Renewed calls for free cervical vaccine

THE INSTITUTE of Obstetrics and Gynaecologists is appealing to the Government to introduce the cervical cancer (HPV) vaccination…

THE INSTITUTE of Obstetrics and Gynaecologists is appealing to the Government to introduce the cervical cancer (HPV) vaccination programme at a cost next year of about €9.7 million.

The institute, in association with the Irish Cancer Society and the Irish Society for Colposcopy and Cervical Pathology, is renewing its call for the vaccination to be made available to all 12-year-old girls, despite the abandonment of the mass vaccination plan two years ago due to lack of funds.

The organisations want the vaccine rolled out alongside CervicalCheck, the national cervical screening programme. The annual cost of HPV vaccination for the State’s 26,000 12-year-old girls was estimated at €9.7 million in 2008.

In their pre-budget submission published yesterday, the organisations said the State had a serious problem with cervical cancer, with particularly high mortality rates.

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Some 286 women were diagnosed with cervical cancer in 2007. Almost 60 per cent were under 39 years of age and 49 per cent presented with either stage III or stage IV of the disease, where the cancer had spread into the pelvic wall and other organs. A total of 81 women died from cervical cancer in 2007.

Prof Walter Prendiville, consultant gynaecologist at the Coombe Women’s Hospital, said mass vaccination would save money in the long run.

“This is not big bucks, it’s very small beer. We’re going through a difficult time with rain and recession and we need something positive. There is little you can do to prevent cancer in people, but this is one thing that really works.”

Research published last year by the Health Information and Quality Authority (Hiqa) found that the vaccination scheme was the most cost-effective strategy option in the Irish healthcare setting regarding the prevention of HPV types 16 and 18, which account for 70 per cent of all cervical cancers.

The cost-effectiveness ratio of the vaccination programme came out at a saving of €17,383 per year of life gained by those who have been vaccinated. Combined with screening, 90-95 per cent of cervical cancers could be prevented, Prof Prendiville said.

“If our healthcare system is serious about reducing cervical cancer incidence and mortality and making significant savings in the healthcare budget in the longer term, it must now introduce mass vaccination in conjunction with screening.”

Vaccination would also dramatically reduce the number of women who have to have colposcopy treatments following an abnormal smear test result.

Prof Prendiville said he realised there were budgetary constants, but these were outweighed by the health benefits.

“I appreciate that this Government, the Department of Health, is in a tough situation in choosing what aspects of care to cut and this Government will not be rewarded for this scheme. It will be a Government in 20 years, but an awful lot of women will be grateful they don’t have to go for colposcopy.”

Nine EU countries have so far offered the HPV vaccination free to at least one age group of females. The UK is the only place where a national school-based vaccination programme has been implemented. Provisional figures for Scotland show vaccine uptake at 92 per cent for the first dose and 88 per cent for the second.

Evidence from the European Cervical Cancer Association (ECCA) concerning the vaccination’s effectiveness shows that a nationwide free school-based programme is vital to achieve coverage of more than 85 per cent of the target population.

Olivia Kelly

Olivia Kelly

Olivia Kelly is Dublin Editor of The Irish Times