Wednesday, March 23, 2011

What effect will the availability of HPV vaccines really have on cervical cancer

According to Epidemiology: Cervical Cancer, during 2010, it was estimated that 35,898 women will develop cervical cancer in the seven major markets. Of this number 13,170 cases will have been in the US and approximately 18,000 in the EU5.

The good news is that between 2010 and 2020, total cervical cancer incident cases in the seven major markets are expected to decrease slightly by 4%. This change is due to
This weak decreasing trend is due to forecast decreases in incidence rates alongside forecasted increases in the most susceptible populations.

One recent advance that should contribute to a gradual fall in the numbers of women suffering cervical cancer is the availability of HPV vaccines.

HPV is the primary cause of cervical cancer and two vaccines have recently been made available to prevent infection with HPV.

Merck and its European marketing partner Sanofi-Pasteur launched Gardasil in the US and Europe in 2006. This was followed in 2007 by GSK's launch of Cervarix in Europe and later in 2010 in the US (see Infectious Diseases Vaccine Market Overview for more on the vaccine market).

The ultimate success of HPV vaccines in reducing the incidence of cervical cancer will be dictated by uptake. It is believed that uptake of about 80% is required for "herd immunity" - in other words 80% of girls in the target age range must be vaccinated to drive the eradication of HPV.

UK Department of Health figures suggested that by 2009, approximately 70% of 12-to-13-year-olds in England had been fully vaccinated. This high uptake is due in part to full state funding of the vaccine. The HPV vaccine is offered free of charge to the target population in Germany, Italy and the UK.

So, good news in some of the largest EU countries but elsewhere in Europe the picture is not as good. In France 65% of the cost is borne by the social security scheme and a recent report in the March issue of the Journal Vaccine by Fagot et al reports that just 33% of girls of the age of 14 years in 2007 and 24% in 2008 were reimbursed for required 3 doses of HPV vaccine.

This low rate of reimbursement is reflected in reports last year of low uptake. According to a Parisian study, reported by Rouzier and Giordanella, HPV vaccine coverage for female adolescents is around 17%, with less than half of girls vaccinated receiving all three doses.

According to the cervical cancer epidemiology report France has one of the lowest incidences of cervical cancer in Europe but based on the current uptake of HPV vaccine this may not continue to be the case.

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