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Cervix cancer—cervical cancer vaccine. DR NITIN KHUNTETA
Cervix cancer—cervical cancer vaccine

In India, Cervical Cancer is the most common cancer in women. Every year, in India, 132,000 new
cases are diagnosed and 74,000 women die due to this cancer. Globally, Each year, nearly 500,000 new cases are diagnosed of which nearly 270,000 women actually die.

Cervical Cancer is caused by the Human Papillomavirus (HPV).These are classified into 'high-risk' (oncogenic) and 'low-risk' types . 15 oncogenic HPV types have been linked to Cervical Cancer . Low-risk HPV types, such as HPV 6 and 11, are not known to cause cancer,but are responsible for benign genital warts . Globally, HPV 16, 18, 45 and 31 are 4 most common oncogenic HPV types. HPV 16 and 18 together account for 70%.
Together,HPV 16, 18, 45 and 31 are responsible for 80% of Squamous cell carcinomas of the cervix.These same 4 HPV types are also responsible for 90% of Adenocarcinomas of the cervix.

Oncogenic HPV can spread via skin-to-skin genital contact and does not necessarily require penetrative sexual intercourse. Men act as a reservoir of infection, capable of passing on the virus to their female partners who are then at risk of developing Cervical Cancer.

Yes! Cervical Cancer can now be prevented through vaccination.

Cervical cancer vaccine composed of HPV 16 and 18 antigens in the form of VLPs (Virus like particles) combined with a novel adjuvant system called AS04. Adjuvants play a key role in enhancing the immune response elicited by a vaccine. They are used in almost all commercially available vaccines.The most commonly used adjuvant is Aluminium hydroxide. The novel adjuvant system AS04 which combines traditional Aluminium hydroxide with MPL (i.e. Monophosphoryl Lipid A). MPL binds to a novel receptor called the TLR 4 on Antigen presenting cells.This interaction results in a better memory B cell response. Memory B cells are long-lived cells, which then constantly produce a sustained level of antibodies over a long period of time.

Cervical vaccine has been licensed for use in girls and women aged 10-45 years. Antibodies are an important correlate of long-term protection. It is believed that antibody levels that are consistently high over a period of time and are likely to stay high, would provide long term protection against Cervical Cancer.

It is recommended that subjects who receive a first dose of Cervical cancer vaccine complete the three-dose vaccination. If flexibility in the vaccination schedule is necessary, the second dose can be administered between 1 month and 2.5 months after the first dose. Vaccination should be postponed until after completion of pregnancy.

Cervical cancer vaccine is generally safe and well tolerated. The most frequently reported solicited symptoms after administration of vaccine are injection site reactions including pain, redness and swelling. The majority of the solicited local and general symptoms reported are mild to moderate in intensity.

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