[ejstronge]

> You can develop cervical cancer via some other route, but the vast, vast majority of cervical cancers are caused by HPV infection.

What are these other ways? There's an intuition that bodies are like computer programs that can fail in unpredictable ways, but this is usually false and belies a failure to see links between 'novel' and previously described mechanisms.

[necovek]

Computer programs always fail in predictable — but usually unpredicted — ways.

Human bodies, not so much, mostly because we lack the capability to monitor, measure and emulate the behaviour of such complex systems. As such, we gain medical knowledge using statistics, usually covering most common "failure modes" first, but we increasingly learn that those are never as clear cut either as our observation technology improves (as it does with science otherwise too — eg. Newtonian mechanics is completely true up to some error bars and constraints achievable in that period).

[epcoa]

Spontaneous mutations? Which no matter how much you carve out modifiable risk factors will always be a thing. At least 5% of cervical cancers are HPV negative, so it's not even all the uncommon (not I would call "vast, vast" IMHO)

[ejstronge]

> Spontaneous mutations? Which no matter how much you carve out modifiable risk factors will always be a thing. At least 5% of cervical cancers are HPV negative

Random mutations causing cervical cancer essentially does not happen - as a sibling commenter writes, well-studied cases of this are so rare that they’re below our sensitivity of detection/technical error rates.

This is what I mean when I say we try to apply our intuitions to medicine - they’re not reliable and the truth is idiosyncratic.

Because our prior for cervical cancer being caused by HPV is so incredibly high, we would require overwhelming evidence to reject the hypothesis that any new case is due to HPV. There are ways to do this, and, should they be attained, would be published in a reputable journal based on their novelty.

[tialaramex]

Where did you see 5%? I'm not an expert (though I think I know one) but the study I'm looking at says 0.3% - hence my "vast, vast". That's 3 patients out of 1000.

In that study they take cancer cells and check for HPV, get about 7% negatives which I'm guessing is what you're describing too, but they take those negatives and PCR them to figure out, well, OK, what was wrong with these cells and when you take the cells to pieces very often your assay goes oh, these instructions are HPV. So, you know, the cancer cells aren't "infected" with HPV but well the genetics are just HPV, the replication has gone haywire and tangled parts of HPV with the human cell instructions and now it's cancer.

Crucially we can assume that if you don't get infected with HPV this wouldn't happen. So HPV was still causal.