Provincial Health Services Authority (PHSA) improves the health of British Columbians by seeking province-wide solutions to specialized health care needs in collaboration with BC health authorities and other partners.
HPV vaccines: these vaccines are powerful tools to diminish the rate of HPV-associated cancers including cervical, oropharyngeal, anal, vulvar, vaginal and penile malignancies. Three HPV vaccines have been developed and approved for use by Health Canada:
All 3 vaccines protect against the 2 types of HPV that cause about 70% of cases of cervical cancer. The HPV9 vaccine protects against 5 additional types of HPV that cause about 15% to 20% of cervical cancers. The HPV4 and HPV9 vaccines also protect against 2 types of HPV that cause about 90% of cases of genital warts.
Vaccination is recommended for girls and women between the ages of 9 and 45 years before they come in contact with HPV. The vaccine may also benefit women who are sexually active and have not yet been infected with HPV.
In British Columbia, the HPV9 vaccine is recommended and provided free to girls in grade 6. In September 2016, the HPV9 vaccine replaced the HPV4 vaccine which was previously provided as part of the school-based immunization program. The HPV9 vaccine is also provided free to females who are 9 to 26 years of age or infected with HIV. Since September 2017, BC's publicly funded immunization program includes the HPV9 vaccine for grade 6 boys. Therefore, all grade 6 students in BC, both female and male, are offered the HPV9 vaccine series for free as part of the regular school-based immunization program. For more information please refer to the Ministry of Health announcement:
B.C. extends free HPV coverage to boys.
The HPV4 vaccine is recommended and provided free to girls and young women born in 1994 to 2004 who have not received the vaccine. Girls and young women in this age group who missed getting the HPV4 vaccine can contact their health care provider to get immunized at no cost.
See the list of regional colposcopy clinics.
WHO histological classification of tumours of the uterine cervix – 2017
larger version of the Cervix Staging Diagram.
Following biopsy confirmation of carcinoma of the cervix, history and physical examination and the following staging investigations should be done:
Management of these patients is highly individualized and should be discussed at the multidisciplinary conference. Salvage radiotherapy +/- chemotherapy, salvage surgery, palliative chemotherapy or clinical trials could be considered.
Surveillance after primary curative therapy for cervical cancer is recommended, although its effectiveness is not well studied.
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