The question of whether it is appropriate to vaccinate older women against Human papillomavirus (HPV) is presented for debate in the latest issue of the Medical Journal of Australia.
Dr Rachel Skinner - Senior Lecturer at the School of Paediatrics and Child Health at the University of Western Australia - and her co-authors provide a review of the available information and evidence to help doctors advise women over 26 years of age on the risks and benefits of HPV vaccination.
HPVs are the major cause of cervical cancer. Cervical cancer mortality rates in Australia have been reduced through effective screening programs but there are still 800 new cases of cervical cancer and 300 deaths each year.
Two HPV vaccines are currently available for girls aged 12 and older, through a school immunisation program, and to all women up to the age of 26 years through their GP.
"Recently, a bivalent HPV vaccine has been licensed for use in women aged up to 45 years. Older women have robust immune responses to this vaccine and so should derive benefit from vaccination if they are exposed to HPV type 16 or 18 in the future," Dr Skinner says.
"Despite the vaccine's effectiveness in individual women, it is unlikely the Federal Government will fund a vaccination program for women over the age of 26 as it is not likely to be cost-effective.
"However, if a woman up to the age of 45 years desires protection against cervical disease over and above regular Pap screening, and is prepared to pay for this vaccine, there is considerable potential for individual benefit.
"HPV infection is most common in women under 25 years, drops significantly from 30 years of age, and then appears to increase again in those over 45 years.
"Clinical trials evidence shows that vaccination will have no effect on current or prevalent disease, but should provide a high level of protection from future infection."
The Medical Journal of Australia is a publication of the Australian Medical Association.