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Cervical Cancer Vaccine Recommended for Adolescent Girls

How are HPV and Cervical Cancer Related?

Human papillomavirus (HPV) is a common sexually transmitted disease that can cause genital warts called condylomas. These condylomas can occur on the inside or outside areas of the genitals and may spread to the surrounding skin or to a sexual partner.

Because HPV infection does not always cause warts, the infection may go undetected.

According to the National Cancer Institute (NCI), research has clearly shown that HPVs are the major cause of cervical cancer. Studies also suggest that HPVs may cause a fraction of the cancers of the anus, vulva, vagina, and penis, and some cancers of the oropharynx (the middle part of the throat that includes the soft palate, the base of the tongue, and the tonsils).

Women who have many sexual partners have a higher chance of developing an HPV infection in the cervix. Infection with high-risk HPV types, specifically, increases the odds that a woman will develop cervical cancer.

However, while HPV infections are very common, cervical cancer is not.

More About Cervical Cancer

The cervix is the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.

Precancerous conditions of the cervix are identified as cells that appear to be abnormal, but are not cancerous at the present time. However, the appearance of these abnormal cells may be the first evidence of cancer that develops years later.

Precancerous changes of the cervix usually do not cause pain and, in general, do not cause any symptoms. They are detected with a pelvic exam or a Pap test.

If abnormal cells on the surface of the cervix spread deeper into the cervix, or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer.

Cervical cancer occurs most often in women over the age of 40. It is different from cancer that begins in other parts of the uterus and requires different treatment. Most cervical cancers are squamous cell carcinomas and adenocarcinomas.

Always consult your physician for more information.

[January 24, 2007] Young women should be vaccinated against human papillomavirus (HPV) when they are 11 to 12 years old in order to prevent cervical cancer, new American Cancer Society (ACS) guidelines recommend.

Picture of a woman talking to an adolescent girl

Other major health groups have also called for widespread vaccination in this age group.

The announcement of the new guidelines is especially timely as January is National Cervical Health Awareness Month, as proclaimed by the US Congress.

During Cervical Health Awareness Month, the National Cervical Cancer Coalition (NCCC) is focused on educating women about the importance of the Pap test as a screening tool for cervical cancer/HPV and about vaccines that can further reduce the burden of this devastating disease.

To start the year right, the NCCC encourages women to contact their health care provider to schedule a Pap test to check for cervical cancer. This screening is a crucial part of a woman’s health care regimen, yet one that many overlook.  “It’s important to remember that cervical cancer is a preventable disease - as long as it’s caught early enough,” says Sarina Araujo, Executive Director of the NCCC. 

Thousands of Women Affected

Despite significant advancements in the screening and treatment of cervical dysplasia, cervical cancer remains a threat to thousands of women annually. Women in developing countries are particularly vulnerable, according to the NCCC.

In 2007, an estimated 11,150 cervical cancer cases will be diagnosed in the United States, and about 3,670 women will die from the disease, the ACS notes. Almost all cervical cancers are caused by the human papilloma virus (HPV).

Because certain strains of HPV have been found to cause most cases of cervical cancer, research efforts have focused on developing a vaccine against HPV.

Two HPV vaccines have been developed, and clinical trials of these vaccines have been successful. According to a study published in April, 2005, one of the vaccines was 89 percent effective in preventing infection by four particular strains of HPV and 100 percent effective in preventing cervical cancer, precancerous lesions, or genital warts.

This vaccine was submitted for US Food and Drug Administration (FDA) approval in early 2006. The other vaccine was to be submitted for regulatory approval in Europe later in 2006.

Broad Use of Vaccine Provides Greatest Hope

The new guidelines emphasize that the full potential of the HPV vaccine will be reached only if widespread vaccination is achieved in groups of women who do not get regular cervical screenings. The guidelines are published in CA: A Cancer Journal for Clinicians.

"The vaccine holds remarkable potential, but unless the same populations of women who right now do not have access to or do not seek regular Pap tests gets this vaccine, it will have limited impact," Dr. Harmon J. Eyre, lead author of the guidelines and chief medical officer of the American Cancer Society, says.

Pap Tests Still Required After Vaccination

"Also, as HPV vaccination for the prevention of cervical cancer is introduced and promoted, it remains critical that women undergo regular screening even if they have been vaccinated," according to Dr. Eyre.

The new ACS guidelines state that:

  • Routine HPV vaccination is recommended for females ages 11 to 12 years.
  • Females as young as 9 years may receive HPV vaccination.
  • HPV vaccination is also recommended for females ages 13 to 18 years to catch up on a missed vaccine or to complete the vaccination series.
  • HPV vaccine is not currently recommended for women over age 26 or for males.
  • There is not enough data to recommend for or against HPV vaccination for women ages 19 to 26.
  • Screening for cervical cancer and pre-cancers should continue in both vaccinated and unvaccinated women.

Early detection of cervical problems is the best way to prevent cervical cancer. Routine, annual pelvic examinations and Pap tests can detect precancerous conditions that often can be treated before cancer develops.

A pelvic examination and Pap test allow the physician to detect abnormal changes in the cervix. If an infection is present, it is treated and the Pap test is repeated at a later time. If the examination or Pap test suggests something other than an infection, a repeated Pap test and other tests are performed to determine the problem.

Abnormal Pap Tests in Adolescent Girls

When abnormal cells are identified on a Pap test, additional testing is generally recommended in order to determine if the abnormality requires treatment. However, a 2006 report from the American College of Obstetricians and Gynecologists (ACOG) recommends that abnormal Pap test results in adolescents may be managed somewhat differently.

Most cervical lesions of a lower grade will go away without treatment in adolescents. Thus, ACOG 's current recommendation is to repeat the Pap test at 6- or 12-month intervals for a year after the original abnormal Pap test, depending on the individual situation of the adolescent involved.

However, the plan of action for further testing and treatment after abnormal results from a Pap test will depend on the type of abnormality found and the adolescent's general health status.

Always consult your child's physician for more information.

  
 
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