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Center Recommends Cervical Cancer Vaccine

CancerWise - June 2007

What does a vaccine to prevent cervical cancer mean for parents, girls and young women?

Many questions have been raised since a vaccine called Gardasil® was approved recently by the U.S. Food and Drug Administration (FDA) for girls and women between the ages of 9 and 26.

The ideal time to administer the vaccine series (three injections in a six-month period) is between the ages of 11 and 12, before girls become sexually active, according to the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP).

The vaccine targets four strains of the sexually transmitted human papilloma virus (HPV). Two of the strains can cause abnormal changes in the cervix that may lead to cervical cancer.

Although many states are debating whether to make the vaccine a requirement, the decision whether to administer the vaccine still remains in the hands of parents and their health care practitioners.

M. D. Anderson supports the recommendation that girls receive the vaccine between the ages of 11 and 12.

“It’s likely that after girls begin receiving the vaccine, we’ll see the incidence of pre-cancerous cervical abnormalities decrease because HPV infection from these two strains will have been prevented,” says Therese Bevers, M.D., the director of the M. D. Anderson Cancer Prevention Center, which offers the vaccine as well as referrals.

Vaccine targets four types of HPV

The vaccine is the first developed to prevent cervical cancer, precancerous genital lesions and genital warts by targeting four types of HPV: 6, 11, 16 and 18. Types 16 and 18 cause 70% of all cervical cancers and a smaller percentage of vaginal and vulvar cancers. Types 6 and 11 cause about 90% of genital warts.

The vaccine is approved for all girls and women between the ages of 9 and 26 because those are the ages in which the HPV vaccine has been studied. The current vaccine was not studied in women older than 26; therefore, at this time, it is not recommended for women beyond this age.

Boys and men can be infected with HPV, but the vaccine hasn’t been approved for them. Research is under way to evaluate the vaccine’s effectiveness in this group.

Vaccine targets girls who have not had sex

Girls and women who have not been infected with any of the four HPV types will get the full benefits of the vaccine.

Any sexually active female should be counseled on the diminished benefits of the vaccination after HPV exposure and infection.

Females with a current or past HPV infection of one type, however, still may benefit from the vaccine. For example: if a person was infected with type 6 before receiving the vaccine, then she will be protected from types 11, 16 and 18 after receiving the vaccine.

Continue screening exams

Vaccines such as Gardasil constitute a significant development in cervical cancer prevention, but screenings for precancerous cervical abnormalities should continue.

“The vaccine only targets four of the many different types of HPV infection, so cervical cancer screenings with pap tests are still important,” Bevers says.

Little information also is available on how long the vaccine protects women from HPV infection. Further studies are needed to determine if immunity decreases over time and if booster vaccines will be needed.

For more information about receiving the vaccine, call the M. D. Anderson Cancer Prevention Center at 713-745-8040.

For more information about cervical cancer and the HPV vaccine, the Pap test or making a cancer screening appointment, call askMDAnderson at 877-632-6789.

– From staff reports

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© 2014 The University of Texas MD Anderson Cancer Center