HPV (human Papilloma Virus) and HPV-vaccination (vaccination against cervical cancer)
Infections caused by the human papillomavirus (HPV) are the most common sexually transmitted diseases worldwide. 5 years after onset of sexual activity, 50% of young women have been infected, in the course of their lives 70% become infected (EMEA: Europ. Beurteilungsbericht (EPAR) GARDASIL, Stand Oct. 2006 under: http://www.EMEA.eu.int/htms/human/epar/a-zepar.htm).
There are more than 100 different kinds of HPV types; more than 35 attack the genital tract and 13 are considered to be carcinogenic.
80% of cervical cancer worldwide occurs in third world countries. In Germany the frequency has dropped radically since the pap smear test was introduced (WHO 2005: Report of the Consultation on Human Papillomavirus Vaccines; http://www.who.int/vaccine_research/documents/816%20%
As expected, STIKO (Vaccination Commission) passed the recommendation for general vaccinations against HPV for girls ages 12 to 17 years in late February 2007. Now the Federal Commission must decide whether the vaccination will become an obligatory vaccination financed by Germany’s legal health care provider.
Does cervical cancer pose a health problem in Germany?
Let’s take the numbers in Germany. Of 100,000 women who live in Germany, every year 15 women contract cervical cancer. In terms of Germany’s overall population this amounts to approx. 6,200 cases of cervical carcinoma (Robert Koch-Institut/Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (GEKID) (Hrsg.): Krebs in Deutschland 2003-2004 - Häufigkeiten und Trends, 6. Aufl. 2008; zu finden unter http://www.rki.de,Gesundheitsberichterstattung, Dachdokumentation Krebs, Broschüre zu Krebs; Accessible on March 10, 2008)
Connection between HPV Infection and cervical carcinoma
Nowadays the assumption is that there is no cervical carcinoma without an HPV infection. It is important to note, however, that an HPV infection rarely leads to a cervical carcinoma. The prerequisite is that the infection persists, in other words, that it is a chronic infection. However, even then only rarely does a cervical carcinoma develop.(a-t 2008, 3:29-38)
Due to the fact that a high risk HPV infection can be detected in more than 90% of the women who have cervical cancer the conclusion is that there is causality between infection and pathology. That is why the vaccination which is now available, Gardasil®, which protects against HPV-infections of the type 6, 11, 16 and 18, as well as Cervarix®, which is soon to be approved, which is to protect against the virus types 16 and 18 as well as 31 and 45, is seen as a vaccination against cervical cancer. Vaccination protection is only achieved if there is no infection with HPV at the time of the vaccination. That is why those who are in favor of vaccinations recommend that both boys and girls are to be vaccinated before they become sexually active – between 11 and 18 years of age. It is not known how long the protection lasts after the three fold vaccination. What has been proven is that there is vaccination protection for more than four and a half years. However, there are no long term trials. Presently the assumption is that a booster shot should be administered after ten years.
For more information on what you should know about HPV and HPV vaccinationHPV vaccination