Vaccination against the human papillomavirus is an effective strategy for preventing cervical cancer, a report the European Centre for Disease Prevention and Control has concluded.

The report, produced at the request of the European Commission and several EU Member States, reviewed evidence of the likely public health impact of HPV vaccination, and sets out several policy options on how to best implement routine vaccination programmes.

Two cervical cancer vaccines are currently approved in Europe – Sanofi Pasteur MSD’s Gardasil and GlaxoSmithKline’s Cervarix – and both offer protection against HPV types 16 and 18, which collectively account for around 73% of cases on the continent.

According to the ECDC panel, maximum benefit from these vaccines would be obtained by giving them to adolescent girls before they become sexually active. The age range of this group will vary from country to country, but will typically be in the 12-15 years old bracket, it said.

Importantly, the report stresses that the public health benefits of vaccinating adolescent girls will not start to show for many years because it takes decades for the disease to develop, and that cervical cancer screening programmes must be continued because there is still be a low risk of developing the disease from an infection with HPV types other than 16 and 18.

“Screening and HPV vaccination need to be made to work together in a cost-effective way that produces maximum benefit for women,” Professor Johan Giesecke, ECDC’s Chief Scientist, told delegates at the European Cervical Cancer Summit in Brussels yesterday.

The report concludes that school-based immunisation is likely to be “the lowest cost option” for administering the vaccine to young girls, although this will again vary between member states, where other settings such as doctors’ surgeries and medical clinics may be more appropriate.

Furthermore, while there is evidence from some countries that the introduction of HPV vaccination programmes may be cost effective as a cancer prevention measure, the report states that, as healthcare costs vary across Europe, an analysis needs to be done by individual member states.

UK programme in September
Several countries in the EU are already considering routine vaccination programmes. Earlier this year, France’s health authority issued a statement saying that it recommends the use of a quadrivalent vaccine – ie Gardasil - to immunise girls. And, in October last year, the UK’s Department of Health said that, from September, English school girls aged 12 to 13 will be routinely vaccinated against HPV at a cost of up to £100 million a year. It is hoped that the move will save up to 400 lives each year in the country alone.

Cervical cancer is the second most common form of the disease after breast cancer in women aged 15-44 years, with 33,000 cases and 15,000 deaths in the EU each year.