Recommendations
American Cancer Society Develops Recommendations for HPV Vaccination
In a report published in CA: A Cancer Journal for Clinicians, the American Cancer Society recommends routine human papillomavirus (HPV) vaccination of girls between the ages of 11 and 12 years, and notes the continued importance of cervical cancer screening for both vaccinated and unvaccinated women.
Human papillomaviruses consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer. The types of HPV most commonly linked with cervical cancer are HPV 16 and HPV 18, but several other high-risk types contribute to cancer as well.
The types of HPV that cause cervical cancer or genital warts are transmitted sexually. HPV infection is extremely common and generally occurs soon after an individual becomes sexually active. Although most infections resolve on their own, some persist and can lead to precancerous or cancerous changes to the cervix, vulva, vagina, penis, and anus.
Recognition of the link between HPV and cervical cancer led to the development of vaccines designed to prevent infection with certain high-risk types of HPV. Gardasil®, developed by Merck, targets HPV types 6 and 11 (which are linked with genital warts) as well as the cancer-associated types 16 and 18. Gardasil was approved by the U.S. Food and Drug Administration (FDA) in June 2006. Cervarix™, developed by GlaxoSmithKline, also targets HPV types 16 and 18.
Because use of these vaccines represents a new approach to cervical cancer risk reduction, the American Cancer Society convened an expert panel to develop HPV vaccination guidelines.
The guidelines include the following points:
Routine HPV vaccination is recommended for girls 11 to 12 years of age.
- The vaccine may be given to girls as young as nine. In addition, girls between the ages of 13 and 18 may benefit if they were not vaccinated earlier. The vaccine is approved for women up to the age of 26, but the American Cancer Society concluded that there are insufficient data to support universal vaccination of women between the ages of 19 and 26. The guidelines note, “A decision about whether a woman aged 19 to 26 years should receive the vaccine should be based on an informed discussion between the woman and her health care provider…”
- Currently, HPV vaccination is not recommended for women over the age of 26, or males of any age. These recommendations may change as more data become available.
- Cervical cancer screening remains important for both vaccinated and unvaccinated women. The vaccine does not protect against all high-risk types of HPV.
The full text of these guidelines can be accessed online at http://caonline.amcancersoc.org/cgi/content/full/57/1/7
