A study just published in the Lancet suggests that Australia’s cervical cancer vaccination programme is already showing signs of success, with a decrease in the number of high-grade cervical abnormalities in vaccinated girls under 18.
To quickly recap, the human papilloma virus (HPV) is a sexually transmitted infection which causes cervical cancer in women. A number of countries, including NZ, now vaccinate girls from the age of 12 against the most common HPV types. There are currently two vaccines on the market: Gardasil and Cervarix.
DÃ©bora Miranda recently wrote about the plight of women with cervical cancer in Africa. Apparently more than 1 in 5 cases of cervical cancer are in women in developing countries, which lack the screening programmes we have access to. The Global Alliance for Vaccines and Immunisation (Gavi) recently announced that Merck offered a 67% reduction in the current public price of their Gardasil vaccine, to $5. Merck also support the Gardasil access programme having pledged to donate 3 million doses of Gardasil to low income countries.
But why are only girls vaccinated? HPV can also cause a variety of cancers in men, including anal cancer and a subset of penile and oral cancers. In fact, in the developed world, the number of HPV-related cancers in men is similar to that of cervical cancer in women.
I was recently chatting with Daniel Keogh, aka Professor Funk, who paid to get himself vaccinated and produced a fantastic video encouraging young men to do the same.
Daniel raised two important points:
1. Why should girls be made responsible for sexual health? After all, its the boys who will be infecting them.
2. What about those boys who are bi or gay?
Indeed, what of the boys? Last year, Joel Palefsky wrote an article published in the Journal of Adolescent Health outlining the case for vaccinating boys as well as girls from a young age. It certainly makes sense. Presumably, the decision to only vaccinate girls is based on some cost-benefit analysis and the boys lost out. But maybe we should be turning this on its head and vaccinating the boys instead. That way they won’t spread HPV to girls, protecting them against cervical cancer, while also protecting bisexual and gay boys.
On an almost unrelated note, I’ve just finished reading The immortal life of Henrietta Lacks by Rebecca Skloot. An amazing story and one which every scientist should read. Cells from Henrietta Lacks’ cervical cancer tumour turned into the first immortalised cell line. And that tumour arose because Henrietta Lacks was infected with multiple copies of the most virulent HPV strain known. So HPV also gave us HeLa cells, the most commonly used cell line instrumental in many of the scientific advances made in the last 60 years.