September is here, bringing that back-to-school feeling. This year, along with a new pencil case and protractor, girls aged 11 and 12 will be getting an added extra – a vaccine that will protect them against HPV, the virus that causes cervical cancer.
The roll-out of the programme has already started in Scotland, as the lucky kids there have gone back to school earlier than the rest of the UK. There will also be a ‘catch-up’ programme for girls up to the age of 18.
But will the vaccine really eradicate cervical cancer in the UK?
For background, there’s a nice piece about cervical cancer, HPV and the vaccine on our patient information website, CancerHelp UK.
The most important thing to remember is that although the vaccine is a welcome addition to our arsenal against cervical cancer, it’s not our only weapon. Here in the UK we have extremely effective national screening programmes of cervical smear tests, which are thought to save around 5,000 lives every year. In fact, Cancer Research UK’s last major campaign was Screening Matters, highlighting the importance of screening in detecting and preventing cancer.
Even with the introduction of a vaccination programme, it’s unlikely that screening will ever be phased out. For a start, the vaccine being used in the UK, Cervarix, only protects against two strains of HPV that are responsible for about 7 out of 10 cases of cervical cancer. There are other strains of the virus that the vaccine won’t protect against. And, as with any such initiative, it’s unlikely that every single girl will get the vaccine, either by accidental omission or by choice.
N.B. There’s been some discussion in the media about the pros and cons of Cervarix compared with Gardasil, another (more expensive) cervical cancer vaccine. Both vaccines protect against the two strains of HPV that cause cervical cancer, and in this respect are equally effective. However, Gardasil also protects against other types of HPV that cause genital warts but not cancer. Although genital warts are unpleasant, they are not a life-threatening condition.
After all that, although every life lost to cancer is precious, the vaccine will only save up to 400 lives per year, according to most reports. And the vaccination programme is also expensive, costing millions at a time when the Government is coming under fire for failing to fund pricey cancer drugs.
So why vaccinate at all?
As mentioned earlier, cervical screening saves around 5,000 lives every year. This is because the smear test picks up pre-cancerous changes that can be treated before they develop into full-blown cancer – changes that are due to HPV infection. That’s thousands of women every year going through the anxiety of having an abnormal smear, the discomfort of treatment, and the fear that the problem may return.
So as well as the cost of treatment to the NHS, there’s an emotional cost to be considered, along with practical considerations like taking time off work for treatment. On paper, the vaccine may not look like great value for money in terms of cost-per-life-saved. But add in the costs of treating pre-cancerous conditions and it starts to look like a much better deal.
Finally, let’s not forget that this is an exciting moment – this is the first time that a vaccine to prevent cancer has been made nationally available. And looking outside our borders, the development of cervical cancer vaccines could make a big difference elsewhere in the world.
Cervical cancer is one of the most common cancers in Africa, and a major killer of women in this area. Making vaccines more widely available throughout the developing world would save thousands upon thousands of lives.