Fiona Reddanfinds out how the cervical cancer vaccine can be acquired privately and how to avail of the national screening programme
ALONG WITH the Government’s decision to means test the provision of medical cards to the over-70s, the other major health story of 2008 was the withdrawal of the cervical cancer vaccination programme for teenage girls.
While the free programme may be introduced at some stage, the Government is instead prioritising a national screening programme for older women which will help detect the virus that causes the cancer.
But, in the absence of a free programme, can the vaccine be acquired privately and at what cost? And how do older women avail of the national screening programme?
Q What is cervical cancer?
A Cervical cancer is currently the eighth most frequently diagnosed cancer in women in Ireland, and its frequency continues to rise. About 180 new cases of cervical cancer are diagnosed each year and about 70 women will die from it.
There is strong evidence that cancer of the cervix is caused by a virus called the human papilloma virus (HPV). The cancer develops slowly over a number of years, first becoming precancerous and then leading to cancer itself, which is why screening is particularly effective for this type of cancer. Cervical cancer can happen at any age but is more common in women in their 40s and 50s.
Q What is the vaccine?
A Two vaccines – Gardasil and Cervarix – aimed at preventing HPV infection have been licensed for use in the European Union. Many developed countries such as Australia, France and the UK have been quick to introduce vaccination programmes, aimed at reducing the risk of teenage girls developing the cancer later in life.
The Irish programme was aimed at vaccinating 12-year-old girls, and although its introduction is now uncertain, parents can still get their daughters vaccinated privately.
Q How much does the vaccine cost?
A Available on a private basis since 2006, the vaccine currently costs €600 for a course of three shots. However, one group is offering it for less than that.
Depending on your insurance plan, you may be able to claim back some of the €600 costs of the vaccine. Under its “We plan” Level 2, Hibernian Health offers a €250 contribution towards the cost of the vaccine, provided that the procedure is carried out by the Charter Medical Group, which is based in Dublin.
There is also the option of claiming back some of the cost of the vaccine against your tax, as it is covered by the Revenue Commissioner’s Med 1 scheme.
With all medical expenses now assessed at the standard rate of tax, the overall cost for the vaccine would be €480.
However, the Tropical Medical Bureau in Dublin has just announced it will charge €390 for the three injections, instead of €600.
The bureau has chosen Vervarix. It said it was “in discussions with VHI, Quinn and Hibernian Vivas and hope to be able to announce their support to have the vaccine covered under their health insurance policies”.
It also said it would hold a series of information meetings around the State to raise awareness of the new programme.
Q Where is the vaccine delivered?
A Your GP can give you the vaccine or you can attend a specialist clinic such as the Charter Medical Group.
The three injections, which are given in the arm, are given at zero, one and six-month intervals.
Q Who is the vaccine aimed at?
A As cervical cancer is caused by the Human Papilloma Virus (HPV), which is transmitted via sexual activity, the best time to be vaccinated is at the age of 12, as it allows a girl’s immune system to be prepared long before she becomes sexually active and is likely to encounter HPV.
However, Gardasil has been designed to be administered to girls and women up to 26 years.
The vaccine protects against the HPV, but as there are more than 100 different types of this virus, even sexually active women are unlikely to already have had exposure to all the HPV strains, which means that it can still be effective even after a girl has become sexually active.
Q How effective is the vaccine?
A The vaccine guards against the most common cancer- causing types of HPV – HPV 16 and HPV 18 – which are responsible for 70 per cent of cervical cancer cases, and it has a 99 per cent success rate against these strains of the virus.
It is estimated that the vaccine, along with cervical cancer screening, could prevent up to 95 per cent of cervical cancer cases.
Q What are the risks associated with the vaccine?
A As the vaccines are relatively new, one concern is that they haven’t been sufficiently tested over a long period of time, which means that the vaccine may become ineffective after a certain period of time.
For a full overview of the risks, you should discuss with your doctor.
Q Is screening still necessary even if you have received the vaccine?
A As the vaccine protects against only certain strains of the cancer-forming virus, which account for 70 per cent of all cancer cases, screening is still absolutely vital for early detection and in safeguarding against the other 30 per cent of cancer cases, which is where the National Cervical Screening Programme comes in.
Launched last September, the National Cervical Screening Programme provides free smear tests to women aged 25-60, which are carried out by a panel of more than 3,800 GPs, practice nurses, women’s health, family planning and well woman clinics. The test is a simple procedure whereby a sample of cells is taken from the cervix to look for early changes before they become cancer cells.
Q How can I access the national screening programme?
A To avail of the programme, women should check with their usual health provider to verify if they are a registered “CervicalCheck” smeartaker or check on the programme’s website, www.cervicalcheck.ie. An appointment can then be made in the doctor’s usual premises, and women should bring their Personal Public Service (PPS) number with them to ensure that the test is taken as part of the screening programme.
Thereafter, women aged 25-44 will be invited to have a smear test every three years, and those aged 45-60 every five years.
Q How long do the results take?
A While women may have experienced significant delays in the past with regards to getting the results of their tests – indeed in many cases they were outsourced to the US – the new programme commits to providing results within four weeks of having a smear test taken.