Cervical Cancer

In the UK there are about 2,800 cases of cervical cancer per year and 1,100 deaths. The cause of cervical cancer has been narrowed down to a single agent - the human papilloma virus (HPV). The evidence points firmly to cancer causing HPV types that have been found in over 99 per cent of cervical cancers.

Almost all cases of cervical cancer are associated with HPV (human papillomavirus) infection, which is a virus that can infect the cells of the cervix but does not have any symptoms. In the UK there are about 2,800 cases of cervical cancer per year and 1,100 deaths. The peak incidence of cervical cancer occurs in women in their 30s, with a lifetime risk estimated as 1 in 116.

What is human papillomavirus?

HPV is a common, highly infectious virus, which can infect the cells of the cervix. Up to 80% of women will be infected at some point in their lives. Nearly half of these infections will be by a strain of HPV which has the potential to cause cervical cancer – although experts stress that only a small percentage of women that are infected will go on to develop the disease as, in most instances, infections of this nature tend to clear naturally.

There are over 100 different strains of HPV but only 15 strains are considered to be cancer-causing. Other types of HPV can cause genital warts. The types of HPV that can cause cervical cancer do not have any symptoms. The virus can become active after a long period of being inactive and can then cause abnormal cell changes which might eventually turn into cancer. Some other factors, including smoking and long-term use of oral contraceptives, may also make an HPV infection more likely to persist – and therefore increase the risk of cancerous changes in the cervical tissue. But these lifestyle factors alone do not cause cervical cancer.

 

How do you catch HPV?

HPV is sexually transmitted infection (STI), and is transmitted through genital skin-to-skin contact. Sexual intercourse is not necessary, but condoms can provide partial protection against HPV. Men can also carry the HPV virus, although in most cases, the types of HPV that cause cervical cancer are less likely to have harmful health effects on men.

 

Can infection with HPV be prevented?

Vaccines that prevent HPV infection are now available. In clinical trials, the vaccines are over 99% effective at preventing pre-cancerous lesions associated with HPV types 16 and 18, which cause over 70% of cervical cancer. Some vaccines will also protect against genital warts.

The vaccines are variously licensed for women. The government will make them freely available to girls from 12 years old up to 18 from September 2008, through the schools vaccination programme. However, it will still be important for women to attend cervical screening when invited. Cervical screening (the smear test) picks up abnormal cell changes in the cervix that can lead to cervical cancer if left untreated.

 

UK Vaccination Programme

The objective of the HPV immunisation programme is to provide three doses of HPV vaccine to females before they reach an age when the risk of HPV infection increases and they are at subsequent risk of cervical cancer.

The schools programme will begin at the start of the 2008/09 school year.

• the first cohort to be immunised will be girls born between 1 September 1995 and 31 August 1996 (school year 8 in 2008/09)
• a three-dose course of HPV vaccination is required over about six months

A two-year catch-up campaign will start from the beginning of the 2009/10 school year for all girls aged up to 18 years (i.e. 17 years and 364 days) at 31 August 2009, that is:

• all girls born between 1 September 1991 and 31 August 1993 (school years 12 and 13 in the academic year 2009/10) will be offered immunisation from the beginning of the 2009/10 school year, and
• all girls born between 1 September 1993 and 31 August 1995 (school years 11 and 12 in the academic year 2010/11) will be offered the vaccine from the beginning of the 2010/11 school year.

To find out more

 

1. Green Book - Chapter 18a
    
2. NHS Immunisation website
    
3. GSK
    
4. Tell Her
    
5. Cancer Research UK
    
6. Cervical Screening (NHS)
    
7. Jo’s Trust.