Eliminating Cervical Cancer
The amazing story of the HPV vaccine
Cancer. It’s a terrifying word. Not just a disease, it has taken on a deep and pervasive cultural terror far outstripping any other issue. Having heart disease is a cause for worry; having cancer is a reason for terror. Partly that’s a rational fear of diseases that aren’t easy to cure, partly it’s because the treatments for cancer are almost as scary as the disease itself, and partly it’s because we still don’t know that much about many cancers and nothing inspires terror like the unknown.
And cervical cancer is no exception. It is one of the biggest killers in developed countries, and is responsible for nearly 10 million deaths each year worldwide, despite only impacting about half of the population.
Except, in some places, not for long.
Some countries may eliminate cervical cancer entirely within our lifetimes. Gone.
Human Papillomavirus, or HPV, is a very common infection that virtually every person in the world will get in their lifetime. HPV is responsible for most human warts, and is often extremely difficult to get rid of, making it generally both not a big issue and incredibly annoying for most people.
Here’s a photo, for those interested:
But HPV isn’t just an annoying wart-causing infection. Unfortunately, because HPV doesn’t just go away — it comes back again and again — over time it can cause damage to the cells in a number of places in your body. When cells are damaged, it can lead to a number of nasty issues, chief among them cancer.
This is particularly problematic for areas that aren’t routinely observable, like cervixes. Cervical HPV is easy to catch, long-lasting, and often totally asymptomatic, which makes it particularly dangerous. That infection you don’t notice, and never know about, can cause cancer 30 years later.
Now, not all HPV strains cause cancer. But, based on work done in the 90s, Australian scientists isolated the strains that they thought caused the majority of cervical cancers: HPV 16 and 18. As far as these scientists could see, more than 70% of all cervical cancers were caused by these same two strains of a single disease.
They had an obvious thought: “What if we could prevent those strains of HPV?”
And thus, the HPV vaccine was born.
Have You Herd About Immunity?
In 2006, the HPV vaccine was first licensed based on this work, in Australia. It was called Gardisil, and it actually protected against 4 strains of HPV: 16 and 18, the most dangerous ones, and 6 and 11 which don’t cause cervical cancer but are problematic in other places.
Based on extremely positive early studies, and the incredibly low rate of problems with the vaccine, Australia almost immediately made it a routine funded vaccine for all school-age girls. A few years later, school-age boys were included as well, when public health authorities noticed that they were already benefiting from herd immunity brought about by the vaccine. Amazingly, there was also what’s known as cross-protection, with the vaccine preventing strains of HPV that weren’t even included.
And now, a decade later, we can see the results of all those girls and boys being vaccinated.
They are truly remarkable.
Before the vaccine, 1 in 4 women had cancer-causing HPV.
Ten years later, that number had gone down to 1 in 100.
That’s a decline of almost unheard-of proportions, in under a decade. Evidence is also emerging that this reduction in HPV infections is already causing fewer women to get cervical cancer. Not only that, but fewer men and women are getting penile, anal, and throat cancer as well.
And because, as I mentioned, HPV causes virtually all cervical cancers, this drop is already leading to a dramatic reduction in the number of people getting cervical cancer.
The effect is so enormous that it appears that cervical cancer may be totally eliminated in Australia within our lifetimes.
It’s truly wonderful.
Unfortunately, the HPV vaccine has had a lot of bad press. People have raised concerns about the vaccine leading to teenagers having more sex, or serious health problems, despite the strong and consistent evidence to the contrary. With a decade of research, we can confidently say that the HPV vaccine is one of the safest medical interventions around. It also doesn’t lead to more unsafe sex in teens.
What it does do is save lives.
Australia may eliminate cervical cancer within a few decades. Many other countries around the world are following suit. The HPV vaccination has proven to be one of the most amazing public health victories of our time.
If you’re lucky enough to live somewhere where the HPV vaccine is paid for by the government, make sure you/your kids get it*. If not, you should see how much it costs — or if it’s covered by your insurance — and if you can get the vaccine anyway.
HPV vaccination is safe, effective, and prevents cancer.
It’s hard not to get excited about that.
*Important note: HPV vaccination is most effective in people who have not yet been exposed to the cancerous strains — i.e. people who have not yet had sex. It gets less and less effective as the population gets older, and by the time you’ve reached 40 it’s pretty much pointless. Keep this in mind and talk to a doctor if you’re planning to get the vaccine.