Author: Max Pemberton
Few politicians will ever admit they are wrong, so I salute health ministers who have finally capitulated to medical opinion and last month announced a U-turn on the cervical cancer vaccine that is given to 12- and 13-year-old girls.
Until now, Cervarix, which protects against two strains of the human papilloma virus (HPV) that are a factor in at least 70 per cent of diagnoses, has been the NHS vaccine of choice. However, another vaccine, Gardasil, also protects against a further two strains of HPV which cause genital warts, the most common sexually-transmitted infection, requiring costly and unpleasant treatment.
As doctors have been arguing for some time, this has important public health implications. The current cost to the NHS of treating the 100,000 new cases of genital warts in England each year is £23 million. In several countries, including Australia, where Gardasil has been used in nationwide vaccination programmes, a 75 per cent decrease in the number of new cases of genital warts in the past three years has been reported.
Critics of NHS policy complained that Cervarix was chosen over Gardasil not on the basis of clinical efficacy but because its manufacturers offered it at a discounted price, making it the most cost-effective. Indeed, many doctors have admitted in the medical press that they have bought Gardasil for their daughters privately, while they had to give their patients Cervarix. But ministers have seen sense as now Gardasil will be available on the NHS.
But the battle against HPV has not been entirely won with this volte-face. Many doctors and public health officials believe that it is not only girls who should be protected. Gardasil prevent warts, but there is also emerging evidence to suggest that it can protect against other cancers caused by HPV, such as anal and penile cancers. And a study published in The New England Journal of Medicine showed that those infected with HPV were 32 times more likely to develop oral or throat cancers. This finding dwarfs the increased risk associated with two acknowledged factors for developing these cancers: smoking (three times more likely to develop cancer) and drinking (2.5 times). Research published last month in the Journal of Clinical Oncology found that HPV now accounts for more head and neck cancers than tobacco or alcohol.