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Vaccinating girls can protect them against cervical cancer

Vaccines against the human papillomavirus that causes more than 99 per cent of all cervical cancers have to be made cheaper to enable developing countries to make them part of routine immunisation programmes, said cancer experts and scientists from the WHO. Sanchita Sharma elaborates.

health and fitness Updated: Jun 01, 2009 12:20 IST
Sanchita Sharma

Vaccines against the human papillomavirus (HPV) that causes more than 99 per cent of all cervical cancers have to be made cheaper to enable developing countries to make them part of routine immunisation programmes, said cancer experts and scientists from the World Health Organisation (WHO). Cervical cencer is the number one cancer among women in INdia, affecting 1.3 lakh women each year.

Cervical cancer factoids

*Infects 5 lakh women globally each year, 1.3 lakh in India
*Kills 2.5 lakh women each year: one woman dies every two minutes
*Accounts for 5 per cent of all global cancers
*10 per cent of all cancers among women globally
*15 per cent of all cancers in women in developing countries
*HPV vaccines offer 70 per cent protection against cancers
*HPV causes cancers of cervix, vulva, vagina, anus, larynx (oral) and oro-pharynx
*Cervical cancer screening has reduced cervical cancer deaths in
developed countries
*25 developed countries offer public funding for cervical cancer vaccination

Globally, 5 lakh women are diagnosed with cervical cancer every year, of which half -- 2.5 lakh, one woman every two minutes -- die.

Currently, 25 countries -- all developed -- offer funding for HPV vaccination that offers protection against 70 per cent of the HPV viruses that cause cervical cancer, which is the second most cancer in the world after breast cancer.

HPV is the most common sexually transmitted disease and infects one in 10 women worldwide. Of the over HPV 100 strains, two -- HPV 16 and HPV 18 -- cause over 70 per cent cases of cervical cancer, followed by HPV 45, 53 and 58.

"HPV is essential to get cervical cancer. Now two vaccines -- Merck's quadrivalent vaccine Gardasil (against HPV 6,11,16 and 18) and GSK's bivalent vaccine Cervarix (against 16, 18) -- offer almost complete protection against the most dangerous strains. They need to be made available cheaper to make them affordable to developing countries, who need them the most," said Dr John Clemens, director general, of the Internatioal Vaccine Institute, which is hosting an international symposium on HPV vaccination in the Asia Pacific and the Middle-Eastern Regions. Almost 80 per cent cervical cancer seaths take place in developing countries.

In April this year, the World Health Organisation (WHO) recommended hat HPV vaccination be made part of routine immunisation programmes.

"WHO recommended three doses of HPV vaccine be given to girls between the ages of 10 and 13 years just before the age of sexual initiation.

Tee vaccination should be integrated with screening of older women for cervical cancer," said Dr Linda Eckert, scientist, WHO Initiative for Vaccine Research.

HPV vaccine costs US$125 per dose in the US, with the three-dose regimen priced at US$375. Along with cost of storage and vaccination, the cost per person is well over Us$400. "The current vaccines are expensive, but with WHO granting pre-qualification to Gardasil last week -- and Cervarix will follow soon -- international funding agencies such as UNICEF can negotiate prices with manufacturers for lower prices for developing countries," said Eckert.

Countries with a non-existent screening for cervical cancer such as India are likely to benefit the most. "If there is no screening at all, the benefits will be tremendous as the women will be protected against cervical cancer for years to come. Studies have shown that strong protection remains for six years and indications are that it will continue for some more years," said Eckert.

The two available vaccines don't target all the HPV strains but offer some cross-protection to other cancer-causing strains. "If you factor in the cross protection, the protection offered by vaccination is up to 75 per cent," said Dr F. Xavier Bosch, chief, Cancer Epidemiology, Catalan Institute of Oncology in Barcelona.