skifan08 said... "To assert that being infected with a mutagenic strain other than 16, or 18 makes vaccination useless is a bit of an exaggeration."
that's not what I said. that's your interpretation of what I said. I said 'not necessary or useful' to someone who suggested that all sexually active individuals be vaccinated with Gardasil.
Scientists have linked 8 human papillomavirus (HPV) strains to over 90 percent of the cases of cervical cancer. (By extension, these same eight are responsible for most anal cancers) This information is the result of examining 60 years worth of data that involved 10,575 cases of cervical cancer in 38 countries. In descending order of frequency, strains 16, 18, 45, 33, 31, 52, 58, and 35 have been linked to that majority of cases of cervical cancer.
when I said 'not necessary or useful'... that was an accurate statement. it depends on the individual's previous sexuaI exposures. i then suggested that every sexually active adult considering vaccination with Gardasil should have an anal PAP smear before Gardasil use to ensure that the cost is justified... another true statement. I'll point out again that if you are infected with ANY high-risk HPV other than the two Gardasil protects against (types 16 and 18 ) AND you already have the process of dysplasia underway (determined by the PAP I suggest you get), then vaccination with Gardasil won't necessarily protect against anal cancer as the other high-risk HPVs are already causing neoplasia. While you can still get protection against the two low-risk (i.e. wart) viruses that Gardasil protects against (types 6 and 11), it's hard to justify for two reasons.... first it is a rare gay man (or human for that matter) that doesn't have a few wart viruses already (yes, in their anal canal and yes even if they don't bottom... it's a 'field' effect) and second wart viruses don't cause cancer... they are a nuisance but not the 'danger' that the high-risk viruses are.
Unfortunately, everything in medicine comes down to risk and money. As an ASCCP certified anal health specialist who has done over 300 high-resolution anoscopies, biopsies and IRCs, I will suggest again that 'random' use of Gardasil is not smart. Getting an anal PAP smear to perform cytological analysis on cells from the squamocolumnar junction of the anus and to determine the population of viruses you are infected with is the appropriate starting point for a well informed discussion with your care provider.
If you want to discuss wholesale vaccination of youth who aren't sexually active yet, that's a different talk show.