New Cervical Cancer Vaccine Guidelines
American Cancer Society Differs From Other Groups on Vaccinating Women Over 18
Vaccine's Protection continued...
Since the vaccine will not work on those already infected, Einstein says it was important for ACS to hold back from routinely recommending it in this age group.
"The recommendation is for women in this age group to talk to their doctor about whether or not the vaccine can benefit them. But the research does not justify universally recommending the vaccine," says Einstein.
Stephanie V. Blank, MD, a gynecologic oncologist at the NYU Cancer Institute in New York City, disagrees.
While women aged 19 to 26 may benefit less from the vaccine, the shift away from routine recommendations is likely to have more of a financial than a medical advantage, Blank says.
"Giving the vaccine to a woman who has already been exposed is not going to harm her -- and, in fact, it may help her, since it's unlikely that she would have been exposed to all four of the cancer-related strains of HPV for which the vaccine provides protection," says Blank.
Indeed, Blank tells WebMD that as long as a woman knows she needs to follow up with regular screening Pap tests, whether she has been vaccinated or not, "Those aged 19 to 26 should also be encouraged to get vaccinated." (All cervical cancers are not caused by HPV.)
Not for Those Over 26
Currently, there are no HPV vaccine studies on women over age 26. The FDA has approved Gardasil only for girls and women age 9 to 26.
Also, there is not enough evidence to say whether booster shots will be needed throughout a woman's life.
NYU's Blank says it's important to note that while most cervical cancer cancer is related to HPV, not all HPV infections -- even those caused by strains 16 and 18 -- will result in cervical cancer.
"Most HPV infections, even potentially carcinogenic ones, resolve or become undetected in a year or less," says Blank. Many women never even know they were infected.
Moreover, she says, even persistent HPV infections don't always progress to precancerous lesions.
According to the ACS report, 75% of all low-grade lesions, and up to 90% of high-grade lesions, resolve without treatment -- and never go on to cause cancer.