Boys aged 12-13 in Northern Ireland are to be offered a vaccine to protect them against Human Papillomavirus (HPV) related cancers. The Department is also introducing a better test for bowel cancer to increase uptake rates and to detect more cancers earlier.
From September this year the HPV vaccine will be offered to all boys in year nine at school.
In addition, it has been decided that the Faecal Immunochemical Test (FIT) will replace the Faecal Occult Blood (FOB) test as the primary screening test for bowel cancer in the Bowel Cancer Screening Programme (BCSP) in Northern Ireland.
Department of Health Permanent Secretary Richard Pengelly said: “I am very pleased to be able to announce both these decisions today.
“The evidence is clear in both cases that very significant health protection benefits can be achieved for our citizens.
“Both decisions have been under active consideration for some time and can now be made, following confirmation of the Department’s budget allocation for this year.”
A very high proportion of all women under 25 have already taken up the opportunity to be vaccinated against the HPV virus since the programme was first introduced in 2008 and the intention is to protect boys through similar uptake rates.
This extended programme offers the opportunity to make some HPV-related diseases and cancers a thing of the past building on the success of the programme in girls. The prevalence of the main HPV cancer-causing types 16 and 18 has already been reduced by over 80%.
Commenting on the HPV announcement, Chief Medical Officer Dr Michael McBride said:
“We can now look forward to a future where we can be even more confident that we will reduce cervical cancer and other HPV related cancers that affect both men and women.
“This is an effective vaccine against a particularly harmful virus. I would encourage all parents to take up this offer and ensure their boys and girls are vaccinated.”
The new FIT bowel screening test will be introduced from early 2020.
Evidence has shown there is increased patient acceptability of the FIT screening test and increased uptake of screening will mean even more lives can be saved.
Every year in Northern Ireland there are around 1100 new cases of bowel cancer, with over 400 deaths. The Bowel Cancer Screening Programme aims to pick up bowel cancer at an early stage, when treatment can be 90% successful.
Dr McBride commented: “The existing test for bowel cancer has proved hugely valuable in detecting cancer early and it is therefore essential that people invited to participate in the Northern Ireland Bowel Screening programme from 60-74 continue to complete and return the test they receive in the post until the new test is available.”
Extending the HPV vaccination programme to include adolescent boys is based on advice from the Joint Committee of Vaccination and Immunisation (JCVI) an independent panel of experts that provides advice to the four UK Health Departments.
The extension of the vaccine to boys builds on the success of Northern Ireland’s HPV vaccination programme for girls which started in 2008 and the HPV programme for men who have sex with men (MSM) introduced in 2016.
In January 2016, the UK National Screening Committee recommended that quantitative Faecal Immunochemical Test (FIT) should be adopted by the Bowel Cancer Screening Programme (BCSP) as the primary screening test for bowel cancer.
Notes to editors:
- A HPV vaccination programme for girls was introduced across the UK in 2008. The HPV vaccine currently used in the UK offers protection from four HPV types including those that are responsible for about 70% of cervical cancers
- Uptake for the girls’ HPV immunisation programme in Northern Ireland has achieved high levels over the last 10 years – with almost 90% of girls completing the full course of doses.
- At present two doses of the vaccine, given 6 months apart, are required to achieve adequate protection against the main types of HPV.
- The current vaccination programme for girls has also had an impact on HPV infections in boys through the development of what is known as herd protection, with diagnoses of first episode genital warts in young heterosexual males declining by 70% between 2009 and 2017 in 15- to 17-year-olds.
- The decision to extend the programme to boys is based on a wide range of scientific and other evidence considered by the JCVI.
- FIT is a quantitative test which allows the presence of blood in the faecal sample to be measured more reliably using an automated process (FOB is a qualitative test);
- FIT is sensitive to a much lower concentrations of blood than FOB and therefore can detect cancers much more reliably and at an earlier stage (higher cancer detection rate than FOB), and also more pre-cancer lesions.
- FIT requires a single faecal sample, whereas FOB requires three, and is more acceptable to those invited to screening. Pilot studies of FIT testing carried out in England and Scotland reported markedly increased participation (uptake) rates in both pilots. The increased uptake occurred across all deprivation quintiles. Currently uptake in NI is lower in more deprived groups, and therefore the more deprived groups could gain the greatest benefit from the introduction of FIT, helping to address health inequalities.
- In evidence to the House of Commons in January, Department of Health Permanent Secretary Richard Pengelly said a decision on the FIT test would be made following confirmation of the Department's budget allocation for 2019/20.
- Replacing FOB testing with FIT requires an additional investment of £300k in 2019/20 increasing to just over £1 million per annum from 2020/21.
- The annual costs of the introduction of HPV for boys is estimated at just under £750k.
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