Scottish vaccine scheme cuts cervical cancer risk by 90 per cent

Leslie Hanson
April 6, 2019

In 2008, the United Kingdom introduced a nationwide vaccination program where all girls aged 12 to 13 were immunized against two of the most troublesome strains of the human papillomavirus, HPV 16 and HPV 18, which are known to cause cancer in both women and men. Most importantly, the rate of growths classified as a cervical intraepithelial neoplasia (CIN) grade 3 also dropped substantially, by almost 90 per cent.

The researchers found that over 58 percent of the participants had the virus but only 18 percent had received the full dose of the HPV vaccine. Most types cause no symptoms at all, while some can cause annoying but harmless warts on our hands, feet, or genitals, depending on where they like to call home.

This may be because the vaccine is most effective for those who have not encountered HPV before.

My team performed an eight-year study of the women eligible for the Scottish national vaccination and cervical screening programmes.

While "the surgical procedure removes all the tissue that is headed towards cancer, it does not remove all the HPV".

"The main message (from this study) is that the vaccine works".

Routine cervical cancer screening is still highly recommended for women, even if they have been vaccinated, but this may change, say the authors. In 2008, routine HPV immunisation of 12 and 13-year-old girls was introduced in schools across the UK.

That's crucial because a CIN3 growth puts women at their greatest risk of someday developing cervical cancer.

The research, which used data from 138,692 women born between 1 January 1988 and 5 June 1996 who had their smear test result recorded when they were aged 20 years, also revealed evidence of herd protection against high-grade cervical disease in unvaccinated women. Halkitis said it was also known that those living with HIV are more likely to be impacted by HPV infection and HPV-related cancers.

As expected, women who were older when vaccinated still had a lower rate of cervical disease than unvaccinated women, but not to the same degree as those who got the vaccine when young.

The success of the vaccine program is already proving to be remarkable. "We must also actively develop, resource, and scale-up more effective, feasible and culturally acceptable strategies for cervical screening, such as self-collection of specimens, if we are ever to effectively reduce the global burden of cervical cancer".

But in the long term, it may be that "two or three screens in a lifetime using HPV testing might be sufficient", the paper said. "Ultimately, the clinical and economic rationale for cervical screening will need to be reviewed".

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