THE NATIONAL cervical cancer vaccination programme had been due to begin this week and the Minister for Health, Mary Harney, must now fulfil her commitment to reinstitute the programme next year, a leading expert in the area has said.
Dr Gráinne Flannelly, consultant gynaecologist and lead clinician in the colposcopy clinic of the National Maternity Hospital, said introduction of the vaccination scheme would save money as well as lives in the long run.
In August last year, Ms Harney said a national immunisation programme for all 12-year-old girls against the human papilloma virus (HPV), which causes most cervical cancers, would begin. That November, she said the plan was being postponed as the State could not afford the estimated €10 million a year it would cost.
Dr Flannelly was speaking at a conference at the weekend, Cancer at a Crossroads, hosted by a group of the same name with the Irish Cancer Society.
The Minister and the HSE’s National Cancer Control Programme (NCCP) came in for sustained criticism at the conference from leading oncology and medical research figures. The sharpest criticism came from specialists in cervical and tobacco-related cancers.
Dr Flannelly said the recessionary conditions were an opportunity for the Government to negotiate down the cost of the vaccination with manufacturers.
Prof John Crown, consultant oncologist at St Vincent’s University Hospital in Dublin, said the Portuguese government engaged in a bidding war with two vaccination manufacturers, and the price was brought “right down”.
Implementing a national vaccination programme would reduce to the incidence of HPV, said Dr Flannelly. Almost every woman who is sexually active has HPV at some stage, she said. In only a small number does it remain a sustained infection, and only in a smaller proportion of these women does this go on to produce abnormal, possibly cancerous, cells.
Vaccination would mean women over 30 could in future self-check for HPV, and only those few who were positive would need a full smear, she said. “At the moment this would not be useful, as there are high levels of non-persistent HPV in the population.”
The scheme would reduce numbers needing smears, and those with abnormal smears needing investigation. “This is cost-effective. We need a commitment now from the Department of Health that this is on the agenda for 2010. We need to see that in the estimates for the next budget.”
Regarding the Minister, Prof Luke Clancy, consultant respiratory physician and director of the Research Institute for a Tobacco Free Society, said: “You have to wonder what she has against tobacco control. She seems to have no interest in stopping the causes of cancer and wants to go straight to diagnosis. It makes your heart sink.”
He called for a nationally supported and easily accessible network of tobacco dependence treatment centres, where drugs and psychological support would be available. This would be cost-effective in a country with one million smokers, a significant number of whom develop smoking-related illnesses, including cancers.
Funds for research were vital, he added, if young doctors were to move into the area. His institute had secured a €3 million grant from Europe, dependent on it getting a €100,000 grant from the Government, he said. “We didn’t get it.” The institute has had to borrow it elsewhere, as its associate organisation the Irish Cancer Society could not afford to offset the refused €100,000 either.
Prof Crown said there was “zero evidence” that closing cancer treatment services at Sligo General hospital would have any impact on reducing cancer rates.
