BioEd Online

A vaccine against cervical cancer has made it one step closer to the doctor's office. On 18 May, an external advisory committee recommended to the US Food and Drug Administration (FDA) that they allow one such vaccine, called Gardasil, to be licensed for use in girls from the age of nine.

The recommendation has raised complaints from some conservative and religious groups, who are concerned that immunising pre-adolescents against a sexually transmitted disease could lead to an increase in promiscuity.

But scientists emphasise that younger people are well known to mount a better immune response to vaccines than older recipients. And, they add, it is difficult to get teenagers to visit the doctor if they are not sick. "The younger the better," says FDA advisory committee member Philip LaRussa of Columbia University, New York.

The FDA should make a decision later this year. Should they follow this advice, as is widely expected, the vaccine will still need to undergo review with the US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

Viral cause

Cervical cancer is the second leading cause of cancer among women worldwide, resulting in more than a quarter of a million deaths each year. A vast majority of these cases are caused by certain strains of the human papillomavirus (HPV).

Gardasil, manufactured by Merck, has proven effective against HPV infection in tests with women 16 to 26 years of age (see ' Cervical cancer vaccine proves effective'). The vaccine has also been seen to create antibodies in girls aged nine to 15. The FDA panel recommended approval of the vaccine for use in both of these age groups.

Currently, the best preventative measure against cervical cancer is to check women's vaginal smear tests for signs of abnormalities. A vaccine would theoretically prevent infection in the first place.

John Schiller of the National Cancer Institute in Bethesda, Maryland, who helped to develop the vaccine and is the father of a 16-year-old girl, notes that such a vaccine is most needed in developing countries that cannot afford to perform smear tests. At the moment the vaccine needs to be given three times at an estimated cost ranging from $300 to $500 in total. He hopes that further work will be able to drive the price down.

A similar vaccine by GlaxoSmithKline, called Cervarix, will seek FDA approval by the end of this year. Ongoing studies are also underway by both companies to see if the viral vaccine will work in men and young boys.

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