Bermudian women can significantly reduce their chances of getting cervical cancer by getting a simple new vaccine now available in Bermuda.

Gardasil is being offered to patients of one Hamilton doctor hoping to reduce the incidence of cervical cancer here.

"Gardasil, made by the Merck Corporation, is a vaccination that immunises against certain viruses that are believed to be causal in development of cervical cancer in women," said Jay Jay Soares of the Hamilton Medical Centre.

There are over 116 different human papillomavirus viruses (HPV), and scientists are still finding new ones. Many strains go unnoticed, but others can cause cervical cancer, and genital warts. Most strains of the HPV virus are transmitted through sexual contact.

"This vaccine immunises you against the two strains that cause the majority of cervical cancer," said Dr. Soares. "It also immunises against two that are associated with the external warts."

There is another vaccine produced in England, not yet available in the United States, called Cervarix that protects against some strains of cervical cancer, but not genital warts.

"The Gardasil vaccine basically allows women to significantly reduce their chances of getting cervical cancer," he said. "It is three vaccines within a six-month period. We are charging $161 per vaccine."

Dr. Soares said HPV viruses are so common, they are probably present in just about every person who is sexually active.

"In the old days scientists noticed that women who never had sexual intercourse almost never got cervical cancer," he said. "Nuns, for example, almost never got cervical cancer. When I was in school they thought that there was something carcinogenic about semen.

"Since then they have updated the theory and realised it is actually the transmission of the HPV virus that is the cause directly associated with the development of cervical cancer."

In most people the HPV virus burns itself out without causing harm, but for some people it isn't naturally irradiated by the body's immune defences.

"And scientists think those people are at greater risk for getting it," said Dr. Soares.

Gardasil is Food and Drug Administration (FDA) approved in the United States for women ages nine to 26. In other countries it is approved for children, male and female, between nine and 18, and for women from 18 to 45.

"Boys are given the vaccine in some cases because men can be carriers even though they are not known to have any problems from HPV other than genital warts from some of the strains," said Dr. Soares. "It is thought that if you immunise the men, they can't pick it up in the first place to pass it to women.

"In theory, men and women of almost any age should benefit from this. The FDA has only approved it until the age of 26 because the manufacturing company was seeking the fastest route to get it onto the market. The narrower the population tested, the faster the route onto the market. Their view is that it will be tested later on women over age 26."

And a cervical cancer vaccine can still be given to women who have had cervical cancer.

"That is because there are so many types of cervical cancer, that she isn't necessarily immune to other forms of the virus," said Dr. Soares.

He said that if women have regular pap smears, their chances of dying from cervical cancer are remote.

"The pap tests for pre-cervical cancer cells," he said. "It is critical to have a yearly Pap smear.

"Even if you have had the vaccine it is still important because remember the vaccine doesn't protect against all HPV viruses.

"Cervical cancer, when it is advanced, is quite deadly. Catching it before it turns into a cancer with a Pap smear is key."

If cervical cancer is caught in the pre-cancer stage, Dr. Soares said it is a simple surgical procedure, sometimes done under local anaesthetic, to remove the affected area.

Dr. Soares thought he saw about two or three people a year who had developed full-blown cervical cancer. He estimated he saw about four people a month who had abnormal paps that required a colonoscopy and perhaps biopsy.

"So it is pretty significant," he said.

Dr. Soares has a two-year-old daughter. "I absolutely intend to get her vaccinated against cervical cancer when she is old enough," he said. "The best time to do it is before their first sexual experience. That way they have had almost no possibility of having any contact with the virus."

He said there is no risk of catching cervical cancer or HPV from this vaccine.

"It is not a live virus, it is only proteins from the virus," he said. "But some people have an allergic response from it."

However, critics of the vaccine worry that the virus has not been out long enough to really know the long-term effects on a child.

There are also some concerns that it may trigger Amyotrophic Lateral Sclerosis (ALS) otherwise known as Lou Gehrig's Disease in people with a family history of it.

So far there have been three cases of ALS that some scientists think may be linked to the Gardasil vaccination.

Dr. Soares said that most insurance companies in Bermuda cover most of the vaccine cost, but check with your insurance company first.

The risk factors for cervical cancer include:

Sexual behaviours — early age of first intercourse and a history of multiple sex partners

Tobacco use — women who smoke are about twice as likely as non-smokers to get cervical cancer

Women whose mothers were given the drug Diethylstilbestrol (DES) during pregnancy to prevent miscarriage.

For more information about cervical cancer visit www.idph.state.il.us/about/womenshealth/factsheets/cervical.htm.