Health
U.K. study shows cervical cancer is preventable with HPV vaccine, experts say – CBC.ca
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).”
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].”
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.
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A new report from the Heart and Stroke Foundation shows that women are more likely to suffer adverse mental health effects after a stroke, and that services and supports are lacking.
The report, Stroke and Mental Health: The Invisible and Inequitable Effects on Women, was released on Thursday.
Dr. Clair Barefoot, clinical psychologist at the Nova Scotia Rehabilitation Centre, says recovering from a stroke can take a big toll on people.
That, coupled with the additional roles women often take on—such as caring for children, can cause additional strain and force them to leave rehab early.
Barefoot says supports and services are generally lacking across Canada.
She says it is quite difficult and expensive for people to find personalized care, so she would like to see more psychologists in hospitals and more funding for the private sector so that people can access more of those services after they’re discharged.
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Cancer test maker Grail Inc said on Friday that its telemedicine vendor erroneously sent letters to about 400 patients suggesting they may have developed cancer.
Grail’s flagship cancer detection blood test Galleri is designed to detect more than 50 types of cancer before symptoms appear.
The company, owned by Illumina Inc, ILMN-Q said the letters were mistakenly sent by PWNHealth due to a software issue and that it “was in no way related to or caused by an incorrect Galleri test result”.
Grail said it had reached out to the patients immediately after the issue, adding that no patient health information has been disclosed or breached due to this.
The software issue being faced by PWNHealth has now been resolved, it said.
Illumina is currently appealing regulatory orders in the U.S. and EU, which are asking the gene sequencing company to divest Grail after it jumped regulators to close its acquisition of the cancer test maker.
Unprotected sex with more than one partner in a six month period is the biggest risk factor behind a recent rise in syphilis cases in Waterloo region, according to a report on infectious disease trends from Region of Waterloo Public Health.
The annual infectious diseases surveillance report gathers and analyzes information on the infectious diseases that physicians, laboratories and hospitals are required to report to the region’s public health unit in line with Ontario Public Health Standards.
Infectious diseases are illnesses caused by microorganisms such as bacteria, viruses, and parasites that have the potential to cause serious illness and outbreaks.
There were 116 reports of infectious syphilis in the region last year, a rate of 17.8 per 100,000 population compared to 23.1 across the province. The number is down from a high of 143 reported cases in 2021, and a rate of 22.2 per 100,000 that was higher than the provincial average of 20.6.
The report says rates of syphilis, while lower than the province, have increased substantially in recent years, especially among females. This trend has also been observed in the province, which suggests a shift in epidemiology and sexual health practices.
The most common sexually transmitted infections in Waterloo Region continue to be chlamydia and gonorrhea.
There were 1,388 cases of chlamydia reported across the region last year, a rate of 192.8 per 100,000 population compared to 255.9 provincially. That’s down slightly from the age-standardized rate of 196.9 per 100,000 reported in 2021.
Gonorrhea case counts continued to spike across the province in 2022, while experiencing a slight decline in the rate of infection in Waterloo region.
Waterloo region reported 266 cases last year, a rate of 38.2 per 100,000. That’s compared to 77.5 per 100,000 province-wide.
Across the board, the demographic with the highest number of cases of sexually transmitted infections locally and across the province is the 20 to 29 age group.
Mpox, previously known as monkeypox, was declared a disease of global public health concern and became a newly reportable disease in Ontario in 2022.
There were only four local cases of mpox last year. Public Health says it has been monitoring the situation, working with health care providers to provide up-todate treatment guidance, and providing mpox vaccines to high-risk individuals.
The mpox virus is most commonly spread to people through close, physical contact with an infected person.
Campylobacter enteritis and salmonellosis were the most common enteric diseases in Waterloo Region in 2022. The local rates for enteric diseases were similar to or lower than those of the province.
Risk factors for enteric illnesses such as Campylobacter enteritis and salmonellosis include consuming undercooked meats and unpasteurized dairy products, ingesting contaminated food or water, and contact with infected persons.
Rates of vaccine preventable diseases in Waterloo Region were similar to those of the province. The most common vaccine preventable diseases in Waterloo Region were pneumococcal disease and pertussis (whooping cough).
In 2022, as we returned to normal activities, we saw a return of circulating respiratory viruses including pertussis with rates higher than had been seen during the first two years of the pandemic.
Public Health says immunization is the best way to prevent whooping cough. Pneumococcal vaccine is also recommended for infants, older adults 65 years and older, and those at high risk from the infection.
Region of Waterloo Public Health undertakes a number of activities to prevent or reduce the burden of infectious diseases in the community.
Programs and services include case management, contacts and exposures for diseases of public health significance; inspections, investigations and outbreak management, including community outbreaks and those in institutions; health promotion activities and services for primary care providers, emergency service workers, childcare providers, and other community groups; and clinic-based services for sexual health, immunization, and tuberculosis screening and management.
Region of Waterloo Public Health says it will provide highlights of respiratory disease trends, including influenza, in a report to council this fall.
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