for women ages 9 to 26, but now the consensus in the medical community is that doctors need to be more educated about the risk of cervical cancer and the vaccine's side effects. Dr. Joseph Zanga, chief of pediatrics at the Columbus Regional Healthcare system in Columbus, GA, told ABC News that HPV infections may clear up on their own and that routine pap smears are still the best prevention against cervical cancer. He added:

"Perhaps the most important, currently missing 'warning' is that the vaccine may not be forever... we know that it protects for 5-7 years so that a girl getting the series at [age] 11-12 will enter the time of her most likely sexual debut unprotected but believing herself to be."

But finding unbiased information on Gardasil's side effects may have been complicated by the vaccine's manufacturer. A separate article published in the Journal of the American Medical Association reported that at least three medical associations promoted the vaccine using money provided by Merck. The analysis of the pharmaceutical company's marketing techniques by Columbia University public health experts revealed that the American College Health Association, the American Society for Colopscopy and Cervical Pathology, and the Society of Gynecologic Oncologists used the same strategies as Merck to promote the vaccine and did always not disclose that they were accepting money from the company, The Washington Post reports. Merck and the three medical societies say it was not inappropriate for the groups to each accept about $200,000 to $300,000 from the drug company because they money funded education programs about the vaccine but didn't influence their content.

In the JAMA article the Columbia researchers say that the medical societies used arguments that were very similar to Merck's marketing approach, which downplayed the vaccine's potential side effects and overemphasized the threat of cervical cancer to adolescents. According to the American Cancer Society, 11,000 women in the U.S. develop cervical cancer every year, and 4,070 die from it, but USA Today reports that many of the deaths are among poor white women in Appalachia, black women in the South, and Latinas along the Texas-Mexico border. Since cervical cancer can be detected by regular pap smears, these women without access to medical care are most likely to die from it. Dr. Sheila Rothman, the article's co-author, wrote that Merck "practically ignored" these at risk groups, and focused instead on the message that all women are equally at risk, helping the company reach as many customers as possible.

A representative for Merck said that there are several programs that make the vaccine available to poor women, but the JAMA report says these facts were not emphasized in the medical society's marketing material, which often failed to mention that they received Merck funding. "It screeched the message, 'all women are at equal risk, protect yourself from cervical cancer, and this is the way to do it,'" said Rothman, "The fact that the medical societies repeated this message is what concerns us."

Gardasil HPV Vaccine Faces Safety Questions [ABC News]
Medical Groups Promoted HPV Vaccine Using Drug Company Money [The Washington Post]
Report: HPV Vaccine May Be Going To The Wrong Women [USA Today]

• Also, in a confusing statement, the Iranian state-run news network is claiming that an extreme Marxist group killed Neda because they thought she was a terrorist's sister. The network says the killers "thought that they were targeting one of the government opposition people, and that is why they immediately distributed the video of the aftermath of the killing through the official and unofficial media in order to reach their murderous objectives against the Iranian government and revolution." Right. • A strange ring of smoke recently appeared in the sky over an amusement park in Eastern Virginia. The UFO-like ring may have been caused by one of the rides, but it has yet to be fully explained. • Government officials in the UK have decided not to lower the screening age for cervical cancer from 25, because they say lowering the age could lead to too many false positive results. • The BBC has apologize after tennis player Elena Baltacha was heard screaming a four-letter word (starts with f) in frustration during her first round match at Wimbledon this week. After she won the match, Baltacha admitted that she felt rather "emotional," but she was always determined to win. • A woman from North Dakota has plead guilty to drunkenly feeding her six-week-old baby. She was charged with child neglect after giving her baby the breast milk cocktail (the original White Russian?), but she will not be forced to register as an offender against children. • "Bra banks" in the UK allow women to donate their unwanted bras, which are very difficult to recycle, to other women in need. There's even one at the Houses of Parliament. • A Connecticut church is drawing criticism after it posted footage on YouTube of a violent exorcism intended to drive a ''homosexual demon'' from the body of a 16-year-old boy. • Now that women make up 20% of the Air Force, more dads are staying home with their kids while moms fight in Iraq or Afghanistan. • A study has found that Girl Scout meetings can be an ideal place to teach healthy diet and exercise habits  hopefully this won't result in the Girl Scouts eliminating delicious Thin Mints. • Hollywood Madam Michelle Braun allegedly charged almost $50,000  far more than Heidi Fleiss  for a night with one of her escorts. But does the Daily Fail have to call them a "stable"? • According to a US News & World Report blogger, keeping money separate can help couples avoid conflict. • The newest demeaning and overgeneralized term to describe male behavior is "neosexual," which apparently refers to a guy who has "shrugged off the femininity of the metrosexual and returned to his more masculine, primitive roots." • Rainbow party alert! A study found that one in five teens engage in sexting, and one in four "knew someone who had a bad experience because of information posted on the Internet." •

This isn't the first time we've heard that pap smears may be on their way out, but the results of the study of 130,000 women in India have put "another nail in the coffin" for Pap smears, as Stanford professor of gynecology Dr. Paul D. Blumenthal puts it in The New York Times. Scientists say that the new test could replace cruder screening methods in poor countries and allow women over 30 in wealthy countries to drop annual Pap smears and have a DNA test once every 3, 5, or 10 years.

The new study divided healthy Indian women between the ages of 30 and 59 into four groups. One group got the usual rural care, which is just advice to go to a hospital if they wanted screening. Another group got a "visualization" test, typical in poorer countries, in which a health worker looks at the cervix with a flashlight and swabs it with vinegar. Any white spots that develop may be precancerous lesions, so they are frozen off. A third group got pap smears and the fourth got a DNA test. For both tests cells are scraped from the cervix, but for the Pap test the cells are examined by a pathologist in lab and the results take days, while the DNA test can be read by a machine within hours.

After eight years, the control group and the visualization group had the same rates of cervical cancer and death, while the Pap-smear group had three-fourths the rates. Women who had the DNA test had half the rates of cancer and death, but none of the women who were negative on their DNA test died of cervical cancer.

Qiagen, the company that makes the DNA test, has developed a $5 version for use in poor countries that runs on batteries and doesn't require water or refrigeration. If a woman was tested just once every ten years and her results were negative, the chances that she would develop cancer would be low. In countries where women are hesitant to get pelvic exams, doctors say they test would still work if the women took the vaginal swab themselves.

Currently in poorer countries cervical cancer kills more than 250,000 woman a year. In the U.S. the cancer was a leading cause of death in the 1950s, but now it kills fewer than 4,000 women a year. In Europe most women don't start having Pap smears until 30, but the American Cancer society currently recommends that woman start yearly testing three years after they have sex, or no later than 21. After several normal results they may start testing only every three years. There are 150 strains of the human papillomavirus and cervical cancer is caused by only a few. Women pick up strains when they start having sex but most cases clear up on their own in about two years, and it's rare that the cancer would develop in under 15 years.

In 2002, the cancer society and the American College of Obstretricians and Gynocologists began recommending the HPV test as well and there is increasing evidence that the Pap smear is no longer necessary. "But we haven't been able to get doctors to go along," Dr. Debbie Salsow of the American Cancer Society said. "The average gynecologist, especially the older ones, says, ‘Women come in for their Pap smear, and that's how we get them in here to get other care.' We're totally overscreening, but when you've been telling everyone for 40 years to get an annual Pap smear, it's hard to change."

[Image via morgueFile.]

DNA Test Outperforms Pap Smear [The New York Times]
Cervical Cancer: Prevention And Early Detection [The American Cancer Society]

Earlier: New Study Suggests Pap Smears May Be Thing Of The Past

Pharmaceutical company Merck has had a human papillomavirus vaccine for males in the works for some time and is currently seeking FDA approval for the vaccine. In women, HPV causes genital warts and can lead to cervical cancer, which about 10,000 women are diagnosed with each year. For men, the vaccine also prevents HPV, which can cause penile and anal cancer, and cancer of the mouth and throat. About 7,500 men are diagnosed with these cancers per year and vaccinating boys also helps prevent the spread of the virus to men's sexual partners.

Though there have been concerns raised about the safety of the vaccine for girls, the debate has centered mostly on whether being vaccinated against the STD would make girls more likely to have sex. Now that there is a male vaccine people are focusing on whether it's safe and cost effective to have boys vaccinated, especially when they can't get cervical cancer, reports The Washington Post. The prospect of boys sleeping around hasn't entered into the debate. "We are still more worried about the promiscuity of girls than the promiscuity of boys," said Susan M. Reverby, a professor of women's studies and medical history at Wellesley College. "There's still that double standard."

Since the male vaccine was proposed, people have wondered if parents would be willing to vaccinate their sons. "For girls, you can go right to protection against cervical cancer. That's a powerful argument," said Gregory D. Zimet, a professor of pediatrics and psychology at Indiana University. "For boys, you have to make several arguments. Part of it is an altruistic argument. I think it's persuasive, but it's more complex." Debbie Stein of Maryland says she would have her 11-year-old son vaccinated. "My feeling is it's a serious virus that causes cancer, and there's no reason not to vaccinate him," she said. "I think it will protect him and protect his wife in the future. I don't want to see him when he's 35 or 40 have a wife die of cancer."

Merck says they won't launch another big (and ultimately unsuccessful) push to have schools require boys be vaccinated like they did after the FDA approved Gardasil for girls in 2006. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices is currently examining the results of a study presented last month on the safety of the vaccine for boys. If the panel endorses it, that will influence whether schools require the shot, and if insurance companies will cover the costs.

In June the committee will consider several cost-benefit analysis, since the vaccine costs about $500 for three shots. Though vaccinating boys will reduce the amount of virus that is transmitted back to girls, some are questioning if it's worth it since boys are less affected by cancers associated with HPV. Professor Zimet says questions of cost shouldn't be what's driving public health policy. "This is a vaccine that principally benefits women's health. I wonder if it was the reverse, and there was a vaccine for women that helped prevent prostate cancer in men, this would be as much of an issue," he said.

A Vaccine Debate Once Focused on Sex Shifts as Boys Join the Target Market [The Washington Post]

Earlier: Drugmaker Seeks FDA Approval For Gardasil For Males
Gardasil For Guys: Will Boys Get It?

I have been aware of Jade Goody for some time now; she was all over the British tabloids in 2002 when my fiance was living overseas, and when I went to visit, her face seemed to be everywhere. I assumed, at the time, that she was a singer or actress of sorts. My fiance informed me that she was "just some girl from Big Brother," a show that never quite took off in the States as much as it had in England.

A few years later, in 2007, Jade came under fire for making racist remarks toward her Celebrity Big Brother castmate, Shilpa Shetty. Stuart Jeffries of the Guardian notes that Goody quickly became reviled for her behavior: "The People had already branded the 20-year-old "Miss Piggy" on account of her appearance, and ran headlines such as "Ditch the witch" and "Gobby Jade is public enemy no 1". For a moment, it seemed that a vulnerable and evidently poorly educated woman was going to be lynched – certainly figuratively – for the 21st-century crimes of being dim, mouthy and libidinous on a reality show."

A year later, Jade appeared on yet another reality show, Bigg Boss, an Indian version of Big Brother, wherein she discovered that she was battling cervical cancer, and that the cancer had spread. She left the reality show and became the star of her own strange saga, a reality show based purely in reality itself; she was dying, and the tabloids were invited to document every moment. An OK! magazine tribute cover was published weeks before Goody actually died, a bizarre testament to the coverage surrounding Goody, which seemed to be a countdown to getting the scoop of her actual death, rather than a celebration of her actual life.

Perhaps this is because Jade Goody filled the role of reality TV star to the extreme: she was "famous for nothing," she once said, a woman who went from obscurity to a national sensation due to the public's desire to create heroines and villains out of their neighbors, their peers, people who look and act quite like they do. Her short life was defined by public opinion; she was loved, then fiercely hated, and then pitied, but all of these things came through a lens, a distanced view; she was simply another character for the public to follow, and she knew and seemingly accepted this, giving her blessing to the tabloids to follow her until the very end. As Jeffries notes, "Like a working-class Princess Diana, Goody became the object of strangers' intense feelings, and she became a sacrifice, a woman whose suffering and death made it possible for people to ritually cry for someone they scarcely knew."

Goody hoped that her public struggle would raise awareness about cervical cancer and inspire young women to be more proactive about their health. But Goody's legacy may be her ability to use the reality tv/tabloid media to her advantage, even in dark times: for example, she recently held an elaborate wedding to her prisoner boyfriend, Jack Tweed, in order to sell the media rights and leave her sons with a substantial amount of money, knowing she'd be leaving them soon. Jade Goody was able to make a living out of living; as long as there was a camera present, and a photographer ready to chase her every move, she was able to capture the minds of millions, for better or worse. She forced the public, however unwittingly, to discuss racism, the challenges of cancer, and ultimately, the boundaries of fame.

"It's easier sometimes for me to deal with bigger things in the public eye," Goody once said. One wonders how that life will be remembered, if the public will take any lessons from her death, or if, as the world of reality tv often seems to move, the public's eye is already on the lookout for the next heroine, the next villain, the next star in the never-ending tabloid show.

Obituary: Jade Goody [The Guardian]
Jade Goody and her Big Mouth: Quotes From Her Life [Telegraph]

In fact, when compared to other vaccines, those receiving Gardasil shots reported fewer "serious adverse events." The Journal reports that 6% of Gardasil complaints were "serious," while "most vaccines have reported serious adverse events rates between 10% and 15%."

Even with these findings, immigrant advocates are still not happy that immigrant women between the ages of 11-26 are required to get the Gardasil shot before receiving their green cards. As we reported earlier, the expense of this shot is a serious barrier, and the L.A. Times reported yesterday that some experts think the shot could be fairly ineffective. "Many women will very likely get this only for the purpose of the visa," according to Kate Bourne of the International Women's Health Coalition. "Quite likely they will be at the upper end of the age range, which means they are more likely to already be sexually active, and this vaccine is useless to them." The only group of women and girls required to get the Gardasil vaccine beyond immigrants is residents of the state of Virginia, because as we all know, Virginia IS for lovers, despite what Nancy Pfotenhauer says.

Side Effects Not Linked To Gardasil [WSJ]
Immigrants' Advocates Decry Cervical Cancer Vaccine Order [LAT]

Earlier: Experts Question The Cost Effectiveness Of HPV Vaccine
Experts Appalled At Gardasil Requirement For Immigrant Women

The CDC says they were unaware of this consequence, and Dr. Jon Abramson, head of the CDC's Advisory Committee for Immunization Practices, tells the Journal, "If we had known about it, we would have said it's not a good idea…We don't want someone coming into the U.S. who hasn't been vaccinated against measles or chickenpox, [but] HPV can only be communicated by sexual contact…This is not something that endangers kids in a school setting or puts your population at risk."

Even Merck, the company that manufactures Gardasil and has been accused of overly aggressive lobbying tactics, isn't particularly fond of the requirement. A spokesperson for Merck tells the Journal, "We were not aware of the policy and we did not lobby for this provision in any way." In addition, Gardasil has encountered its fair share of controversy over its efficacy and potential side-effects since becoming widely recommended. The National Association of Pacific American Women's Forum's Priscilla Huang likened the Gardasil requirement to using immigrants as "test subjects" because the research on the vaccine is thought to be incomplete by some. (And with rumored disturbing side-effects.)

Requiring the vaccine  one of the priciest on the market  could cost immigrants as much as $360, and in addition to the $500 or more new United States residents must spend on application fees, the cost is pretty prohibitive. Immigration advocate Tuyet Duong says the requirement "is outrageous; it's creating an economic barrier." The Journal was hard-pressed to find anyone who resoundingly supported forcing immigrants to get the vaccine, and it notes that 'a government official said the cervical vaccine's inclusion on the list might be reviewed." Your bureaucracy at work!

UPDATE: A tipster who works in immigration law writes in: "To make your story even a little worse, the fee for a green card application is $1010. It more than doubled in the summer of 2007. (It is $600 if you are under age 14.) This is not counting the costs of the medical exam, including the vaccines, which must be paid to the doctor in cash."

U.S. Requiring Controversial Vaccine [The Street]
Gardasil Requirement for Immigrants Stirs Backlash [WSJ]

Earlier: Experts Question The Cost Effectiveness Of HPV Vaccine

• The creator of 'For Better or Worse,' the long-running comic strip, has announced that the comic strip will travel back 30 years in the past to the time when the strip first began. • Cambridge University is soliciting the producers of popular British soap operas, asking that the school be included in story-lines to help shed the University's snobby image. • Female police officers in the English county of Cumbria now have the option of wearing specially-designed maternity uniforms if they become pregnant. • Last Thursday, the British Columbia Court of Appeal ruled against the assertion that "bubble zones" around abortion clinics — where anti-choice activists harass women entering the clinics — are an infringement on free speech. • Australia has just sworn in its first female governor general (the Queen's representative to Australia), Quentin Bryce. • More firsts for women in Europe: Two women have become the first women to pass Vienna's Spanish Riding School's entrance exam to ride the famous Vienna dancing horses. • The LPGA Tour decided today to banish rules that suspend players who cannot speak English well enough to be understood at pro-ams, in interviews or in making acceptance speeches. • Male Maasai warriors in Kenya who travel to the tourist town of Mombasa to marry white women or find jobs to provide for their community sometimes work as hairdressers, a large cultural taboo. • Disgraced Olympic track star Marion Jones was released from prison today after serving a six-month sentence for lying to federal prosecutors about performance-enhancement drug use. • A new book titled Why Men Die First says that men die earlier than women because they are "more fragile and inherently vulnerable than females" which means they have to visit the doctor often if they want to live long lives. •

Yesterday, an article in the New York Times pointed out that there is a finite amount of funds available in countries that provide universal healthcare, and that shelling out vast sums of cash for a drug whose efficacy is still in question is potentially bad policy. "Some of our provinces are running out of money to provide primary care," Dr. Abby Lippman, a professor at McGill University told the Times. "I'm not against vaccines, but in Canada and the U.S., women are not dying in the streets of cervical cancer."

However, the Times also notes that, "giving the vaccine to 12-year-olds would cost $43,600 for every 'quality adjusted year of life' it saved by preventing a cancer death; that price would often be considered acceptable by health officials in wealthy countries, experts say."

In the end, it appears that researchers need more time to analyze the cost and effects of HPV vaccines before making any sort of definitive statement about them. If you've already received the shots, there's no real evidence that they're destructive, so don't freak out, Chicken Littles. If you haven't had the shot, keep following the research as it emerges, and always ask your doctor as many questions as you need or want to.

Researchers Question Wide Use of HPV Vaccines [NYT]
Drug Makers’ Push Leads To Cancer Vaccines’ Rise [NYT]
Adult Cancer Shot May Not Be Worth High Price [AP via MSNBC]

Earlier: Sore Subjects