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Cervical Cancer Vaccines for Women over 18
20/09/2009 19:45:00
Cervical cancer is the second most common cancer in UK women under age 35. There are approximately 2500 new cases and over 1000 deaths every year. Cervical cancer is caused by infection with Human Papilloma Virus (HPV), now the most common sexually transmitted disease in the Western World, affecting 80% of women during their lifetime. HPV infections rarely cause symptoms and are passed on unknowingly between sexual partners. Barrier contraception does NOT provide 100% protection against HPV infections. The vaccines are currently licensed in the UK for use in females over the age of 9 years. The NHS offers HPV vaccines ONLY to girls aged 12-17, even though several Studies have shown that women up to the age of 55 would benefit from HPV vaccination, even if they have already been infected with HPV. The degree of protection against cervical cancer produced after vaccinating sexually active women is comparable with that produced by vaccinating sexually naive women never exposed to HPV infections. A recent Study of 10,000 women over the age of 26, with fewer than five previous male sexual partners and no previous cervical smear abnormalities caused by HPV, produced the remarkable result that NONE developed HPV cell changes in the cervix during the two-year follow up period after HPV vaccination. There are two vaccines available to protect against HPV infections; Gardasil and Cervarix. Both vaccines are equally protective against HPV strains 16 and 18, which together are responsible for 80 percent of cervical cancers. Cervarix protects ONLY against these two strains. Gardasil ALSO protects against HPV strains 6 and 11, which are responsible for causing 99 percent of genital warts (affecting over 150,000 people in the UK every year), and vaginal and anal cancers. Gardasil also offers cross-protection against other strains of HPV which cause cervical cancer. It was controversially decided that the NHS would use Cervarix, whereas Gardasil is the vaccine of choice in most other Western European Countries, USA, Canada, and Australia. This Practice routinely uses Gardasil. Gardasil is well tolerated; side effects include a mild rise in temperature and/or a red tender swelling at the site of the injection. It should not be given during pregnancy, but can be given while breastfeeding. Three separate doses are needed within a period of 6 months to provide protection for at least 8 years following administration. As with all vaccines, research is ongoing to determine how long protection lasts and whether or not a booster is needed. Many women over the age of 18 are asking for treatment but are being denied access to HPV vaccines because NHS GPs have been instructed not to prescribe HPV vaccines for women outside the 12-17 age group specified by the NHS Schedule. In my opinion it is morally and medically unethical to deny women protective and life saving treatment purely because of financial considerations. If you are unable to access HPV vaccines from the NHS, Gardasil is available from this Practice at the fee of £165 per vaccine, or if paid in advance, a total of £450. Please do not hesitate to ask for more information if required. It is important to continue routine cervical cancer 'smear' testing even after HPV vaccination. This is because the vaccine does not yet protect against all the strains of HPV which cause cervical cancer. Routine 'smears' in the UK currently detect over 25,000 women with early and treatable pre-cancerous cell changes (CIN 3) each year. Women who develop invasive malignant cervical cancer have either never had a cervical 'smear', or more than 10 years have passed since their previous 'smear'. Cervical cancer spreads much more quickly in women age 20-40 than in older women, yet routine NHS 'smear' testing does not begin until age 25.
For further information please see 'The Prevention of Cervical Cancer' - Lopes.T. and Singer.A., Royal Society of Medicine Press. (Source - Proceedings of Conference at RSM, London 26th September 2006 – ISBN 978-1-85315-669-4). For more infomation, please view the document on the Vaccine Documents / Links page.
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