The human papilloma virus
(HPV) vaccination was recently introduced to prevent cervical cancer in
females. It is administered as three
doses to girls between 12 and 26 years preferably before they are sexually
active.
The HPV virus spreads
through sexual contact. Persistent infection with HPV types 16 and
18 has been found to be associated with cervical cancer. On the other hand, HPV types 6 and 8 are
usually low-risk types for cancer and cause genital warts. Vaccinating girls before their first sexual
intercourse could help to reduce infections with HPV and bring down the
incidence of cervical cancer.
Cervical cancer progresses
through different stages. Initially,
cells lining the cervix show some abnormalities called dysplasia that can be
detected on a Pap smear. These cells
could result in a pre-cancerous state called 'Cervical Intraepithelial
Neoplasia' (CIN). CIN could be low or
high grade depending on the extent of the abnormality. It could further progress to form squamous
intraepithelial neoplasia or carcinoma in situ. These could spread to the surrounding tissues resulting in an
invasive cancer.
A study was conducted in
Victoria, Australia to study the impact of HPV vaccination program on the
incidence of cervical cancer. HPV
vaccination was recently introduced for all women in Australia between 12 and
26 years of age between the years. The
researchers studied the incidence of low grade abnormalities or LGA (which
included low-grade squamous intraepithelial lesions and atypical squamous cells
of undetermined significance) detected on Pap smear and high grade
abnormalities or HGA (which included cervical intraepithelial neoplasia of
grade 2 or worse or adenocarcinoma in situ) detected on the cervical tissue
sample obtained using a procedure called colposcopy. Invasive cancers were classified separately.
The authors found that there
was a significant decrease of 38% in HGA in girls below 18 years of age within
3 years after the introduction of the HPV vaccine.
The researchers thus conclude that early administration of HPV vaccine
before a girl becomes sexually active helps to reduce the incidence of cervical
cancer. However, longer duration studies are
warranted to study if the vaccine can protect from cervical cancer in the
longer term.
Reference:
1. Early effect of the HPV vaccination programme on cervical
abnormalities in Victoria, Australia: an ecological study; Dr Julia ML
Brotherton , Masha Fridman Cathryn L May. Genevieve Chappell, A Marion Saville,
Dorota M Gertig; The Lancet, Volume 377, Issue 9783, Pages 2085 - 2092, 18 June
2011
Source-Medindia