Cervical cancer (cancer of the cervix) is a disease where abnormal cells grow uncontrollably on the cervix of the uterus (womb) and if not treated in time, can spread throughout the body. Every year around 700 Australian women are diagnosed with cervical cancer and over 200 die from the disease. In Australia, cervical cancer ranks as the 15th most frequent cancer among women, and the fifth most frequent cancer among women aged between 15 and 44 years of age.
Cervical cancer is almost always caused by the human papilloma virus (HPV) and is largely preventable through screening and vaccination. Until recently, the only effective way to reduce the risk of invasive cervical cancer was to detect it early by having a Pap smear every two years, starting from age 18 or starting two years after the first sexual contact, if older than 18. This test is usually done by a doctor or nurse, who collects a sample of cells from the woman’s cervix and sends it to a laboratory for analysis.
HPV is a virus that infects the skin, usually through sexual contact, causing cells to grow abnormally. Sometimes these appear as warts. The virus can also be passed from mother to child during birth if the mother has an active infection.
HPV is a common virus, and almost all sexually active men and women are infected at some time during their lifetime. Unless warts are noticed, there are often no noticeable symptoms, and often people don’t know they have the infection. There are more than 100 strains of HPV, only some of which cause cervical cancer. About 14 types of HPV have been identified as cancer-causing. Of these, two strains (HPV 16 and 18) cause around 80 percent of all cervical cancers in Australian women. HPV lives on the skin so it can be spread through intimate skin-to-skin contact. Anyone who's had any form of sexual contact could have HPV, and should be aware of their sexual health risks.
A vaccine works by injecting a controlled amount of a disease into the body which stimulates the immune system to make antibodies against that disease. The HPV vaccine is based on technology developed in Australia by a team led by former Australian of the Year, Professor Ian Frazer. It provides protection against the strains of HPV that cause 80 percent of cervical cancer in Australian women.
HPV vaccination works best if people are vaccinated before they become exposed to the risk of HPV infection, that is, before they become sexually active. This is why the Government has implemented a school-based HPV vaccination program that provides HPV vaccine for all females through school programs at 12-13 years of age. The vaccine is given in three injections over six months, in the upper arm or thigh. It is not yet known if booster shots will be necessary in the future. About 70 percent of Australian girls will have had the full course of vaccine by age 15.
Women aged between 18 and 70 who've had sex, even if only once or infrequently, still need to have two-yearly Pap tests even if they have had the HPV vaccine. This is because the HPV vaccine only provides protection from some HPV types.
Pap tests can detect any changes that may have occurred in the cells on the surface of your cervix early on. If these changes are noticed early enough, you can usually be treated successfully so that cervical cancer doesn't develop.
The HPV vaccine is a major Australian medical breakthrough to help with the prevention of cervical cancer. Australia was the first country in the world to roll out the vaccine. Combined with Pap tests, HPV vaccination provides women with their best chance of protection against cervical cancer and cervical abnormalities. The number of new cases of cervical cancer is expected to decrease due to Pap test screening and vaccination, making it the only type of cancer that is declining as the population ages.
HPV is used in more than 100 countries and more than 65 million doses have been given safely.
All medicines, including vaccines, can produce adverse reactions in a few people, including the risk of an allergic reaction in some people. All girls or women receiving the HPV vaccine are monitored afterwards for signs of a reaction. The majority of side effects and adverse events with vaccines are mild and last only a short time.
Discuss any concerns you may have about the HPV vaccine with your GP.
The most common side effects after HPV vaccination are pain, swelling and redness at the vaccination site.
Other side effects include:
Fainting is common after injections and vaccinations, especially in adolescents, but might not be directly attributable to the vaccine or its components.
There have been controversial media reports that the HPV vaccine is associated with serious adverse events including neurological disorders and death. However, after looking into clinical trials and reported adverse events, the World Health Organization, Australian and other governments have concluded the HPV vaccine is safe and that many of these reported adverse events are coincidental.
In Australia, no deaths or other serious adverse reactions have been reported. There have been a few cases of severe and mild allergic reactions, which were quickly treated at the time.
Girls and women aged nine to 26 should be vaccinated against HPV. The vaccine is most effective when administered at an early age and before the start of sexual activity. It is advisable to be vaccinated even before contemplating early sexual activity as any form of skin to skin sexual contact can transmit the virus. Even girls and women who've had sexual contact should still be vaccinated, as the majority will not yet have been infected by a HPV strain that causes cancer. If a young woman starts sexual activity between doses, the course should still be completed as the effectiveness of the vaccine will only be slightly reduced.
Women over the age of 27 years should talk to their doctor about whether the vaccine is right for them. The more exposure to HPV a person has had (for example, through sexual activity with a person who has HPV), the less effective the vaccine will be, so the benefits of the vaccine may be reduced for this group.
It’s not known if there are any benefits to vaccinating males against HPV.
Cancer Council Australia: Cervical Cancer Vaccine
http://www.cervicalcancervaccine.org.au/
Immunise Australia Program
http://www.immunise.health.gov.au/
Australian Cervical Cancer Foundation
http://www.accf.org.au
HPV Vaccine Safety FAQ - Centers for Disease Control and Prevention (US)
http://www.cdc.gov/vaccinesafety/Vaccines/HPV/hpv_faqs.html
Cancer Council Australia: Cervical Cancer Vaccine. What is cervical cancer? [online] Surry Hills, NSW: Cancer Council [Accessed 25 Jun 2011] Available from:
http://www.cervicalcancervaccine.org.au/
Cancer Council NSW. Cervical Cancer Vaccine Fact Sheet. [online] Surry Hills, NSW: Cancer Council [Accessed 25 Jun 2011] Available from:
http://www.cancercouncil.com.au/
Centers for disease control and prevention (CDC). Reports of Health Concerns following HPV vaccination. [online] Atlanta, GA: CDC. [Last updated 28 Jun 2011, accessed 13 Jul 2011] Available from:
http://www.cdc.gov/vaccinesafety/vaccines/hpv/gardasil.html
Department of Health and Ageing (DOHA). The Australian Immunisation Handbook. 9th ed. [online] Canberra, ACT: Commonwealth of Australia. 2008 [Last updated Sept 2010, accessed 12 July 2011] Available from:
http://www.health.gov.au
DOHA. National Cervical Screening Program FAQs. [online] Canberra, ACT: Commonwealth of Australia. [Last updated 14 May 2011, accessed 25 Jun 2011] Available from:
http://www.health.gov.au
DOHA. Immunise Australia Program. [online] Canberra, ACT: Commonwealth of Australia. [Last updated 4 Apr 2011, accessed 25 Jun 2011] Available from:
http://www.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-hpv
Therapeutic Goods Administration (TGA). Gardasil (human papilloma virus vaccine) [online] Woden, ACT: Commonwealth of Australia. Jun 2010 [Last updated Feb 2011, accessed 25 Jun 2011] Available from:
http://www.tga.gov.au/safety/alerts-medicine-gardasil-070624.htm
World Health Organisation (WHO). Australia: Human papilloma virus and related cancers, fact sheet 2010. [online] Geneva, Switzerland: WHO. Sept 2010 [Accessed 25 Jun 2011] Available from:
http://www.who.int/en/
Last published: 30 July 2011
Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.
Bupa Australia Pty Ltd makes no warranties or representations regarding the completeness or accuracy of the information. Bupa Australia is not liable for any loss or damage you suffer arising out of the use of or reliance on the information. Except that which cannot be excluded by law. We recommend that you consult your doctor or other qualified health professional if you have questions or concerns about your health. For more details on how we produce our health content, visit the About our health information page.
