Cervical cancer is no longer a disease confined to middle-aged and older women, with cases steadily emerging among younger women, raising the importance of preventive vaccination.
According to the National Cancer Registration Statistics, cervical cancer ranked fourth in crude incidence rate among women aged 15-34 as of 2022, following thyroid cancer, breast cancer, and colorectal cancer. "Young women cannot afford to be complacent about this disease," said Choi Min-chul, professor of obstetrics and gynecology at Asan Medical Center. "Regular screening and preventive vaccination are paramount."
The primary cause of cervical cancer is infection with the human papillomavirus (HPV). HPV types 16 and 18 in particular are known to be associated with approximately 70-80% of cervical cancer cases. The HPV vaccine prevents infection by these high-risk strains and can help prevent not only cervical cancer but also vaginal, vulvar, anal, and oropharyngeal cancers.
HPV vaccines are currently divided into bivalent, quadrivalent, and 9-valent versions. The bivalent vaccine focuses on preventing HPV types 16 and 18, while the quadrivalent vaccine adds protection against HPV types 6 and 11, which cause genital warts. The most recently introduced 9-valent vaccine has expanded coverage to additional high-risk strains, including types 31, 33, 45, 52, and 58.
The most notable recent change is the expansion of vaccination to males. As of the 6th, the government added 12-year-old male adolescents (born in 2014) to the list of beneficiaries of the National HPV Vaccination Program. While the vaccination policy had previously focused on females, the change reflects the fact that HPV can also cause anal cancer, oropharyngeal cancer, and genital warts in males.
Above all, experts emphasize that male vaccination is crucial for establishing herd immunity. Reducing HPV transmission itself enhances cervical cancer prevention in women. The Korean Society of Gynecologic Oncology recommends vaccination for males aged 15-26, while those 27 and older are advised to decide on vaccination after consulting with medical professionals.
Many ask whether the vaccine is still effective for adults or those already infected with HPV. Experts explain that those aged 45 or younger can expect benefits from vaccination. In a clinical trial involving women aged 24-45, the quadrivalent vaccine reportedly demonstrated more than 90% efficacy in preventing HPV-related diseases. However, the current vaccine is a "preventive vaccine" and does not remove or treat existing HPV infections.
Safety controversies have surfaced repeatedly. In 2013, some vaccine recipients in Japan reported chronic pain and convulsions, sparking controversy, but subsequent investigations by the Japanese government and the World Health Organization (WHO) found no direct causal link to the HPV vaccine. Japan resumed active recommendation in 2022, and the HPV vaccine is currently used in National Immunization Programs (NIP) in more than 100 countries worldwide.
Currently, the HPV vaccination rate among 12-year-old girls in Korea stands at approximately 74%, while the cervical cytology screening rate is 51.5%. The WHO has set targets of 90% for HPV vaccination coverage and 70% for cervical cytology screening. Experts believe that if vaccination and screening continue to expand, Korea could accelerate the timeline for eliminating cervical cancer.
