Critical Values - January 2009 - (Page 27) Volume 2 • Issue 1 • January 2009 Content provider: CDC/ Judy Schmidt, Photo by James Gathany The data say the available HPV vaccine is terrific. The current major barrier is cost, and the secondary barrier is abundant misinformation about side effects that don’t exist. Unfortunately, a strong anti-vaccine lobby in this country does not believe in vaccines in general. Their impact seems to be slowing adoption of the HPV vaccine. Every analysis has shown that the vaccine is both safe and costeffective, particularly for 11- and 12-year-olds. The real long-term systematic process will eventually be similar to the experience with Hepatitis B and other childhood immunizations: The child is immunized, and the adult is protected for life. Eventually adults will not even be considered for vaccination, because all the adults will have been vaccinated as young adolescents. Still, that will be a 5to 10-year transition or more to become a reality. Q. What will be the impact on the profession of cytotechnology? A. There are going to be many retirements, but people will still be needed to do 30 million tests (as opposed to 60–70 million) for quite a while. Then the number of tests being done will decline even more, and that’s the problem—how to attract people to a field clearly perceived to be on the decline? Most cytotechnologists in this country do nothing but screen Pap smears. In my opinion we would not need to do as many Pap tests as we do even today if we screened more effectively. It’s just the unfortunate reality. If the whole country were doing half as many Pap smears, a smaller workforce would be needed. The average age of technologists is “older” and many are retiring, so there is a need for a supply of people to do the existing work. It’s delicate and problematic. At the end of the day, does the workforce need to be the same size? Probably not. I’m not about lying to cytotechnologists. I’m about informing them and saying that we all have to make plans. Q. What would you say to cytotechnologists? A. You’re smart, educated, and essentially master’s-prepared people. You can do a lot of things. If you’re in a laboratory that has a large medical, non-GYN volume, you can do that. You can also get involved with molecular pathology, as well as other areas of the laboratory. You can get involved with management. You can do lots of things besides looking at Pap smears. Some proportion of you will be looking at Pap smears for one to two more decades. Will it be the same number as we need today? I don’t think so. Time will tell. Dr. Stoler is Professor of Pathology, Cytology and Gynecology, and Associate Director of Surgical Pathology and Cytopathology at the University of Virginia Health System in Charlottesville, VA. 27
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