Vaccine for cervical
cancer now available

Next to breast cancer, cervical cancer afflicts Filipino women the most. Statistics show an estimated 7,277 new cases and 3,807 deaths due to cervical cancer occurred in the country last year, 50 percent more than the new cases recorded in 2000. Annually, at least 2,000 Filipino women die from the disease, or 10 Filipino women die each day from cervical cancer.

Each year, cervical cancer kills around 300,000 women around the world, while nearly 500,000 new cases are diagnosed. More than 80 percent of these cases occur in developing countries.

The good news is, cancer of the cervix, can now be prevented, says Dr. Efren Domingo, president of the Society of Gynecologic Oncologists of the Philippines. He adds that recent developments in cancer management and treatment found that in 99 percent of cases, cervical cancer is caused by the human papillomavirus (HPV), a common virus.

There are more than 100 types of HPV, most of which are relatively harmless and do not cause any noticeable symptoms and will go away on their own. Of these types, about 30 infect the genital areas of women and men.

HPV infection causes abnormal growth and division of cells in the cervix – the opening of the woman’s womb. If left unchecked, the infection can eventually lead to cancer. Apart from causing cervical cancer, HPV infection also causes genital warts, vaginal, and vulvar cancers.

According to Dr. Domingo, often women do not realize that they have been infected with HPV because there are usually no symptoms. Infection with HPV will typically clear, but some infections with high-risk HPV types may ultimately lead to cervical cancer. Cervical lesions are due to abnormal cervical cells, known as cervical intraepithelial neoplasia (CIN). Following initial HPV infection, the course of progression to cervical cancer depends on the type of HPV.

Low-risk HPV types (such as HPV 6 or 11) have a negligible risk of progressing but may persist. Overall, the majority of HPV infections spontaneously clear within the first 24 months.

High-risk types (such as types HPV 16 and 18) are often associated with CIN 2 or higher lesions. Although CIN caused by HPV infection often clears without treatment, the likelihood of progression to invasive cancer is greater in more severe grades (CIN 2/3).

Cervical cancer is most likely to develop among women 35 years or older. If not detected and treated early, cervical cancer could be fatal.

The problem, he says, is that most women do not bother to have themselves screened for cervical cancer. He cites a study by the UP-PGH which found that less than 40 percent of Filipino women have ever had a Pap smear.

There are ways a person can reduce his or her risk of infection by staying in a long-term, mutually monogamous relationship with an uninfected partner or limiting the number of sexual partners; practicing protected sex using condoms, in particular but the level of protection from HPV infection with condom use has not yet been determined; refrain from any sexual genital contact with someone with the virus; and women should talk to their doctors about having regular Pap screening tests and discuss results with them.

But the more effective way to prevent cervical cancer is vaccination. "Since cervical cancer is caused by a virus, vaccines work well in preventing the infection," Dr. Domingo says.

The Bureau of Food and Drugs (BFAD) recently approved a vaccine against cervical cancer and this is now available in the Philippines. Dr. Domingo said that the quadrivalent human papillomavirus (types 6, 11, 16, 18) recombinant vaccine developed by Merck Sharp & Dohme, has been found in clinical trials to be nearly 100-percent effective in preventing cervical cancer associated with the most common types of HVP.

He added that the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted unanimously to recommend that American females 11 to 26 years old be vaccinated.