February 2, 2010
by Christina England
Cervical cancer kills around 940 women in the UK every year and the majority of these women are over the age of 45 years. Although shocking, this is a comparatively low figure,compared to those dying from other cancers, the highest rate of death being those dying from breast cancer which kills around 12,000 people a year. Despite these relatively low figures, the UK Government is keen to make sure that every girl over the age of twelve is vaccinated with the new HPV vaccine Cervarix which was introduced to the UK in September 2008.
Cervarix is a vaccine that protects women against strains 16 and 18 of the sexually transmitted disease HPV or Human Papillomavirus which causes 70% of cases of cervical cancer and precancerous cervical lesions seen in women today. Cervical cancer, is a cancer of the lower part of the uterus or womb and precancerous cervical lesions, are the changes in the cells of the cervix that have a risk of turning into cancer. Cervarix works by causing the body’s own defences to make antibodies against Human Papillomavirus types 16 and 18. Cervarix will not protect against all types of HPV only strains 16 and 18. Cervarix is currently used for females from the age of 10 years onwards.
Many parents and young women however, are now questioning how necessary this vaccine is. This is due to the information recently released from Cancer Research UK, which states that cervical cancer is actually only the twelfth most common cancer in women in the UK and the majority of women who do die are over 45 years of age. They also state that over the last 30 years the numbers of those that have died with cervical cancer has actually fallen by two thirds. Parents have also questioned why a vaccine for sexually transmitted diseases is being offered to children as young as twelve and are worried that this is giving children the message that sexual activity at such as young age is OK some even naming the vaccine the ‘promiscuity vaccine’.
These facts are worrying many experts and some question whether giving the HPV vaccine to children as young as twelve is necessary and whether to wait until the child is older.
Dr. Diane Harper, a leading expert, involved in the original clinical trials for Cervarix says that this decision was not a scientific decision but a political decision.
“The age at which the vaccine is recommended is a political decision, not a scientific decision.” she told me in an email.
“Scientifically Cervarix has performed equally well in all efficacy tested ages from 16-26 years. Cervarix has also induced antibody titers in girls and boys 10-15 years and in women 16-26 years old that are equivalent to the titers seen in the 16-26 year old efficacy cohort which produces outstanding efficacy. Scientifically we also know that 10% of 10-11 year olds have already been infected with HPV and that there is no age at which all girls are not exposed to HPV.”
She continued to say that the Cervarix vaccine only helps to prevent the HPV infection, it does not prevent cancer. She feels that the PAP screening tests are equally as important as the vaccine and feels that in the long term PAP screening will prevent more cervical cancer than the vaccine itself.
“Pap screening has effected the early detection of cancer precursors, and treatment with excisional methods (leep, cone) has completely removed the pre-cancers, hence preventing cancers from developing. Your population needs to continue with Pap screening as the vaccination will not prevent as many cancers from developing as will routine Pap screening.”