Medicine

Scottish HPV vaccine programme dramatically reduced cervical disease, study shows

Scottish HPV vaccine programme dramatically reduced cervical disease, study shows

Routine vaccination of teenagers in Scotland has led to a huge reduction in cervical cancer, a study has found.

The human papillomavirus (HPV) is a sexually-transmitted infection and some types are linked to cervical cancer, one of the most common cancers in women under 35 in the UK.

Scotland has an established national cervical screening programme and in 2008 introduced a national HPV immunisation programme for girls aged 12 and 13, with a catch-up programme up to age 18.

The therapeutic vaccine, called Tipapkinogen Sovacivec (TS), injects a specific protein that triggers an immune system response to attack high-risk HPV types that cause almost all cervical cancer precursors, known as cervical intraepithelial neoplasia (CIN).

The study reported no difference in the effect of screening between women with and without high-risk HPV in their tumors.

The researchers note that continued monitoring of these rare types of cervical cancer is necessary when the screening of cervical cancer now is to be done by HPV testing instead of primary cytological analysis of cell samples. She called for scaling up of HPV vaccination to countries where it is not yet available or accepted. They compared rates of CIN in women born in 1995-96, who were routinely vaccinated against HPV at the age of 12 or 13, and women born in 1988-90, who were not vaccinated.

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There was an 88% reduction in the rate of grade 2 CIN and a 79% reduction in grade 1. Cervical pre-cancer occurs quicker than cancer and therefore this focus has allowed us to see the impact of the vaccine earlier.

The team, led by Dr Tim Palmer at the University of Edinburgh, analysed vaccination and screening records for 138,692 women born between 1988 and 1996 who had a screening test result recorded at age 20. The higher the number, the higher the risk is of developing invasive cancer.

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.

"We are, of course, building on this success and extending the HPV vaccine programme to boys later this year".

According to the authors, there's been a reduction of up to 90% of cervical disease abnormalities (or pre-cancerous cells). "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".


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