Guardasil was approved by the FDA and the European Medicines Agency earlier in 2006.
The vaccine is a major breakthrough in the prevention of cervical cancer and is being hailed by medical specialists and public health officials around the world.
After breast cancer, cervical cancer is the second most common cause of mortality due to cancer. Worldwide, around 240,000 woman die annually from the disease.
In the UAE, cervical cancer is the second most common form of cancer among women, according to Dr Saad Aswad, associate professor of gynaecology at the UAE University and Senior Consultant Gynaecologist Oncologist, Tawam Hospital, Al Ain, UAE.
He said in developing countries the mortality rate due to cervical cancer is 27 per 1,000 population and this falls to 6 per 1,000 in developed countries due to better preventative screening measures. “However, as yet there is no active screening campaign in the UAE,” he pointed out.
“In 2004 we approached the government [to establish active screening for cervical cancer]. To date nothing has happened. “We believe the way forward now is through a vaccine,” he said. He said the annual average number of reported cases of cervical cancer in the UAE tripled in 2005 compared to reported cases from 1998 to 2004.
In most cases cervical cancer is caused by HPV (Human Papillomavirus) and this is what the vaccine targets. There are more than 100 types of HPVs. Some of these viruses cause warts which are non-cancerous and these can be transferred by skin-to-skin contact. Others, particularly HPV types 16 and 18, are sexually transferred and considered ‘high-risk’.
HPV types 16 and 18 are responsible for around 75% of all cervical cancers. HPV 6 and 11 cause approximately 90% of all genital warts. In clinical studies Guardasil prevents 100% of HPV 16 and 18 related cervical cancers. The vaccine prevents 99% of cases of genital warts caused by HPV 6 or 11.
Guardasil will protect against any diseases caused by HPV 6, 11, 16 and 18. However, if a woman is already infected by any of these types it will not alter the existing infection.
HPV is not only responsible; for cervical cancer, but also some oral, oropharyngeal, laryngeal, penile, vaginal, vulva and anal cancers.
Guardasil is indicated for females between the age of 9 and 26. It is a three-dose vaccine and should be administered in three injections in the upper arm or upper thigh over a sixmonth period.
Men are also carriers of the HPV virus and are presumed to be a source of storage for it. Prevalence in males ranges from 9% to 48% in different parts of the world. Trials for the efficacy of the vaccine in men are ongoing, however, in Mexico, Australia and New Zealand the vaccine has already been approved for use in boys.
Dr Marc Steben, a medical consultant at Canada’s Quebec National Public Health Institute and Gynaecology-Oncology Department, University of Montreal Hospital Centre, said the vaccine is extremely cost-effective is one takes into account the cost of regular screening and treatments of cervical cancer.
“It is one of the most costeffective measures a country can adopt ... compared to treatment and screening in later life,” he said.
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