Smoking and cervical cancer: cause or coincidence?

Article Abstract:

Researchers agree that women who smoke cigarettes are more likely to develop cervical neoplasia (tumor or abnormal tissue growth) than are nonsmokers. Recent evidence of the presence of high levels of nicotine and cotinine in the cervical mucus of smokers suggests that carcinogenic substances from cigarette smoke might be concentrated in the cervix and play a direct role in the development of cervical cancer. However, even well-designed studies that associate cigarette smoking and cervical cancer are confounded by the extraneous differences that exist between smokers and nonsmokers with respect to exposure to other risk factors for cervical cancer (e.g., sexual activity). It is widely assumed that the most important cause of cervical cancer is a sexually transmitted infectious agent known as human papillomavirus. Furthermore, as a group, women who smoke tend to be more sexually active than women who do not smoke, and therefore may be exposed to a variety of sexually transmitted diseases, including the causal agent for cervical neoplasia. Since this agent has not been unequivocally identified, however, it is not possible to control for differences in exposure to the causal agent between smokers and nonsmokers. The resolution of the causality of the association of passive and active cigarette smoking and cervical cancer may have to await identification of the sexually transmitted infectious agent that appears to be the most important factor leading to cervical cancer. Although much about the origins of cervical cancer is not clear, it is clear that women should quit smoking cigarettes for many reasons other than a possible increased risk of cervical cancer. Evidence is also accumulating that passive exposure to smoke of other people's cigarettes is harmful to both children and adults.

Health aspects, Causes of, Physiological aspects, Cervical cancer, Cancer, Tobacco, Passive smoking, editorial

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Recommendations of the Immunization Practices Advisory Committee pneumococcal polysaccharide vaccine

Article Abstract:

Pneumonia caused by the organism Streptococcus pneumoniae, a particular strain of Streptococcus, remains an important cause of illness and death among the very young, the elderly, and people with compromised immune systems. Pneumococcal pneumonia is estimated to be responsible for between 10 and 25 percent of the 40,000 annual pneumonia deaths in the U.S. Data from Great Britain suggests that 34 percent of all cases of pneumonia that require hospitalization are caused by the pneumococcal organism. Recent studies suggest that pneumococcal bacterial infection of the blood (bacteremia) affects between 15 and 50 individuals for every 100,000, depending upon the particular risk group. The rate of bacteremia in some Native American populations may even be as great as 6 times that in the general population. An evaluation of the current pneumococcal vaccine has resulted in some changes of strategy and guidelines for immunization. Adults who should be immunized include: individuals with chronic illness (e.g., diabetes, alcoholism, cerebrospinal fluid leaks, cardiovascular disease), adults who have compromised immune systems (e.g.,splenic dysfunction, lymphoma, etc.), and individuals infected with the AIDS virus (i.e., those who test positive for HIV, the human immunodeficiency virus). Children under two with specific chronic illness and children over two who have infection should also be immunized. While approximately half the inoculated individuals have minor reactions, such as redness at injection site, fewer than 1 percent of injected individuals have a severe systemic reaction to inoculation. Although the best time for revaccination is not clear, current opinion suggests that revaccination be considered on an individual basis between 3 and 5 years after the primary inoculation.

Planning, Evaluation, Product/Service Evaluation, Prevention, Pneumonia, Pneumococcal, Pneumococcal pneumonia, column, Pneumovax 23 (Vaccine)

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Vaccines and risks: the responsibility of the media, scientists, and clinicians

Article Abstract:

Journalists, scientists and physicians all have a responsibility to inform the public about the health risks present in the environment. A 1996 report stated that erroneous reporting of the adverse effects of vaccines may scare many parents and prevent them from vaccinating their children. Writers need to discover what the expert consensus is and report only valid studies. Scientists need to defend their studies and physicians need to tell patients that every action involves risk of some kind. An open and honest attitude can build an atmosphere of trust among the public.

Editorial, Children, Medical research, Vaccination of children, Media coverage

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