In the news race to report CDC’s numbers on HPV infection rates, some important context was missing

HPV infection rates

A vial of the vaccine Gardasil, for protection against certain HPV strains. Photo credit

Most teens aren’t getting vaccinated for the human papillomavirus (HPV), putting them at higher risk for cancer when they become sexually active.

That’s a serious problem. But news coverage shouldn’t inflate that risk in conveying the message that parents and doctors need to act.

That’s what happened with HPV prevalence data released on April 6th by the CDC. As journalists raced to report the findings that same day, along with the CDC’s pro-vaccination message, some important context was missing or underplayed.

As a result, news consumers might have been a bit more alarmed than they needed to be.

Three messages were obscured in the coverage:

1. There are many HPV strains, and only some of them are linked to an increased risk of certain cancers. All the stories we looked at focused on high genital HPV infection rates. But some headlines and leads reported overall infection rates for all 37 HPV strains that were checked, while others more appropriately focused on infection rates involving only the 14 strains of HPV that increase cancer risk. That resulted in a confusing dichotomy, where some headlines read like this:

While others proclaimed a more alarming message:

2. Most infections clear up quickly. Most coverage downplayed the key fact that HPV has a very high “clearance rate” compared with other sexually transmitted diseases. In other words, 90% of HPV infections, including those linked to cancer, go away on their own within a couple of years and most cause no symptoms. Out of nine news stories we looked at, three didn’t report that information. The remainder reported it in the fourth, sixth or eighth paragraph.

3. Only a tiny fraction of infections turn into cancer. A minority of news outlets informed readers of the actual number of U.S. cancers estimated to be caused by HPV — 30,700 annually. That figure is far lower than the number of people infected with HPV strains linked to cancer, which is somewhere on the order of 50 million at any given time. By our very rough calculation, 1 in 1,600 people infected with a “high risk” HPV strain will actually develop a related cancer.

“Data sheet” lacked essential context

To be fair to journalists, the CDC didn’t help matters. Journalists were notified of a “data sheet” published by the CDC’s National Center for Health Statistics and offered interviews with the lead author. On its own, the document didn’t do a great job of pointing journalists to the most relevant data.

Its “key findings” include both overall infection rates and what it calls “high risk” prevalence rates and mentions the overall rates first. That could confuse journalists who aren’t familiar with HPV and are seeking out the most dramatic numbers.

“With HPV, the high risk (‘cancer causing’) types are most concerning epidemiologically,” said Dr. Preeti Malani, a contributor and University of Michigan medical school professor who has worked as a journalist, via email. “I don’t see a good reason for (reporting) the ‘nearly half’ other than to be alarmist.”

The data sheet also doesn’t mention HPV’s high clearance rate or the number of cancer cases linked to HPV. Reporters had to either know that information already or hunt for it elsewhere on the CDC’s web site.

Some coverage conveyed the nuances

Several news outlets did a good job of injecting the proper context. For example, the Washington Post in its sixth paragraph mentioned the actual number of cancers and stated: “The CDC estimates that nearly 80 million people are infected and that about 14 million new infections occur annually among teenagers and adults. Most of these go away on their own, typically without even causing symptoms, but some HPV strains can lead to genital warts and cancer.”

But others fumbled. Notably, HealthDay gave readers an inflated picture of the risk with a lead stating that “nearly half of American men and women under 60 are infected with (HPV), putting them at risk for certain cancers.”

Readers need to keep in mind that breaking news stories aren’t always as polished as they could be. That’s especially true with complex topics like HPV.

“I have no doubt that some of the news coverage of the CDC data brief induced some panic,” Nick Mulcahy, a medical journalist with more than 20 years of experience, wrote in an email. “Unless you understand HPV and immune response, then you walk away from some of these reports saying, ‘Geez, HPV infection is out of control!’”

Mulcahy tweeted about HPV’s high clearance rate being “buried” in the New York Times coverage. Still, he credits the Times with including that information.

“Any committed reporter given enough time would have eventually come across the fact of a 90% HPV clearance rate,” Mulcahy wrote. “The BIGGER problem here is the rush with which so much reporting is done. That is the biggest enemy of accuracy and thoroughness.”

In this case, hyping the high prevalence rate of HPV may have scared some people into believing their cancer risk is higher than it actually is. Still, there could be an upside to reporting that HPV is incredibly common, with proper context.

Fred Wyand, a spokesman for the American Sexual Health Association and the National Cervical Cancer Coalition, said it’s important for news reports to discuss the “near-ubiquitous nature of HPV,” as many experts believe 75 percent or more of sexually active people have one or more HPV infections in their lifetime.

“Pointing out the prevalence tends to lessen the stigma, since the virus truly cuts across every demographic,” he said via email. “Of course, it’s important to emphasize that the vast majority of HPV infections are harmless and clear naturally.”

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