The bivalent human papillomavirus (HPV) vaccine (Cervarix, GlaxoSmithKline) offers excellent protection against the more serious immediate precursor to invasive cervical cancer (ICC), particularly when given to young adolescent girls before they become sexually active. The findings of two studies published Online First on November 8, 2011 in The Lancet Oncology, also show that the vaccine partially protects against four other cancer-causing HPV types not targeted by the formulation, that together with HPV16/18, cause about 85% of cervical cancer worldwide. "Provided that organized vaccination programmes achieve high coverage in early adolescents before sexual debut, HPV vaccination has the potential to substantially reduce the incidence of cervical cancer, probably allowing modification of screening programs… when conducted alongside vaccination strategies," explains one of the lead authors, Dr. Matti Lehtinen from the University of Tampere in Finland. The bivalent vaccine targets HPV types 16 and 18 that are responsible for about 70% of cervical cancers. Most studies of vaccine efficacy have focused on prevention of cervical intraepithelial neoplasia 2 (CIN2) or higher. However, CIN3 is generally believed to be a more reproducible and predictive endpoint than CIN2, and often progresses to ICC. In 2009, the PApilloma TRIal against Cancer In young Adults (PATRICIA), the largest study of HPV16/18 vaccine efficacy to date, reported that the bivalent vaccine had high efficacy against the precancerous cervical lesions CIN2+. The study included almost 20 000 healthy women aged 15-25 years from 14 countries in Asia-Pacific, Europe, Latin America, and North America. Women were randomly assigned to receive the bivalent HPV vaccine or a control (hepatitis A) vaccine, given in three doses at enrollment, 1 month, and 6 months.
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