Cervical Cancer and HPV. Is vaccination the answer?

What causes cervical cancer? Why do some people get it, and not others?

The answer is HPV. HPV infection causes more than 99% of cervical cancer cases. (Source: https://www.ncbi.nlm.nih.gov/pubmed/22727241)

HPV (Human Papillomavirus) comes in many different forms. 40 of them are sexually transmitted, and of those, only some cause cervical cancer. These are known as the high-risk sub types.

In 2005 the International Agency for Research on Cancer (IARC) working group classified HPV types into the following grades:

• Grade 1 (carcinogenic to humans): HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59
• Grade 2A (probably carcinogenic to humans) HPV 68
• Grade 2B (possibly carcinogenic to humans) 26, 53, 66, 67, 70, 73, 82, 30, 34, 69, 85, and 97
• Grade 3 (not carcinogenic) 6, 11

(Source: International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans; Human Papillomaviruses, Volume 90. Lyon, France; 2007;255-313)

Currently, it is accepted that the following 14 HPV genotypes are the high-risk or oncogenic sub types and have caused invasive cervical cancer: 16, 18 ,31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68.

The NHS vaccination program for HPV uses the GARDASIL vaccine, which protects again HPV 16 & 18, which cause 70% of cervical cancer cases. (Source: https://www.medicines.org.uk/emc/medicine/19033)

It also protects against HPV 6 & 11, which cause genital warts, but are not linked to cancer.

A newer vaccination, GARDASIL 9, is effective against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58, which cause an estimated 90% of cervical cancers.

It's also important to consider the long-term safety of vaccination, and it has been shown that HPV vaccination is about as safe as other childhood vaccinations, although with an increased risk of syncope (fainting) at time of vaccination. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4262378/)

Also important to note is that HPV infections are normally cleared by the immune system within 2 years. Rarely, an HPV infection can persist, and if it remains active for up to 15-20 years, it can cause cell changes that lead to cervical cancer developing. (Source: https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer)

So, the more high-risk HPV sub types that we can vaccinate against, the more protection is conferred. If (when?) we can vaccinate against all high-risk HPV sub types, we should in theory be able to eradicate cervical cancer entirely. (along with anal cancer, and some head & neck cancers)

So, should you, or your children accept the offered HPV vaccination?

As always, it's entirely up to you. The evidence suggests that the vaccination is both safe, and effective at preventing cervical cancer, but as always, make the decision knowing all of the evidence.