Public Forum on Cervical Cancer in CTA1

[alfred98]

Hi guys ans girls...I'm organizing a public forum on the 10/02/2007 at 1.00pm to 2.00pm in Crystal Hotel, CTA1.......anyone interested are welcome to join.....
Anyone with questions will be entertained by me for the forumer..

[TK Ho]

Hi guys ans girls...I'm organizing a public forum on the 10/02/2007 at 1.00pm to 2.00pm in Crystal Hotel, CTA1.......anyone interested are welcome to join.....
Anyone with questions will be entertained by me for the forumer..

Wah loctor, doing advertisement-kah? :p . Joking-nia

It is good to educate the public by the qualified loctor. We cannot stress how important the screening test is.

[alfred98]

Wah loctor, doing advertisement-kah? :p . Joking-nia

It is good to educate the public by the qualified loctor. We cannot stress how important the screening test is.

Some sort lah.......Mostly on the HPV vaccine lor!!!:)

[justin hong]

Good job there Doc.

[Dino]

What language is the presentation in?:rolleyes:

[Oddfather]

What language is the presentation in?:rolleyes:

if in hockchew, I will attend. Have to brush up my hockchew these days. :rolleyes: :p

[petertok]

wow... on HPV virus? New vaccine ah?

I thought cervical cancer diagnosis are mostly pap smear tests or to use table vinegar to detect HPV presence if the tissue turns white?

Hmm.. kinda interesting... fyi, i did a research proposal abt relationship between smoking and cervical cancer among women in jakarta so read a lil bit abt the disease during literature study...

anyhow, what kind of audience will be expected to be attending the forum? is it intended for public or just a forum like CME for health practitioners?

[Sila]

i've been hearing about HPV vaccine through TV ads here, doctor alf. unfortunately i won't be able to attend the public forum in CTA1 but i'm glad you're organizing it. i've been meaning to research this myself.. :)

maybe after the forum you can run a little virtal forum within this forum for questions we may have?

[alfred98]

What language is the presentation in?
In english and mandarin......lor...
if in hockchew, I will attend. Have to brush up my hockchew these days.
I will invite U to translate to hokkien....
wow... on HPV virus? New vaccine ah?

I thought cervical cancer diagnosis are mostly pap smear tests or to use table vinegar to detect HPV presence if the tissue turns white?

Hmm.. kinda interesting... fyi, i did a research proposal abt relationship between smoking and cervical cancer among women in jakarta so read a lil bit abt the disease during literature study...

anyhow, what kind of audience will be expected to be attending the forum? is it intended for public or just a forum like CME for health practitioners?
Public forum means for public lah.......dey!!
Smoking and relationship with cervical cancer is being proven long long time liao......Probably study about the prevalence of cervical cancer among sex worker!!!:laugh: :blink:
i've been hearing about HPV vaccine through TV ads here, doctor alf. unfortunately i won't be able to attend the public forum in CTA1 but i'm glad you're organizing it. i've been meaning to research this myself.. :)

maybe after the forum you can run a little virtal forum within this forum for questions we may have?

Ok!! What U wanna ask??:noworry:

[Kim]

doctor, i have a questions on pap smear....
is it true that virgins are not allowed to take this test??

[SS2006]

In english and mandarin......lor...



:

Doc Alf, you can speak mandarin meh?:p

[alfred98]

doctor, i have a questions on pap smear....
is it true that virgins are not allowed to take this test??

Not say not allow but for what lor.....Pap smear for sexually active ladies to detect precancerous conditions in view of treating it mah!!!
Doc Alf, you can speak mandarin meh?:p

Bolehlah sikit sikit!!!:laugh:

[Oddfather]

doctor, i have a questions on pap smear....
is it true that virgins are not allowed to take this test??

:eek: why are you asking??:o

[laineyee]

Not say not allow but for what lor.....Pap smear for sexually active ladies to detect precancerous conditions in view of treating it mah!!!


Bolehlah sikit sikit!!!:laugh:

:blink: don't understand, ok.. loctor, stupid q coming up..

then if virgins, can't detect the precancerous conditions izzit?
so only someone who is sexually active can get cervical cancer :blink: ?

[alfred98]

:blink: don't understand, ok.. loctor, stupid q coming up..

then if virgins, can't detect the precancerous conditions izzit?
so only someone who is sexually active can get cervical cancer :blink: ?

Aiyoh!! Not sexually active no need to do lor....simple!!
Sexually active need lor.....Because 90% of the cervical cancer are cause by HPV virus which are a sexually transmitted mostly!!!:)

[Dino]

Errrr....if couple are monogamous....still need to do ah? :squeeze: :p

[alfred98]

Errrr....if couple are monogamous....still need to do ah? :squeeze: :p

Yes!!!!

[Kim]

:eek: why are you asking??:o

coz i've been hearing different point of views from different ppl...
just want to clarify lor....
what are u thinking le, oddf??

[Oddfather]

coz i've been hearing different point of views from different ppl...
just want to clarify lor....
what are u thinking le, oddf??

juz asking a innocent question. :rolleyes:

[Kim]

juz asking a innocent question. :rolleyes:

oh? i tot there's nothing innocent where it comes to oddf??:eek: :p

[Oddfather]

oh? i tot there's nothing innocent where it comes to oddf??:eek: :p

hey, I am an innocent old man laaa......:p

[Kim]

hey, I am an innocent old man laaa......:p

dont tipu little girl la....:rolleyes: :smile-2:

[Fishingman]

Wah! Respek man loktor Alfred.

[petertok]

ciss... relationship between smoking and cc proven but lately got studies that proves otherwise ma... so i wanna conduct case control study cannot issit!! =(

so dr alfred, if u wanna show public abt hpv and cc in sex workers.. issit some sort like anti aids punya campaign? to advise not to have multiple partners? but i thought u say wanna intro that hpv vaccine?...

hmm... yalor... organize mini forum here la.. we're public also ma :P

[PreciousPearl]

Lokto Alf, can i pls ask if there is any causal link btw prevalence of cc and female sexual activity from a young age, or is the link simply that of a high level of sexual activity irrespective of age? a couple of my friends have had treatment for early stages of HPV infection but their GPs were not very clear on the above.

[TK Ho]

doctor, i have a questions on pap smear....
is it true that virgins are not allowed to take this test??

Once taken the test, they are no longer 'virgin' :D

[cucuan]

juz asking a innocent question. :rolleyes:

innocent question from not so innocent person:eek:

cucuan

[Oddfather]

innocent question from not so innocent person:eek:

cucuan

:eek: :wacko: :wacko:

[alfred98]

ciss... relationship between smoking and cc proven but lately got studies that proves otherwise ma... so i wanna conduct case control study cannot issit!! =(

so dr alfred, if u wanna show public abt hpv and cc in sex workers.. issit some sort like anti aids punya campaign? to advise not to have multiple partners? but i thought u say wanna intro that hpv vaccine?...

hmm... yalor... organize mini forum here la.. we're public also ma :P

Smoking are associated with western culture expecially in female.....smoking also associated with so many cancer expecially cancer of lung......nicotine is a carcinogen so is associated with any cancer in the body depends which one get it first....Not say cannot do CCS!! But ok lah do lah.....

Lokto Alf, can i pls ask if there is any causal link btw prevalence of cc and female sexual activity from a young age, or is the link simply that of a high level of sexual activity irrespective of age? a couple of my friends have had treatment for early stages of HPV infection but their GPs were not very clear on the above.

CC=sexual activity ...........So the earlier U start the higher the changes lor.......Please don't tell me that asian are conservative so lower risk of CC......the trend is towards what the westerner is having now....so in 10 to 20 years if asian don't do anything about prevention or regular pap smear then prevalence of cancer cervix is veri veri high... The gahments are not going to start this National cancer prevention as they are veri busy with others like.....making money for then self.....

Once taken the test, they are no longer 'virgin' :D

So doing PR can lah!!!!:laugh:

[SS2006]

ciss... relationship between smoking and cc proven but lately got studies that proves otherwise ma... so i wanna conduct case control study cannot issit!! =(

so dr alfred, if u wanna show public abt hpv and cc in sex workers.. issit some sort like anti aids punya campaign? to advise not to have multiple partners? but i thought u say wanna intro that hpv vaccine?...

hmm... yalor... organize mini forum here la.. we're public also ma :P

Petertok, since you're back in S'wan, why don't you attend Doc Alfred's forum?

[siewjang]

Co-incident one of my doctor friend was talking to me on HVP Vaccine. Can tell us more about it? With this vaccine coming up i think Women's PA insurance can close shop liao. hehe...

psstt.... loctor, got discount or not ah for my daughter?

[Zazu]

loctor, which wan is better Gardasil or Cervarix?

[Lava Gal]

aiya...u all ah. loctor advertizing for his forum...u all pulak bombarding him wif Qs here itself, then wats left on the real day. come & support him ler :p

Hi guys ans girls...I'm organizing a public forum on the 10/02/2007 at 1.00pm to 2.00pm in Crystal Hotel, CTA1.......anyone interested are welcome to join.....
Anyone with questions will be entertained by me for the forumer..
loctor...its a sat rite? i will be 'home' for almost whole of feb :D though the 'mission' is study-like-there's-no-tomolow...but since now i know wat to study (portfolio based for exit viva), and have roughly dedicated one day per portfolio...guess i can spare that sat & come support u :)

if need any help, jus gimme a buzz k, doctor! i'd be more than happy to help u out, boss...

Petertok, since you're back in S'wan, why don't you attend Doc Alfred's forum?
eh pete...u in s'wan ah? come la...maybe can meet u in person, FINALLY!!!

p.s: tom is my LAST day attending hosp as a medical student - havin mixed feelings...nostalgia (thinking of past) & palpitations (thinking of future)...but when i think of present - its ADRENALINE RUSH - coz got to settle 'work' b4 i shortly fly away on sat evening to seremban for cousin's wedding. lepas tu interbiew in BP again nx wed...LIFE IS PASSING BY SSOooooo FAST!!:eek:

[SS2006]

So Doc Alf got 2 medical helper...Dr Lava and Doc Pete.
Quickly grab the offer, Doc.

[petertok]

Petertok, since you're back in S'wan, why don't you attend Doc Alfred's forum?

paiseh la... :p

[petertok]

eh pete...u in s'wan ah? come la...maybe can meet u in person, FINALLY!!!


hehe.. c first if im free.. but sked later go there i'm the only male besides Dr Alf. :o

[petertok]

So Doc Alf got 2 medical helper...Dr Lava and Doc Pete.
Quickly grab the offer, Doc.

yohh.. i just finish my first sem leh.. :)

still hv many things to learn from Dr. Alf and Dr. Lava...

[alfred98]

Co-incident one of my doctor friend was talking to me on HVP Vaccine. Can tell us more about it? With this vaccine coming up i think Women's PA insurance can close shop liao. hehe...

psstt.... loctor, got discount or not ah for my daughter?
Is a HPV vaccine my girl!!! So what U wanna know lah......how to explain all here.....I got no typist with me lah........
For your girls....sure good discount one.....but only 9 years old and above ah!!

loctor, which wan is better Gardasil or Cervarix?
Gardasil having 4 strain whereas Cervarix having 2 strain.... Both having the 16 and 18 but Gardasil having 6 and 11 types...which against genital warts.....So for me I will say Gardasil with more added value.....

aiya...u all ah. loctor advertizing for his forum...u all pulak bombarding him wif Qs here itself, then wats left on the real day. come & support him ler


loctor...its a sat rite? i will be 'home' for almost whole of feb :D though the 'mission' is study-like-there's-no-tomolow...but since now i know wat to study (portfolio based for exit viva), and have roughly dedicated one day per portfolio...guess i can spare that sat & come support u

if need any help, jus gimme a buzz k, doctor! i'd be more than happy to help u out, boss...


eh pete...u in s'wan ah? come la...maybe can meet u in person, FINALLY!!!

p.s: tom is my LAST day attending hosp as a medical student - havin mixed feelings...nostalgia (thinking of past) & palpitations (thinking of future)...but when i think of present - its ADRENALINE RUSH - coz got to settle 'work' b4 i shortly fly away on sat evening to seremban for cousin's wedding. lepas tu interbiew in BP again nx wed...LIFE IS PASSING BY SSOooooo FAST!!:eek:
Come come the more the marrier!!!!
So Houseman ah, work for 36 hours ah....don't compliant ah!!!!!:D

[alfred98]

hehe.. c first if im free.. but sked later go there i'm the only male besides Dr Alf. :o

Got plenty of males there lah......All those father to pay thier gege for the vaccine!!!

[Chris C]

hehe.. c first if im free.. but sked later go there i'm the only male besides Dr Alf. :o

:laugh: ....don't worry, i'm sure Alfred won't use u to demonstrate....:D

[petertok]

:laugh: ....don't worry, i'm sure Alfred won't use u to demonstrate....:D

wads there to demonstrate? im not physically equipped with the structures needed to explain cervical cancer mechaniam... :p

[Chris C]

wads there to demonstrate? im not physically equipped with the structures needed to explain cervical cancer mechaniam... :p

:laugh: ....that's why nothing to feel sked off lor....:D

[alfred98]

:laugh: ....that's why nothing to feel sked off lor....:D

Chris!! Hope U are there..ok....bring all the kaki lang and frends....:)

[Chris C]

Chris!! Hope U are there..ok....bring all the kaki lang and frends....:)

I'll try...have to ask my dad and see whether he's free to be around and send my gal for her 2:00pm tuition or not. :)

[alfred98]

I'll try...have to ask my dad and see whether he's free to be around and send my gal for her 2:00pm tuition or not. :)

OK!! 1.00 to 2.00pm onli lah.....can make it leh!!

[Chris C]

OK!! 1.00 to 2.00pm onli lah.....can make it leh!!

Will come if nothing is holding me back...:)

[Lava Gal]

Come come the more the marrier!!!!
So Houseman ah, work for 36 hours ah....don't compliant ah!!!!!:D
marrier...hehe - will mark my diary. need any help, dun shy shy (u have my no rite)...this small fry is available at ur service-O ;)

wont complain la, doc...for all u know this waiting time after xm from march till i get posted i will complain for work-withdrawal syndrome will get to me - die larr....must find productive things to do to keep me occupied (till late apr/mid may possibly):eek:

[alfred98]

marrier...hehe - will mark my diary. need any help, dun shy shy (u have my no rite)...this small fry is available at ur service-O ;)

wont complain la, doc...for all u know this waiting time after xm from march till i get posted i will complain for work-withdrawal syndrome will get to me - die larr....must find productive things to do to keep me occupied (till late apr/mid may possibly):eek:

Just enjoy it while U can!!!:)

[WaterFish]

sounds interesting... ^^ My end of posting hopefully started on Friday so may drop in

[alfred98]

sounds interesting... ^^ My end of posting hopefully started on Friday so may drop in

Someone wanna organise this similiar forum in Teluk Intan whor!!! Can ah??? Have to ask Tai Kor fish mah!!!:blink:

[Voon Chan]

Alfred, ho to say "servical cancer in hokkien"

[alfred98]

Alfred, ho to say "servical cancer in hokkien"

Sar kia tui mui can ser!!!!:laugh:

[Voon Chan]

sound funny to me.
i have to just accept it cause i have to clue as regards the translation

[Chris C]

Alfred, got makan wan or not?:D ....if ada, i'll come with an empty stomach. Dowan to aid background music with my rumbling stomach if there's no food there....:p

[alfred98]

Alfred, got makan wan or not?:D ....if ada, i'll come with an empty stomach. Dowan to aid background music with my rumbling stomach if there's no food there....:p

Got light refreshment lor........Can wah lap that as lunch!!!

[Chris C]

Got light refreshment lor........Can wah lap that as lunch!!!

Ah.....okie,okie......:D

[victor]

Got light refreshment lor........Can wah lap that as lunch!!!

hei alfred, how much and how effective?

[Lava Gal]

in chinese o inggeris? if former...no point i come kan :p

and oh loctor...pls keep me updated, sms can. pleaseee...coz i will be MIA for some time to come. BIG TQ!

[alfred98]

hei alfred, how much and how effective?

Normal price 450 but during campaign 400 lor.....but had to get 30 patients to get this bonus leh.....
So far thier study showing 99% effective with test done at 7 months!!!
in chinese o inggeris? if former...no point i come kan :p

and oh loctor...pls keep me updated, sms can. pleaseee...coz i will be MIA for some time to come. BIG TQ!

In inggeris,chinese and malay lor......
SMS!! Can!! If I remember also lah!!!:cool:

[Sila]

Aiyoh!! Not sexually active no need to do lor....simple!!
Sexually active need lor.....Because 90% of the cervical cancer are cause by HPV virus which are a sexually transmitted mostly!!!:)

i have so many questions actually dunno how to say. :D some have been asked by some of the posts here.

1) if 90% of cervical cancer is caused by HPV virus, do we know the cause of the other 10% of cervical cancer?

2) can cervical cancer be caused by something other than HPV virus which is transmitted by sexual activity? i guess the ultimate question goes back to the earlier one - if one is not sexually active, do they still need to have pap smears, since the HPV virus causes 90% but not 100% of cervical cancer? (this is out of curiousity lah..)

3) what are the side effects of either of the two brands of vaccines mentioned?

4) annual pap smears is the recommended, correct? what does it detect, actually? just the HPV virus, or all kinds of stuff that could lead to or is an indication of cervical cancer?

i guess that's good for now. sorry for having so many questions, and thanks a lot for the answers, doctor alfred! :D

[alfred98]

i have so many questions actually dunno how to say. :D some have been asked by some of the posts here.

1) if 90% of cervical cancer is caused by HPV virus, do we know the cause of the other 10% of cervical cancer?

2) can cervical cancer be caused by something other than HPV virus which is transmitted by sexual activity? i guess the ultimate question goes back to the earlier one - if one is not sexually active, do they still need to have pap smears, since the HPV virus causes 90% but not 100% of cervical cancer? (this is out of curiousity lah..)

3) what are the side effects of either of the two brands of vaccines mentioned?

4) annual pap smears is the recommended, correct? what does it detect, actually? just the HPV virus, or all kinds of stuff that could lead to or is an indication of cervical cancer?

i guess that's good for now. sorry for having so many questions, and thanks a lot for the answers, doctor alfred! :D

1. So far HPV being indicated in 90% of Cervical cancer, which is very high and never in medical history a virus have being found to have this effect on human body. The next closes virus which cause cancer will be Hepatitis B and HIV which cause Kaposi Sarcoma....a form of skin cancer. So the answer for the rest of 10% will be unknown or can be congenital or inherited genes.....like the one for the Breast cancer...BRCA 1 and BRCA 2......

2. Answer as above!!!:p

3. So far there is non...

4. HPV virus can sometime being detected via Pap smear in form of inclusion bodies seen on the smear and mostly by guessing also....But the typing of the virus is very important for us to interpret the result....Current practice will still be the Pap smear to detect early stage of percancerous stage....Like the old classification CIN 1, 2 and 3......but nowadays new Bethesda Classification using LGSIL and HGSIL....
So we don't normally detect HPV infection but changes to the cells lining of the cervix will be our target......Maybe in future when we have the remaining 10% answer then we do onli HPV typing for the patient instead of pap smear....

OK!! Did I answer the questions???

[justin hong]

Doc, one question. How effective is Pap smear test? I mean what is the percentage of successful detection? and the percentage of error?

[alfred98]

Doc, one question. How effective is Pap smear test? I mean what is the percentage of successful detection? and the percentage of error?

Why??? U wanna have one???? There is no 100% thing in medical....Time tested and very accurate...but use in discreet...Mostly operator dependence test....It depends if U do it correctly at the right place or not....or if U do it with U eyes close....:p

[justin hong]

Why??? U wanna have one???? There is no 100% thing in medical....Time tested and very accurate...but use in discreet...Mostly operator dependence test....It depends if U do it correctly at the right place or not....or if U do it with U eyes close....:p

Nolah, creating awareness among my gfs ma..

[alfred98]

Nolah, creating awareness among my gfs ma..

OK!! She's a candidate for the vaccine lah!!:)

[SS2006]

OK!! She's a candidate for the vaccine lah!!:)

Alf, get Justin to attend your forum. Big potential customer here....he'll pay for all his gfs. Maybe you can get a bulk discount too.:p :laugh:

[alfred98]

Alf, get Justin to attend your forum. Big potential customer here....he'll pay for all his gfs. Maybe you can get a bulk discount too.:p :laugh:

Yah!! Get all his 30s gf hor!!!!:laugh:

[justin hong]

Not yet 30lah, still on 26th............:laugh: So Doc, how much discount for 26 sexually active females?

[alfred98]

Not yet 30lah, still on 26th............:laugh: So Doc, how much discount for 26 sexually active females?

26% lor!!!!:laugh:

[victor]

[QUOTE=alfred98;380878]Normal price 450 but during campaign 400 lor.....but had to get 30 patients to get this bonus leh.....
So far thier study showing 99% effective with test done at 7 months!!!

hey alfred! How do they come to conclusion that it is 99% effective? I read from somewhere that it is only speculation and that there is no method to detect the take up of the vaccination???!! What i mean is after you spend all the currency but you don't know whether you are protected or not, isn't it??:confused:

[victor]

how about guys? do we need to get the jab?ouch!!:eek:

[alfred98]

[QUOTE=alfred98;380878]Normal price 450 but during campaign 400 lor.....but had to get 30 patients to get this bonus leh.....
So far thier study showing 99% effective with test done at 7 months!!!

hey alfred! How do they come to conclusion that it is 99% effective? I read from somewhere that it is only speculation and that there is no method to detect the take up of the vaccination???!! What i mean is after you spend all the currency but you don't know whether you are protected or not, isn't it??:confused:

U mean a major multinational fraud is occuring here issit??? So far the data up to 4 years follow up still ok lor.....

U kur hong then what to say lor......1200 for reduce cancer I don't mind paying leh....getting cancer U spends many more then this leh.....

Ok!! For man current the licence for female onli.....but as U see the genital warts in man can be irritating and stigmatic.....so man still can be vaccinated....In Australia...it is licence for man also....:squeeze:

[Sila]

1. So far HPV being indicated in 90% of Cervical cancer, which is very high and never in medical history a virus have being found to have this effect on human body. The next closes virus which cause cancer will be Hepatitis B and HIV which cause Kaposi Sarcoma....a form of skin cancer. So the answer for the rest of 10% will be unknown or can be congenital or inherited genes.....like the one for the Breast cancer...BRCA 1 and BRCA 2......

2. Answer as above!!!:p

3. So far there is non...

4. HPV virus can sometime being detected via Pap smear in form of inclusion bodies seen on the smear and mostly by guessing also....But the typing of the virus is very important for us to interpret the result....Current practice will still be the Pap smear to detect early stage of percancerous stage....Like the old classification CIN 1, 2 and 3......but nowadays new Bethesda Classification using LGSIL and HGSIL....
So we don't normally detect HPV infection but changes to the cells lining of the cervix will be our target......Maybe in future when we have the remaining 10% answer then we do onli HPV typing for the patient instead of pap smear....

OK!! Did I answer the questions???

thanks doc alf!! :D you answered a lot.

it's amazing there's no side effects!! and even if it's 50% effective, that's still a lot better than nothing! if it's 99% effective, and there's no side effect, it's just a matter of cost. then seems like a no brainer - should get the vaccine.

no?

[Chris C]

Loctor, need some clarification here. I told a few of my female relatives and friends(they're in other town and states) about this vaccine, and they eagerly asked their doctors over there about it and got very confusing advice from the doctors there. Most said that it's still very new, don't know how good and safe it was, while one said that it's no use to women who r no longer virgins....:confused:......can clarify this or not, cos' it is really making many of us unsure.....thanks.:)

[alfred98]

Loctor, need some clarification here. I told a few of my female relatives and friends(they're in other town and states) about this vaccine, and they eagerly asked their doctors over there about it and got very confusing advice from the doctors there. Most said that it's still very new, don't know how good and safe it was, while one said that it's no use to women who r no longer virgins....:confused:......can clarify this or not, cos' it is really making many of us unsure.....thanks.:)

FDA approved vaccine lah.....not Malaysian department lah.....so we believe that this body represent the highest body for drugs control....although Malaysia we still have our own body to evaluate new drugs or vaccine coming into Malaysia.....So to get this approval from FDA.....U cannot give some mickey mouse type of studies to bluff this body....It must be double blinds type.....with certain criteria to pro filled..... So for safety wise......no doubt about it....although long term is still unknown....We don't know about which HPV in non virgin have got lioa....but definately not all from the list right....so vaccination still can be proceed although the lady already having 1 or 2 types of HPV in the body....

[Chris C]

FDA approved vaccine lah.....not Malaysian department lah.....so we believe that this body represent the highest body for drugs control....although Malaysia we still have our own body to evaluate new drugs or vaccine coming into Malaysia.....So to get this approval from FDA.....U cannot give some mickey mouse type of studies to bluff this body....It must be double blinds type.....with certain criteria to pro filled..... So for safety wise......no doubt about it....although long term is still unknown....We don't know about which HPV in non virgin have got lioa....but definately not all from the list right....so vaccination still can be proceed although the lady already having 1 or 2 types of HPV in the body....

Ah....ok, kam shia.......looks like many doctors back here r not well informed about it yet. Still a lot of doubts going on, so patients also confused.