The major impact of vaccination against papillomavirus has been demonstrated in this country, where vaccination coverage exceeds 80% among adolescent girls. In France, it barely reached 28% among young girls aged 16.
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In 2020, the World Health Organization (WHO) launched a strategy to accelerate the elimination of cervical cancer. In 2018, this disease killed 312,000 women around the world (about 1,000 in France), for a number of new cases estimated at 570,000 (3,000 in France). Deaths all the more regrettable they are preventable.
“Vaccination against human papillomavirus is one of the pillars of this WHO eradication strategy,” said Jean-Baptiste Méric, director of the Public Health and Care Center of the National Cancer Institute (INCA). The main cause of this cancer, indeed, is a persistent infection with a virus that is sexually transmitted, human papillomavirus or HPV. When this virus moves long in the neck, it can cause precancerous lesions which, in rare cases, evolve towards cancer, usually ten to fifteen years after the persistent infection.
A first vaccine targeting HPV (Cervarix, GSK laboratory) appeared in 2007: it acts against the types 16 and 18 of the human papillomavirus, responsible from 70% to 80% of the COL cancers. Another vaccine is available today (Gardasil, Laboratory Sanofi Pasteur MSD): It is active against four genotypes (6, 11, 16 and 18), and a new version will target 9 genotypes.
Until then, the evidence of the impact of this vaccination were incomplete. “It had been planned for about ten years to observe an effect on COL cancers, given the time between infection and their appearance,” says Jean-Baptiste Méric.
This gap has just been filled by a British study published in the magazine The Lancet , November 3rd. The authors examined the data of the United Kingdom cancer registries between January 2006 and June 2019, including 7 women’s cohorts, aged 20 to 64 at the end of the study. Results: On the follow-up period, 28,000 cervical cancers and 300,000 precancerous lesions, or non-invasive cervical carcinomas (CIN3), were diagnosed. In vaccinated cohorts, there were 450 neck cancers in less and 17,200 cm and less than in non-vaccinated cohorts. Either a drop in Cervical cancer rates of 87% in women vaccinated between 12 and 13 years of age, 62% among those vaccinated between 14 and 16 years, and 34% among those vaccinated between 16 to 18 years. For CIN3 rates, the reductions were 97%, 75% and 39%, respectively,
Major public health problem
“This is an important study because it confirms, with a solid methodology, the trends already observed in Sweden, Finland and the United States among young girls vaccinated before the first sexual intercourse,” said Jean-Baptiste Méric . The measured impact is even slightly higher than the expected effect. “This probably reflects an effect of collective immunity.”
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