Who is saved by a cancer vaccination
Vaccination against human papillomavirus should become a nationwide procedure
Alexandra Tyulyandina, Nezavisimaya Gazeta
Cervical cancer is one of the ten most common oncological diseases and ranks fifth in incidence among all malignant tumors in women and second among all tumors of the female reproductive system. According to statistics, more than half a million new cases of cervical cancer are diagnosed annually in the world. If you believe the Russian data, then in our country this figure reaches 16 thousand.
The cause of cervical cancer in the vast majority of cases is the human papillomavirus (HPV). In some countries, programs for the primary prevention of this oncological disease are actively carried out, which is the world's first project for the vaccination of malignant tumors. Since last year, vaccination of boys has begun in several countries around the world, since they may be carriers of the HPV virus. It has also been shown that the human papillomavirus can cause the development of malignant tumors of the anus, penis, oropharynx.
In order for vaccination to have an effect on reducing the incidence of cervical cancer, a long follow-up period is required. It is known that the risk of this form of malignant tumors increases after 10-15 years of viral transmission. Up to this point, precancerous diseases may be detected. The first data on a decrease in the incidence of HPV infection in adolescents have already been obtained, and there is also a decrease in precancerous pathologies, which will reduce the incidence of cervical cancer in women in the future.
Vaccines have been registered in Russia since 2006, and free vaccination has been started in some cities since 2009. However, these programs are currently closed due to lack of funding.
In those countries where close attention has been paid to the consistently high rates of this disease, national programs have been carried out at the state level for 10 years, which are aimed at the preventive fight against the human papillomavirus. In 2017, very impressive results were published. In Australia, the USA, Great Britain, Denmark, Japan, Scotland, after the start of vaccination of adolescent girls, a decrease in the incidence of HPV infection to 70-85% among vaccinated was noted.
In our country, the introduction of such vaccination is rather skeptical. This is caused, for example, by statements about its harmfulness up to the occurrence of female infertility. However, there is not a single confirmed fact of harm from the vaccine, especially the occurrence of infertility. The vaccine itself is completely harmless, since it does not contain components of the HPV virus.
This year, a scientific paper was published to assess the fertility function of 3,200 women who were vaccinated in adolescence. In this population, the percentage of infertility is comparable to that of unvaccinated and even lower than that of women who are carriers of sexually transmitted infections.
Reducing the incidence and, in parallel, mortality from cervical cancer is impossible without preventive measures, which include vaccination. Therefore, the cancer community actively promotes the need to include a vaccine to prevent HPV infection in a single vaccination day.
In addition to vaccination, there is another type – secondary prevention of cancer – screening, which has proven its effectiveness as a way to detect malignant diseases at early stages. Vaccination should be the main element of prevention, but cervical cancer screening has not been canceled, and it will be a complementary method.
Specialists of the Russian Society of Clinical Oncology (RUSSCO) are confident that in Russia vaccination, which seems to be an expensive program, is the most effective method from an economic point of view. Currently, the cost of one dose (and there should be three in total) for commercial vaccination is about 6 thousand rubles.
According to some estimates, the cost of the state for the annual universal vaccination of girls aged 9 to 17 years may amount to 13 billion rubles, and the annual cost of screening – 16 billion rubles. At first glance, the numbers are huge. It is clear that the budget of our country is probably not ready for them today.
On the other hand, according to existing Russian statistics, the annual losses in the country from the treatment of patients and their disability already amount to 30 billion to 75 billion rubles.
With the adoption of measures to prevent these diseases, you can get obvious budget savings. And it is possible to ensure the implementation of the vaccination program by creating special services on the ground, which, following the example of the countries already listed, where they exist, will be responsible for organizing the process and monitoring its implementation. At the same time, such a service will relieve the doctors themselves of non-core responsibilities for accounting and tracking the timing and number of vaccinations for each patient.
Preventive vaccination against the human papillomavirus primarily aims, as in the case of smallpox, to permanently eliminate the HPV virus from our lives.
About the author:
Alexandra Sergeevna Tyulyandina is a senior researcher at the N.N. Blokhin National Research Center of Oncology, a member of the RUSSCO Board.
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