Velisha Thompson of the City of Johannesburg writes:
Cancer of the cervix (CaCx) is the most common cancer diagnosed in women in South Africa.
Estimates indicate there are 16.84 million women over the age of 15 years who are at risk of CaCx. Black women carry the heaviest burden of the illness.
Human papillomavirus (HPV) infection is a common sexually transmitted infection. At any point in time, there is about 21 per cent of sexually active women in the general population with asymptomatic HPV infection.
Generally HPV infection will clear on its own; however, when high-risk type HPV infection persists, individuals are at the greatest risk of progressing to cervical cancer.
Screening women with cervical Papanicolaou (Pap) smears is the current method of secondary prevention against CaCx, as it allows early detection of CaCx.
However, there are challenges with this method which include: low sensitivity as it fails to detect some early cancer lesions (that is, false negatives); low specificity as it may detect other abnormal cells that are not necessarily cancer cells (that is, false positives) and low coverage (that is, failure to get a high percentage of women participating in the screening programme).
Low coverage is one of the greatest challenges of screening programmes for CaCx, whether by conducting Pap smears or by using other approaches.
The introduction of an HPV vaccine is a significant public heath milestone for South Africa and is expected to significantly contribute to the control of CaCx and reduce associated mortality within the next two to three decades.
Human papillomavirus vaccine
The development of HPV vaccines that prevent infection in the most prevalent high-risk individuals is a significant development.
The vaccine should be given before exposure to HPV infection, therefore it is recommended for use by young girls aged five to 15 years of age, which is assumed to be before sexual debut.
Studies on the cost-effectiveness of the vaccines have shown that vaccination for young girls aged nine to 15 years substantially reduces the incidents of CaCx.
Targeted age group
The HPV vaccination programme is directed at young girls in Grade 4, who are nine years or older in all public schools. This includes girls who are in special schools, where all girls who are nine years old turning 10, will be vaccinated.
Grade 4 girls in private schools and girls who are not attending school are not targeted by the HPV vaccination programme. There will be no catch-up for older girls; girls who are in grades higher than Grade 4 will not receive the vaccine.
The district will develop plans for reaching girls who are in Grade 4 and did not get the vaccine at school for any reason such as being absent on the day the teams visited the school and for those girls who only received one dose of the vaccine.
Parents of girls in private schools and older girls (up to 20 years of age) who are not yet sexually active are encouraged to have them vaccinated by private service providers.
We urge parents to complete consent forms and return to school as soon as possible.
Vaccination dates
The first round will be from 21 February to 28 March while the second round will be in September on a date to be announced.
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