Vaccine targets cervical cancer
Date: 14.8.2006
Gardasil was approved by the U.S. Food & Drug Administration in June, and some mid-valley physicians are already starting to make it available to their patients.
Dr. Cynthia Noble of Samaritan Obstetrics & Gynecology hailed the vaccine as an important medical advance.
“It’s huge,” Noble said. “If you look in this country, we have about 9,700 cases of cervical cancer diagnosed each year. It’s estimated that for 2006, about 3,700 women will die.”
Those numbers are low compared with the developing world, where women often lack access to regular Pap smears, which have helped doctors head off the disease in its formative stages in the United States and other First World nations.
“If you look worldwide, cervical cancer is the second-leading cause of cancer death in women,” Noble said, with a half-million new cases diagnosed each year.
“We might be able to make a difference with this vaccine if we can make it available.”
Price could be a barrier, however, both in this country and abroad. Gardasil costs $120 a dose, and Merck recommends three injections over a six-month span.
So far, only a handful of U.S. insurance companies have agreed to cover the vaccine, although others are widely expected to follow suit.
“I think the insurance people are going to fall in line,” Noble said. “It totally makes sense.”
Additional vaccines may follow. GlaxoSmithKline is seeking FDA approval for a cancer-targeted HPV vaccine called Cervarix, and Merck has announced plans to seek licensure for a male version of its HPV product in the next few years.
There are more than 100 strains of the human papilloma virus, according to the American Cancer Society. About 60 HPV types are responsible for common warts typically found on the hands or feet.
The remaining 40 or so types include viral strains that are implicated in virtually all cervical cancers. That group also includes strains that cause some other cancers of the rectum and genitals as well as genital warts in both men and women.
HPV is spread primarily through sexual contact and is extremely common.
The American Cancer Society estimates that half to three-fourths of people who have ever had sex will have the virus at some point in their lives.
The good news is that most people never develop any symptoms. However, they can still spread the virus.
While Gardasil provides some protection to women as old as 26 who are already sexually active, it is most effective in girls between the ages of 10 and 15. The federal Advisory Committee on Immunization Practices recommends the vaccine be given to all girls at the age of 11 or 12 and says it can be administered to girls as young as 9.
Some critics have argued that giving an HPV vaccine to young girls could be seen as encouraging sex too early. But Noble cites national surveys that show about a third of U.S. teens are sexually active by the ninth grade and that as many as 7.4 percent have had sex before their 13th birthday.
For the physicians in her practice, she said, recommending the vaccine is an easy call.
“For us it’s a no-brainer,” Noble said. “But we’re not pediatricians. It’s a harder sell for them.”
Dr. Amey Lee, an ob-gyn with the Corvallis Clinic, said education is the key.
“We will be putting on some talks on the HPV vaccine this fall with the new school year to educate families with middle-schoolers and high-schoolers,” she said, “because that’s really the target group for the vaccine.”
She’s already spoken to several mothers about Gardasil, Lee said, and they’ve been receptive.
“This is to prevent disease for your children,” she said. “It’s not a judgment.”
Lee hopes public acceptance of the HPV vaccine will follow the same course as the vaccine for hepatitis B, another common viral disease spread by sexual contact.
“When I went into medical school, it was given only to high-risk patients,” she said. “Now it’s given to all infants.”
Bennett Hall is the business editor for the Gazette-Times. He can be reached at 758-9529 or bennett.hall@lee.net
"Source":[ http://www.gtconnect.com/articles/2006/08/06/news/community/sunloc01.txt]
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