The HPV Vaccine and Cervical Cancer Prevention

The medical community recently made a giant step in the direction of eliminating cervical cancer, the third most common cancer among women worldwide. The Gardasil vaccine, approved by the Food and Drug Administration (FDA) in early June, is nearly 100 percent effective in preventing certain HPV infections, which can lead to cervical cancer. But what does this mean to the average patient?

Alison B. Dick, MD, Department of Gynecology at Lahey Clinic Medical Center, helps explain the basics of this vaccine. "The Gardasil vaccine can reduce a woman's risk of getting venereal warts, precervical cancer and cervical cancer," says Dr. Dick. The vaccine targets HPV, or the human papillomavirus, the most common sexually transmitted infection in the country and the cause of nearly all cervical cancers.

Gardasil is designed to protect against four types of HPV; types 16 and 18, which account for about 70 percent of cervical cancer cases, and types 6 and 11, which cause an estimated 90 percent of genital wart cases. "Hopefully, over time this vaccine will help eliminate cervical cancer," says Dr. Dick.

According to the American Cancer Society, 50 to 75 percent of sexually active people will get HPV, and nearly half of those cases will occur in people between the ages of 15 and 25. Most HPV infections are cleared by the immune system, usually causing no symptoms. For infections that do persist, HPV currently has no treatment, but doctors can treat certain abnormal changes caused by the virus.

Gardasil is approved for females between the ages of 9 and 26. The Advisory Committee on Immunization Practices suggests all girls between the ages of 11 and 12 receive the vaccination. "This is all from a practical standpoint," explains Dr. Dick. "Females at that age are usually on track to receive other vaccines, so it would be convenient to coordinate the Gardasil vaccine with those. Also, it is important to administer the vaccine before sexual activity occurs because almost any sexual encounter carries a risk of infection."

The Gardasil vaccine is a series of three shots given within a six-month period. The vaccine costs $120 per dose, but doctors predict that insurance will begin to cover it in the future. Merck recommends the vaccine to females even if they are sexually active, because they may not have been exposed to the viral subtypes for which the vaccine offers protection.

Dr. Dick also notes that it is important for women to continue to have annual pap tests even if they had the vaccine, because some precancerous changes are caused by HPV types other than 16 and 18.

The fight against cervical cancer continues. Merck is testing Gardasil in women up to age 45, and plans on studying the vaccine for men are in the works. It's safe to say that the future of the Gardasil vaccine is still evolving.

For more information about the Gardasil vaccine, contact Lahey Clinic's Gynecology Department at 781-744-8560.