HPV vaccine for prevention of cervical cancer

Cervical Cancer or Human Papilloma virus (HPV) Vaccine

What is cervical cancer?

• Cervical cancer (cancer of the cervix) is a disease where abnormal cells grow uncontrollably and spread throughout the body from the cervix of the womb.
• It is the second most common cancer among women worldwide and is almost always caused by the Human Papilloma virus (HPV) ¹
• In 2002, 689 new cases of cervical cancer were detected in Australia ²
• 212 Australian women died from cervical cancer in 2004 ²
• Until now the only effective way to prevent the effects cervical cancer has been to have regular Pap smears and detect it early.
• The Human Papilloma virus (HPV) vaccine is a major Australian medical breakthrough to help with the prevention of cervical cancer.
• Combined with cervical screening, HPV vaccination will provide women with their best chance of protection against cervical cancer and cervical abnormalities.

What causes cervical cancer?

• HPV is a very common virus and around 4 in 5 men and women are affected at some time.
• There are many strains of HPV, only some of which cause cervical cancer. HPV strains 16 and 18 cause around 70% of all cervical cancers.
• HPV lives on the skin so it can be spread through intimate skin-to-skin contact. Anyone who has had sexual contact could have HPV.
• For most women HPV will not lead to cancer. ¹

What is the Human Papilloma virus (HPV) vaccine?

Based on technology developed in Australia by a team led by former Australian of the Year, Professor Ian Frazer, Gardasil vaccine prevents infection from HPV strains 16 and 18 in 90-100% of cases if individuals are vaccinated before they are infected.

The Therapeutic Goods Administration (TGA), Australia's regulatory agency for assuring that medical drugs and devices are safe and clinically effective, approved Gardasil on 16 June 2006 for females aged 9-26 and males aged 9-15 years. ¹

Gardasil provides protection from 4 strains of HPV including types 16 and 18. Gardasil also provides protection from types 6 and 11 that cause 90% of genital warts and 10% of low grade cervical abnormalities. ³

The HPV vaccine only provides protection from HPV types which cause 20% of cervical cancer so is not a substitute for regular Pap smears. Women who have never had sex still need to have two yearly Pap smears. All women should still practice safe sex.

In October, the US Centers for Disease Control and Prevention reported that research on Gardasil showed there was no evidence of significant risk related to the product's use.

Another recent study showed that after more than 380,000 doses of the vaccine had been administered to young women between the ages of 12 and 26 as part of an Australian national immunisation programme, found just three of 25 girls that reported hypersensitivity had probable hypersensitivity to Gardasil.

The authors concluded that this reaction was uncommon but "Our clinical recommendation is that females with suspected hypersensitivity to the quadrivalent ((Types 6, 11, 16 and 18) vaccine should be evaluated before receiving more doses, and any challenges with the same vaccine should be carried out in a supervised setting."

Overall this is a very positive endorsement of the safety of the vaccine and of the program.

Who should be vaccinated?

• Girls aged 9 to 26 years. The HPV vaccine is most effective when administered at an early age and before the start of sexual activity. As HPV can be transferred by skin to skin contact, it can be transmitted even when there is no penetration or through sharing of items that can come into contact with the genital area such as underwear. Thus, it is advisable to be vaccinated even before contemplating early sexual activity.
• The vaccine should still be administered to young women who have had sexual contact as they are likely to have had a lower risk of exposure to the strains of HPV.
• Even if a young woman is exposed to HPV between doses the course should still be completed as the effectiveness of the vaccine will only be slightly reduced.
• Vaccination of women over the age of 26 years is not recommended and does not have TGA approval as they are likely to have had more exposure to HPV and the benefits of the vaccine may be reduced.

What is the HPV Vaccination Program?

• In response to the overwhelming effectiveness of the HPV vaccine, the Australian Government is running the National HPV Vaccination Program
• The vaccine is administered free for girls aged between 12 and 13 years through school-based programs on an ongoing basis. There will be a 2 year 'catch-up' program for girls attending school aged between 13 and 18 years until the end of the 2008 school year.
• For young women who are not in school and are still under 27 years, GP's and community immunisation clinics will provide the vaccination until the end of June 2009.

For further information go to www.australia.gov.au/

Sources:

3. The National HPV Vaccine Program, Department of Health and Ageing, Australian Government (health.gov.au/cervicalcancer)
4. Australian Institute of Health and Welfare (aihw.gov.au)
5. Australian Family Physician vol. 36 no. 3 March 2007

Last published: 30 July 2011

Disclaimer
This information has been developed and reviewed for Bupa Australia by health professionals and to the best of their knowledge 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 recommendations or assessments and 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.