The distribution of the different types of human papilloma virus that cause cervical cancer are consistent across the world, according to a new study from the University of North Carolina at Chapel Hill.

This means that the vaccines that are currently available to protect against the two most prevalent types of HPV could prevent about 70 percent of invasive cervical cancer cases not just in the U.S, but around the world.

The researchers report that HPV16 is the most common and HPV18 is the second-most common typie in all continents. Gardasil by Merck protects against both of these types as does a similar vaccine developed by GlaxoSmithKline.

Lead study author Jennifer Smith, Ph.D cautions, "While having these vaccines represents a significant step forward, HPV-vaccinated women will need to receive clear messages that they still need to obtain their recommended Pap smears for cervical cancer prevention, given that HPV vaccines will not prevent all invasive cancer or high-grade lesions."

Gardasil, a vaccine against four types of the human papillomarivus (HPV), may reduce the risk of cancers of the vagina and vulva in addition to reducing the risk of cervical cancer.

The HPV virus can lead to precancerous or cancerous changes to the cervix, vagina, penis and anus. Researchers combined information from three clinical trials to evaluate the effectiveness of Gardasil on the risk of precancerous changes to the vulva and vagina.

The study found that among women who had not been infected with the HPV virus, Gardasil was 100 percent effective against precancerous changes to the vulva or vagina. Among those that had been infected with a certain strain of the HPV virus, Gardasil was 71 percent effective. Gardasil was 49 percent effective against all precancerous changes to the vulva or vagina.

The researchers concluded "With time, such vaccination could result in reduced rates of HPV-related vulval and vaginal cancers".

It's not yet clear if the drug Gardasil, the vaccine intended to prevent the human papillomavirus (HPV) in females, is effective for men. But some men are signing up for the chance to take the drug.

Gay and bisexual men in San Francisco are asking their doctors for the vaccine with hopes it will prevent anal and penile cancer, also caused by HPV.

"The prevalence of anal cancer among gay and bisexual men is very high," says Jason Riggs, spokesman for the STOP AIDS Project. "So that's why some people are looking at this as a possible preventive cure for anal cancer and HPV that causes anal cancer."

Anal cancer occurs among gay and bisexual men at a rate 35 times higher than that of the general population. And it occurs more in those infected with HIV.

Albuquerque, New Mexico is on the verge of becoming the latest state to require sixth-grade girls to be vaccinated against the HPV virus. Currently only Texas requires the vaccine, other states are in the process of considering having the vaccine become mandatory.

Federal regulators have approved the vaccine, made by Merck & Co, but the issue of making it a requirement for girls has been surrounded by controversy. The federal government approved Gardasil, a three-dose vaccine that protects against the human papilloma virus, or HPV, in June 2006 for females ages nine to twenty six. The vaccine protects against the HPV strains that cause cervical, vulvar and vaginal cancers.

Some states want the drug to be free to all girls who want it and other states are considering making the cervical vaccine mandatory for girls entering six grade unless their parents sign a form refusing it.

More of The Cancer Blog's coverage of this issue can be found here:

Merck stops cervical cancer vaccine campaign

Texas first to mandate cervical cancer vaccine

Cervical cancer vaccine discount pursued for poor nations

New Hampshire first to immunize young girls

Girls should see gynecologist in early teens

Thirteen year old girl is the first in Britain to have the new cervical cancer vaccine

Vaccine for cervical cancer to be administered to sixth graders

Concerns raised about new cervical cancer vaccine

Cervical cancer vaccine available for college students

Cancer vaccines virginity and sex: a battle first for acceptance

Women In Government applaud FDA approval of cervical cancer vaccine

First cervical cancer vaccine approved

Merck, maker of the cervical cancer vaccine Gardasil, is backing off its lobbying campaign following pressure from medical groups and parents who believe the vaccine should not be mandated as a school attendance requirement for adolescent girls.

The public outcry that caused Merck to announce its stop order on Tuesday stems from the fact that the vaccine protects against the sexually transmitted human papilloma virus (HPV), which causes cervical cancer. School-mandated vaccines are typically for diseases spread through casual contact, such as measles and mumps.

Merck's medical director for vaccines, Dr. Richard M. Haupt says, "We're concerned that our role in supporting school requirements is a distraction from that goal, and as such have suspended our lobbying efforts," adding that the company will continue providing information about the vaccine upon request.

Gardasil, launched in June and the first vaccine to prevent cervical cancer, has inspired controversy since day one. There's the cost -- $360 for three required shots -- and all sorts of insurance concerns and conservative groups who worry the vaccine encourages premarital sex and interferes with parental rights. Even those in support of the vaccine -- like the American Academy of Pediatrics and the American Academy of Family Practitioners -- question Merck's quick push to market this drug, especially in light of the company's withdrawn painkiller Vioxx.

"I believe that their timing was a little bit premature so soon after (Gardasil's) release, before we have a picture of whether there are going to be any untoward side effects," says Dr. Anne Francis, who chairs an American Academy of Pediatrics committee.

Legislatures in 20 states have taken steps to mandate the vaccine for young girls. And with the exception of Texas governor Rick Perry's February 2 executive order requiring Texas girls entering the sixth grade in 2008 get vaccinated, nothing has been made official so far.

Come September 2008, 11 and 12-year-old girls in Texas entering the sixth grade will receive three shots of the Gardasil vaccine used to prevent cervical cancer.

Texas is the first state to require that young schoolgirls receive the cervical cancer vaccine, approved for use by the FDA in June and proven to protect against the most common strains of the human papilloma virus (HPV) -- the cause of most cervical cases cervical cancers.

Texas governor Rick Perry (R), who just signed an executive order making this mandate official, believes the high cost of treating diseases and ensuring the health and well-being of our population justifies the vaccine requirement.

Perry, who has been met with opposition from those concerned that HPV vaccination of young girls promotes premarital sex and interferes with parental rights, will allow parents to opt out of the vaccination requirement with documentation citing religious or philosophical reasons. But he hopes most will comply with the cervical cancer vaccine he believes is no different than immunization against diseases such as polio.

Gardasil drugmaker Merck stands to make billions if the vaccine is made mandatory across the country. The series of three necessary shots cost $360.

Perry, who received $6,000 from Merck's political action committee during his re-election campaign, has other ties to the company. His former chief of staff is one of Merck's three lobbyists in Texas, and his current chief of staff's mother-in-law is state director for Women in Government -- a group active in introducing bills across the country that affect women.

The United Arab Emirates (UAE) is the first country in the Middle East to acquire the cervical cancer vaccine, Gardasil.

Comparisons of cervical cancer statistics for the years 1998 through 2005 show incidences of the disease tripling during this span of time. So acquisition of the vaccine is a true blessing for the women of this country.

"We are proud to have placed the UAE on the map with leading countries such as the US, Australia and EU by approving Gardasil, the first breakthrough vaccine that prevents the cancer," said Dr Wisam Haddadin, Franchise Manager, Gulf Region, Merck Sharp & Dohme.

Gardasil, distributed by Merck, Sharp, & Dohme, is now available in more than 33 countries for the prevention of cervical cancer, most commonly caused by HPV (human papilloma virus). About 2.3 million women are currently diagnosed with cervical cancer worldwide. About 800 women die of the disease every day.

United States drug company Merck hopes to offer the cervical cancer vaccine Gardasil to developing countries at much lower prices -- within months, if possible.

Currently, the three-dose vaccine is not affordable in the developing world -- where 80 percent of cervical cancer deaths occur and 95 percent of females have never had a Pap test . And while the exact discounted price has not yet been determined, Merck professionals report they are committed to slashing the price of Gardasil for these women.

Merck also aims to help developing countries receive drugs sooner. Right now, there is a time lag of 15 to 20 years between the approval of drugs in the West and the time they reach these countries.

Cervical cancer was once the most common cancer in women. But between 1955 and 1992, the number of cervical cancer deaths dropped by 74 percent -- thanks to increased use of the Pap test, a screening tool that can find changes in the cervix before cancer develops and can also detect cancer in its most curable stage. The Pap test is still widely used. And the cervical cancer death rate continues to drop four percent every year.

In 2006, about 9,700 new cases of invasive cervical cancer will be diagnosed in the United States. About 3,700 women will die from the disease. Non-invasive cervical cancer is believed to be four times more common than the invasive form of the disease. Nearly all of these cases can be cured.

Cervical cancer typically occurs in women between the ages of 35 and 55 and rarely in women under the age of 20. It affects mostly Hispanic women, and African-American women develop the disease 50 percent more often than non-Hispanic white women. Women most as risk for cervical cancer are smokers, those with HIV or chlamydia infections, those with diets low in fruit and vegetable consumption, those who between 1940 and 1971 took the hormonal drug DES, and those who have taken oral contraceptives for extended periods of time. Women who have had multiple pregnancies, have a family history of the disease, and have a low socio-economic status are also at risk. Those most at risk, however, are women with human papilloma virus.

Human papilloma virus (HPV) is the most common risk factor for cervical cancer, and some experts believe a woman must have HPV to contract cervical cancer. There are 100 different types of HPV, 13 of which are likely to cause cervical cancer through sexual contact. There are usually no symptoms of HPV, but possible signs of cervical cancer can include vaginal bleeding, unusual discharge, pelvic pain, and pain during sexual intercourse.

There are two ways to stop cervical cancer. First, women can protect themselves against HPV. Protection comes in the form of delaying sexual activity, limiting the amount of sexual partners and their partners, using condoms (thought to be 70 percent effective) and receiving the cervical cancer vaccine, recommended for use in females ages 11-26. The vaccine is most effective for women who have never been sexually active. Second, women can receive regular Pap tests in order to catch pre-cancers. Pap tests are recommended for women three years after their first sexual encounter and before the age of 21 -- and then every year after that.

An abnormal Pap test typically prompts a colposcopy -- a technique that uses a scope to examine the cervix. Diagnosis usually stems from a combination of other scoping methods, pelvic exams, imaging tests, and biopsies used to confirm the presence of cancer and to stage the disease. Stages range from 0-4.

For non-invasive cervical cancer, surgery -- ranging from removal of the cancerous tissue to hysterectomy -- may be the only treatment necessary. For invasive forms of the cancer, surgery is often followed by radiation and chemotherapy. Women interested in preserving their fertility should discuss options with their physicians.

The state of cervical cancer has come a long way over the years. And this year, two critical developments emerged. In June 2006, the FDA approved the first drug for late-stage cervical cancer. The drug, Hycamtin, is recommended for use in combination with chemotherapy. Also is June, the cervical cancer vaccine, Gardasil, was released. Both developments are monumental -- and both will undoubtedly help decrease the already-dropping cervical cancer death rate.

For more information about cervical cancer, visit the following sites:

American Cancer Society
Mayo Clinic
Medline Plus
National Women's Health Information Center

A thirteen year old London girl has become the first in the country to receive the cervical cancer vaccine. The vaccine, Gardasil, launched in Britain last week, protects against the main viruses that cause cervical cancer. Gardasil targets the human papilloma viruses (HPV), which can be transmitted through sex.

Hollie Anderson's mother, Lisa, had the vaccine given to her daughter privately after seeing her own mother battle against cancer. She did this because the government has not yet issued a guidance on which groups will be routinely immunized. Mothers are taking their daughters to private clinics instead to get the vaccination. Dr. George Kassianos, the Royal College of General Practioners' immunization spokesman said: "This vaccine is available on prescription today, but patients should wait for the Department of Health to give us guidance. Everyone agrees that this is a great leap forward. I would ask that department to fast track a decision".

There are 2,800 new cases of cervical cancer diagnosed in Britain every year. About 1,000 women will die of the disease. Mrs. Anderson said "When I found out from our doctor that these injections were becoming available it wasn't a difficult decision to make" I asked Hollie and she said she wanted it. it was her decision. Afterwards she said 'Thank you mum, I know you're protecting me against a disease'.

At this time, there are 200 companies engaged in 600 clinical trials that involve 340 immunotherapy drugs -- all under study in an attempt to assist in the treatment of 40 different cancers. The top five targeted cancers are melanoma, breast, lung, prostate, and colorectal.

While antibody studies are the top headline-makers right now, cancer vaccines are following behind. With the recent approval of Gardasil -- the cervical cancer vaccine -- the push for more vaccine options will become strong. Future industry challenges also include discovering strong antigens, effective immunomodulators, and suitable delivery technologies.

Powerful drugs like Avastin, Erbitux, and Rituxan are just the precursors to what might lie ahead for cancer patients as a result of this widespread effort to knock cancer out of the ballpark.

There is no doubt that the new cervical cancer vaccine -- Gardasil -- is revolutionary. But writer Peter Sprigg, vice president for policy at the Family Research Council, shared yesterday on the washingtonpost.com that the public should consider two cautions when digesting the news of this breakthrough medical advance. He urges us, first, to understand that the vaccine is not 100 percent effective. It is 100 percent effective for the strains of human papillomavirus (HPV) it targets -- but it leaves 30 percent of HPV strains that cause cervical cancer untouched. And it does not prevent all cases of genital warts either. So it is largely effective. But it does not completely eradicate the disease.

Sprigg also believes that parents should determine whether or not their young girls get the vaccine -- that it should not be mandatory. Mandating the vaccine might be in order if HPV was spread through blood or casual contact. But it is not -- it is spread by sexual contact. And families of young girls might best address this issue through education on behavioral issues alone, without interference from the government.

The wonder of the cervical cancer vaccine is not in question by this writer and the council he represents. But there is often a full picture that lingers behind good news and sensational headlines. And Peter Sprigg offers his take on what he believes lingers behind.

Right here in Gainesville, Florida -- at the University of Florida to be exact -- the vaccine for cervical cancer is now available for college students. This vaccine -- called Gardasil -- could prevent women from contracting the human papillomavirus (HPV) which can cause cervical cancer and genital warts. Almost 30 of the more than 100 different strains of HPV are sexually transmitted -- and sometime in their lives, 50 percent of sexually active men and women will contract genital HPV infection. Many will not know they have it and will spread it unknowingly to sexual partners. Protection can come in the form of Gardasil which is approved for use in women between the ages of 9 and 26.

Women who are not sexually active are the best candidates for this vaccine because it is clear that they have not yet been infected. The vaccine is not effective for women who already are infected with HPV. And those who don't know if they are infected can determine if they have HPV through a routine Pap smear. If they do not have HPV, the vaccine is indicated. Once the vaccine is indicated, it is delivered in three separate doses over a six-month period of time. Each dose costs $120 -- which may discourage students from this option.

About 9,700 women in the United States will develop cervical cancer in 2006 and this cancer will kill 3,700 of these women. This vaccine -- if received well by young women who can afford it -- should prove a breakthrough in cancer research and prevention.

In a study just released by Dartmouth Medical School researchers, not all cervical cancer vaccines work the same or offer the same benefits. Comparing Cervarix to Gardasil, both cervical cancer vaccines designed to protect against the human papillomavirus, HPV, found Cervarix to be longer-lasting and provides protection against multiple strains of virus linked to the development of cancer. Gardasil does not offer these same benefits. Gardasil does offer protection against HPV strains associated with genital warts, which Cervarix does not offer.

Cervarix offers high level protection against HPV types 16 and 18 for up to 4.5 years, and cross-protects against HPV-45 and 31, two other strains of the virus associated with cancer. According to the researchers, the long-term response appears to be due to the use of the adjuvant ASO4 with Cervarix rather than the adjuvant alum that is used in the Gardasil vaccine. This is significant because a vaccine that uses adjuvant alum needs to be administered around the time of exposure, so timing is important to vaccine protection. However, a vaccine that uses adjuvant ASO4 can be administered at any time to offer protection. Gardasil uses adjuvant alum, Cervarix uses adjuvant ASO4. When these cervical cancer vaccines are approved for use, I wonder if women are going to faced with the decision of what type of protection they want and in what form. Or will they find a way to combine the benefits of both into one vaccine? Important information for women to keep in mind when the vaccine becomes available, because there are critical differences between the two vaccines mentioned in this post.