Young girls in Ireland should be vaccinated against the human papilloma virus (HPV), as this will reduce their risk of developing cervical cancer, the Health Information and Quality Authority (HIQA) has said.

HIQA has proposed a school-based national programme of vaccination for all 12-year old girls against the HPV virus, in addition to a once-off HPV vaccine programme for 13 to 15-year old girls.

It says both such vaccination schemes would, along with the new cervical screening programme, help reduce the incidence of cervical cancer in Ireland.

HIQA has told Health Minister Mary Harney that such a vaccination programme would also be cost-effective, weighing up the cost of administrating the vaccine versus its effectiveness in preventing cervical cancer and in terms of savings made in the cost of treating women who without the vaccine might get cervical cancer.

HIQA has just published a major assessment of the role of HPV vaccines in reducing the risk of cervical cancer in Ireland.

HPV (human papillomavirus ) is the main cause of cervical cancer, which is the eighth most frequently diagnosed cancer in this country. There are many types of HPV, most of which are harmless. However some can be serious, such as those that cause cervical cancer.

Around 80% of sexually active women become infected with HPV at some stage in their lifetime. Most of these infections have no noticeable symptoms and over 90% are cleared by the body's immune system.

However if the body does not clear the infection, abnormal cells can develop in the lining of the cervix. These abnormal cells can become cancerous. This usually takes a number of years to occur. In 2004 alone, 200 women were diagnosed with cervical cancer, while over 90 women died of the disease.

Vaccination against HPV offers a new opportunity to reduce the incidence of this type of cancer. Currently in Ireland, there are two HPV vaccines available - Gardasil and Cervarix, but they are not available on state vaccine schemes.

HIQA says the vaccines are effective against 70% of the strains of HPV that cause cervical cancer. Its report does not recommend which of the two available vaccines should be used in a national vaccination programme.

Following a request from the National Cancer Screening Service (NCSS), HIQA agreed to carry out a health technology assessment (HTA) on the role of vaccination against HPV in reducing the risk of cervical cancer in Ireland. The purpose of the assessment was to establish the cost effectiveness of a combined national HPV vaccination and cervical cancer screening programme, compared to a screening programme alone.

Recognising the potential controversy related to recommending that 12-year-olds be vaccinated, HIQA has pointed out that at older ages, the vaccine becomes less effective due to an increased likelihood of females being exposed to the virus through sexual contact.

The final report has been submitted to Health Minister Mary Harney, the NCSS and the National Immunisation Advisory Committee. A decision regarding the vaccine is expected from Minister Harney in the coming months.

HIQA Chief Executive Dr Tracey Cooper said it was a matter for Government as to whether the vaccine should be free-of charge for all who need it.

Usually, vaccines are provided free-of-charge in school-based programmes The total cost of the vaccine for a course of three injections is currently €390.

HIQA estimates that the vaccine scheme for 12-year-olds would cost €9.7 million per annum to administer. If a catch-up programme for 12-to-15 year-olds was added, it would incur an additional cost of €29.2 million in the first year only.

The HIQA report on the cervical cancer vaccines states that the longest duration of follow-up study in relation to the effectiveness of the cervical cancer vaccines is currently five years, thus the protective effect against invasive cervical cancer has not yet been demonstrated.

It admits that future evidence is required to establish long-term safety and efficacy of HPV vaccination.

The report states that clincial trials on both available vaccines have demonstrated protection from HPV infection for between three and 4.5 years. HIQA says administering a booster dose of the vaccine after 10 years may be considered in the future.

Dr Cooper said that the HIQA analysis concluded that the potenital benefits of the vacine in protecting against cervical cancer outweighed any potential deficiencies in the efficacy of the vaccine.

A vaccine programme against HPV would target a total of 31,000 12-year-old girls and 93,000 13-15 year-old girls, with an expected uptake of 80%, according to HIQA.

Meanwhile the board of the NCSS has also carried out its own review of the role of HPV vaccines. It said it is of the view that these vaccines have the potential 'to play an important long-term role in the prevention of cervical cancer and that a vaccination programme should be put in place to enable these long-term benefits to be realised'.

However, while the board acknowledged that vaccination and screening are complementary approaches to controlling cervical cancer in Ireland, it said it was of the view that "highest priority should be attached to implementing and sustaining the national cervical screening programme".

Plans are in place for the NCSS to launch such a programme nationally in the coming months.

The board emphasised that HPV vaccines do not eliminate the need for a cervical cancer screening programme because current vaccines do not protect against all the types of HPV that cause cervical cancer.

"Screening will also be necessary to protect women who have not been vaccinated," it added.