''I wouldn't accept much risk of side effects at all in an 11-year-old girl, because if she gets screened when she's older, she'll never get cervical cancer,'' Dr. Haug said in an interview. ''You don't have to die from cervical cancer if you have access to health care.''
Did you read that quote?
If she gets screened.
If you have access to health care. What is the frequency of screening needed, and what happens if she ends up with the HPV virus in between?
You're right. That's a pretty big "if". In the UK, about 75% of those invited for a pap test in 2011-12 actually got tested:
http://www.cancerscreening.nhs.uk/cervical/statistics.html and the CDC has a graph for the USA (for 2000, 2003, 2005, 2008):
http://www.cdc.gov/cancer/cervical/statistics/screening.htm showing similar rates for women over 18 who've had a test in the last three years.
Here's an interesting thing about screening that Clayton might like to ponder...
I looked up the sensitivity of cervical screening. Wiki reckons it's 72% for the conventional pap test and 61-66% for the liquid-based cytology test:
http://en.wikipedia.org/wiki/Cervical_screening The cancer.gov website:
http://www.cancer.gov/cancertopics/pdq/screening/cervical/HealthProfessional/page2#Section_54 says this: "In practice, ASCUS is often used as the test threshold, and CIN 1 is often used as the reference threshold. This combination gives a sensitivity of about 68% and a specificity of about 75%. A more appropriate test threshold may be LSIL, with a reference threshold of CIN 2–3. This combination gives a sensitivity of 70% to 80%, with a specificity of about 95%."
So, at best, the sensitivity of the test is 70-80%. I reckon that means that twenty to thirty percent of those tested who should test positive will actually get a false negative. This paper in Nature says that testing for HPV has been proposed:
http://www.nature.com/nrc/journal/v7/n12/full/nrc2287.html due to the sensitivity of the Pap smear being low. The wiki page on cervical screening gives sensitivity of 88% to 91% (for detecting CIN 3 or higher) to 97% (for detecting CIN2+) for HPV testing.
I'm not sure why Professor Haug said that "if she gets screened when she's older, she'll never get cervical cancer", because those people who get false negatives won't be treated unless / until they have a subsequent positive pap test.
http://www.cdc.gov/cancer/cervical/statistics/ says that there has been a decline in deaths from cervical cancer thanks to pap tests and subsequent treatment. However, there were still over 12,000 cases in 2008 and 4,000 deaths.
So there are two problems with the proposal that screening offers perfect protection - there are those people who don't get screened and those people who have false negative tests.
(There's actually another problem with screening re the specificity of the test - women with false positives may be unnecessarily treated. In fact, there's another issue that isn't touched on by those who say that screening renders the vaccine unnecessary - although treatment following testing is low risk it is not entirely without risk. E.g. for cryosurgery:
http://en.wikipedia.org/wiki/Cryosurgery#Results - "as with any medical treatment, there are risks involved, primarily that of damage to nearby healthy tissue. Damage to nerve tissue is of particular concern.")
Nothing is perfect - not the vaccine, not pap screening and not the treatments. The actual risks and actual benefits of each intervention have to be weighed up, it's no good pretending that one is perfect and that this makes another unnecessary. The vaccine (good, but imperfect protection) doesn't make pap screening redundant and nor does pap screening & treatment (both good, but neither perfect) make the vaccine redundant.