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New Study Supports Cervical Cancer Vaccine

Vaccines are responsible for some of the greatest successes in medical history. Now, exciting data about a new cervical cancer vaccine in development supports the potential for vaccines to continue to have a tremendous impact in the near future. The medical journal Lancet Oncology published a study (4/05) showing that Gardisil™, a vaccine to prevent human papilloma virus (HPV) could reduce persistent HPV infection and related disease (including new cervical pre-cancers and genital warts) by 90%. The vaccine is expected to become available in the United States in 2006.

Why is this necessary? Up to 70% of sexually active women will become infected with HPV during their lifetime. Worldwide, cervical cancer is the second most common cause of cancer-related death in women. Worldwide, HPV causes nearly 470,000 cases of cervical cancer each year. For nearly 31,000 women per year in Europe and nearly 4,000 women per year in the United States, cervical cancer is fatal. HPV infections are also responsible for genital warts in 1-2% of young adults. Genital warts can cause pain as well as sexual dysfunction. Recurrence is common and treatment is inconvenient, uncomfortable, and expensive.

There are more than 100 strains of HPV that have been identified. Ten of them have been shown to significantly increase the risk of cervical cancer. This study, conducted by Luisa Villa (Ludwig Institute for Cancer Research, Brazil) and colleagues, tested the effectiveness of a vaccine which targets four strains of HPV: types 16 and 18, which are associated with 70% of cervical cancers and types 6 and 9, which are associated with 90% of genital warts. The study evaluated 552 healthy women aged 16-23 from Brazil, Europe and the USA. These women were not pregnant, had no previous abnormal cervical smears and reported a history of four or fewer sexual partners. 277 women were randomly assigned to receive 3 doses of the intramuscular vaccine over a 6 month period; 275 women received a placebo. The women were followed up for 36 months and underwent regular gynecological examinations, tests for HPV DNA, and cervical smears. After 3 years, the incidence of persistent infection or disease with HPV 6, 11, 16, or 18 fell by 90% in those who received the vaccine compared with those given placebo. The vaccine was 100% effective against precancerous cervical lesions and genital warts associated with these four HPV types. There were no vaccine related serious adverse events reported.

The study authors suggest that universal HPV vaccination might be most effective if implemented in 10-13 year olds, who are likely to be HPV negative. According to another study, a female college student had a 60% likelihood of becoming infected with HPV during her four years in college. Vaccinating 10 to 13 year olds is likely to meet with some resistance, however, by parents reluctant to admit that their children might become prematurely sexually active or might ever become at risk for a sexually transmitted infection.

Created: 4/29/2005  -  Donnica Moore, M.D.

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