Gardasil: Pap smears still essential, say specialists

Sydney Morning Herald August 26, 2008

AUSTRALIA’S cervical cancer rate could start to rise again if a new generation of young women vaccinated against the disease is not encouraged to continue having Pap smears, says a group of specialist doctors who are calling on the Federal Government to clarify the screening program’s future. The pathologists – who include the inventor of the cervical cancer vaccine, Professor Ian Frazer – met two weeks ago to develop a new policy on preventing the disease. The move comes amid concern that immunisation could give women a false sense of security and undermine Pap smear screening, credited with halving cervical cancer cases and deaths since its introduction in 1994.

It would take five to 10 years before the success of immunisation could be evaluated, when the first cohorts of vaccinated girls became sexually active, said Gabriele Medley, who chaired the meeting for the Royal College of Pathologists of Australasia. The vaccine acts against cancer-causing strains of the sexually-transmitted human papilloma virus (HPV), which most young women contract and then clear spontaneously. The virus only causes disease if it persists.

..Annabelle Farnsworth, director of cancer pathology at Douglass Hanly Moir Pathology, said immunisation, offered to 12-year-olds in a school-based program and to women aged 18 to 26, only offered protection against virus strains most likely to lead to cancer. But other strains could also cause the disease. “What if the other ones become more prevalent?” said Adjunct Professor Farnsworth. Government analysis had shown expected cancer risk was three times higher in vaccinated women who did not have Pap tests than among unimmunised women who had regular two-yearly smears, she said.