A vaccine for human papillomavirus (HPV) can almost entirely prevent cervical cancer and precancers if given to girls early enough, a U.K. study published in the Lancet on Wednesday evening suggests.
Researchers from King’s College London found an 87 per cent relative reduction in cervical cancer among women who had received the Cervarix HPV vaccine when they were 12 or 13, compared to the expected rate among unvaccinated women.
There was a 62 per cent reduction among those who had received their shots between the ages 14 and 16, and a 34 per cent reduction among women who were immunized when they were 16 to 18 years old.
The peer-reviewed study also showed significant reductions in non-invasive cervical carcinoma (CIN3) — a type of cervical precancer — ranging from a 39 per cent reduction in women who had received the HPV vaccine between age 16 to 18, to a 97 per cent reduction for those immunized at age 12 or 13.
“Our findings should greatly reassure those still hesitant about the benefits of HPV vaccination,” the study authors said.
“We have shown that HPV vaccination with high coverage in 12-13 year old girls has almost eliminated cervical cancer and cervical precancer up to age 25 (the extent of the observed data).”
This undated image provided by Merck in October 2018 shows a vial and packaging for the Gardasil 9 vaccine. Gardisil and Gardisil 9 are more commonly used in Canada. (Merck/The Associated Press)
For this observational study, the researchers examined data from a population-based cancer registry. They looked at cervical cancer and precancer assessments conducted between Jan. 1, 2006 and June 30, 2019 in women between 20- and 64-years old.
All the women lived in the U.K., which began its school-based HPV immunization program in 2008. The older generations represented in the data would not have had access to HPV vaccination.
The researchers estimated that between 2006 and 2019 there had been approximately 448 fewer than expected cervical cancers and 17,235 fewer than expected cases of the CIN3 precancer among those in the vaccinated cohorts.
‘Very exciting study’
Cervarix protects against two strains of HPV associated with cervical cancer (Type 16 and Type 18). The Gardisil and Gardisil 9 vaccines are more commonly used in Canada, which started its school-based HPV vaccination program in 2007.
But the study’s results are relevant in this country too, said Dr. Amanda Selk, an obstetrician-gynecologist at Mount Sinai Hospital in Toronto. She was not involved in the British research.
“It’s a very exciting study, because it’s the first study that’s actually shown the HPV vaccine can prevent cervix cancer. All previous studies have shown that the vaccine can prevent the precancers,” said Selk, who is also president of the Society of Canadian Colposcopists. (Colposcopists examine the cervix.)
The results aren’t a surprise, she said, but the study provides additional proof of the vaccine’s importance — and may help convince parents who have been hesitant to have their children vaccinated.
“Many of us assumed it prevented cancers, but there were non-believers who wanted to see the cancer data. So here it is. Now we have it,” she said.
According to the Canadian Cancer Society, more than 1,400 people in Canada are expected to be diagnosed with cervical cancer in 2021 and about 380 will die from it. Both the society and the World Health Organization say nearly all cervical cancers are preventable, and have called for increased uptake of the HPV vaccine.
Dr. Allan Covens, head of gynecologic oncology at Sunnybrook Health Sciences Centre in Toronto, said the British study is “significant” for Canada.
“Both countries have adopted mass vaccination for young women,” Covens, who also was not involved in the U.K. study, said.
“So we can expect to see similar results in reduction in not only cervical cancer, but also precancerous changes [in cervical cells].”
Dr. Amanda Selk, an obstetrician-gynecologist in Toronto and president of the Society of Canadian Colposcopists, says the research offers firm evidence that the HPV vaccine prevents cervical cancer. (Women’s College Hospital)
The goal, Covens said, is to vaccinate young people before they become sexually active and are exposed to HPV. In addition, the younger someone is, the more robust their immune response to the vaccine is expected to be.
“We have the ability to prevent cervical cancer. Cervical cancer is related to a viral infection, and we can mitigate and prevent it with simple vaccination,” Covens said.
“It’s a safe vaccine and we’ve proven that it does exactly what it has been claimed to do,” Covens said.
Continued followup needed
The U.K. researchers acknowledged some limitations in their study, including the fact that since the HPV immunization program only started 13 years ago, the vaccinated population is still young and therefore would be less likely to be diagnosed with cervical cancer anyway.
Because cervical cancer is rare in young women, more followup as they grow older is needed, they said.
However, Type 16 and Type 18 HPV are found in up to 92 per cent of “women diagnosed with cervical cancer before the age of 30,” the authors said in a news release.
Despite the limitation, the study results are still significant, both Covens and Selk said.
In fact, the benefits could be even greater than the results suggest, they said, because the researchers only looked at outcomes for those who had received the Cervarix vaccine.
Gardisil also protects against HPV Types 16 and 18, and two types that cause genital warts. Gardisil 9 also protects against five additional HPV strains that can cause cervical cancer.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
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