Nearly all cases of cervical cancer are linked to HPV infection. HPV is a group of more than 200 viruses that can cause skin and mucous membrane diseases. Typically, HPV enters the body through sexual contact. In most cases, HPV does not cause any symptoms, and treatment for HPV is not necessary. However, the virus can lead to the development of genital warts and cervical cancer. More than 70% of cervical cancer cases are caused by two types of HPV - types 16 and 18.
Effective methods of primary prevention (vaccination against HPV) and secondary prevention (screening and treatment of precancerous lesions) can prevent most cases of cervical cancer.
Thanks to a comprehensive approach to prevention, screening, and treatment, cervical cancer can be eliminated as a public health problem within a single generation.
Nearly all cases of cervical cancer are linked to HPV. This virus is also associated with at least five other types of cancer: vaginal cancer; penile and anal cancer; oropharyngeal cancer and cancer of the back of the throat, including the tongue and tonsils.
A person infected with HPV may not develop cancer for many years after infection, and may not know that they are infected with HPV.
HPV is spread through vaginal, anal, or oral sex, and you can contract it from an infected person who has no symptoms.
Fortunately, there is a vaccine to protect against HPV-related cancer. Doctors recommend that all boys and girls aged 9-14, before they become sexually active, get vaccinated against HPV to protect against cancer caused by this virus.
In Ukraine, HPV vaccination is not included in the National Immunization Schedule but is included in the recommended vaccines.
You can buy it yourself (talk to your family doctor or gynecologist).
Two HPV vaccines are registered in Ukraine: the 2-valent against types 16 and 18 "Cervarix" (manufactured by GlaxoSmithKline) and the 4-valent against types 6, 11, 16, 18 "Gardasil" (manufactured by MSD).
What is human papillomavirus (HPV)?
HPV is a group of more than 100 viruses that can cause skin and mucous membrane diseases in humans. HPV is typically transmitted through sexual contact. In most cases, HPV does not cause any symptoms, and treatment for HPV is not necessary. However, the virus can lead to the development of genital warts and cervical cancer if it persists in the body. Two strains of HPV, types 16 and 18, are responsible for more than 70% of cervical cancer cases.
How can HPV infection be prevented?
While condoms can reduce the likelihood of HPV transmission, they do not provide complete protection against infection. The most reliable way to protect against HPV for girls is through vaccination.
In which countries is HPV vaccination available?
Approximately 100 countries around the world include HPV vaccination in their national immunization schedules. Each country makes its own decision about who should receive the vaccine, based on its national context. In some countries, the HPV vaccine is available for both girls and boys. Some countries offer free vaccination only to recommended age groups of girls, while others, such as the United States, encourage and pay for immunization for all girls and women up to 26 years of age.
Are there positive changes in the healthcare of countries that implement vaccination at the national level?
Yes. Countries with high levels of development that implement vaccination against HPV for girls and women at the national level have seen a significant reduction in HPV infections and abnormalities in cervical development. These countries also expect to see a decrease in the incidence of cervical cancer. For example, Australia plans to eliminate cervical cancer by 2035. Additionally, there has been a 90% decrease in the prevalence of genital warts in these countries.
What age should girls get vaccinated against human papillomavirus and how many doses are needed?
The World Health Organization (WHO) recommends starting vaccination of girls against human papillomavirus at the age of 9-14, before they begin sexual activity: as HPV is transmitted during sexual intercourse and contact with genitalia. It is necessary to administer two doses of the vaccine. Three doses are given if the girl is HIV-positive or over 15 years of age.
What should be the interval between the first and second dose of the vaccine?
The World Health Organization (WHO) recommends two doses of the vaccine for girls in the target age group with an interval of 6 months.
Are there any evidence that vaccination against HPV reduces the incidence of cervical cancer?
Yes. After 10 years of vaccine use and 270 million doses administered, there is sufficient evidence that HPV vaccination is highly effective in preventing chronic infections that lead to cervical cancer. A significant decrease in cervical cancer cases is expected over the next few years, as the first group of girls who were vaccinated as adolescents will soon reach the age at which cervical cancer develops.
Why is vaccination of boys against HPV not as widespread at the national level as vaccination of girls?
The main goal of HPV vaccination is to prevent cervical cancer. Since the human papillomavirus, which causes this type of cancer, is transmitted through sexual contact and can affect both boys and girls, this vaccination is equally important for both sexes. However, not all countries have sufficient financial resources to vaccinate both boys and girls. Therefore, the focus is mainly on vaccinating girls.
What types of HPV vaccines exist?
There are three types of HPV vaccines: bivalent, quadrivalent, and the newest, nonavalent (approved for use relatively recently in 2014). In Ukraine, the bivalent vaccine "Cervarix" (against types 16 and 18), manufactured by GlaxoSmithKline, and the quadrivalent "Gardasil" (against types 6, 11, 16, 18), manufactured by MSD, are registered for use. All three HPV vaccines used are evidence-based and safe and effective. The bivalent vaccine targets the two most common types of HPV (16 and 18), which account for 71% of all cases of cervical cancer. Two of the three vaccines also target types 6 and 11, which cause 90% of genital warts. The newest of the three available HPV vaccines offers protection against nine types of HPV, which cause 90% of all cases of cervical cancer.
How long does the effect of HPV vaccination last?
Since the first human papillomavirus (HPV) vaccine was introduced in 2006, the full duration of protection against this virus is not yet known. However, new data suggest that individuals who were vaccinated more than 10 years ago still have full protection against the HPV types they were vaccinated against. As a result, they are still protected against the development of precancerous cervical lesions, genital warts, and other diseases caused by those types of HPV. There is currently no evidence that this protection in vaccinated individuals is decreasing. Many experts also believe that this vaccine will be effective for several decades.
Why isn't this vaccine offered to children under 9 years old?
When the HPV vaccine was first developed, its developers and healthcare workers were concerned about the unknown duration of immune protection and were not confident that it would last long enough to protect people during their most risky period of sexual activity (up to age 25). Therefore, the age range for vaccination was chosen as 9-14 years old, when most adolescents have not yet begun their sexual lives and the vaccine's effectiveness should be active for the next decade.
However, recent data suggest that the duration of protection is more than 10 years and is likely to be much longer. Therefore, scientists are conducting research on the effectiveness of vaccinating younger children against HPV.
Do women who have been vaccinated against human papillomavirus need to undergo regular screening for cervical cancer?
Absolutely! Women who have been vaccinated against HPV still need to undergo regular screening for cervical cancer. The vaccine protects against types of HPV that cause cervical cancer in 70-90% of cases, but it cannot prevent all potential cases.
Is it proven that the benefits of human papillomavirus vaccination outweigh potential side effects?
Yes! The benefits of HPV vaccination far outweigh minimal risks. Benefits include preventing infection with the types of HPV that cause cervical cancer in 70-90% of cases and cause 90% of genital warts.
As for side effects, there may be pain and redness at the injection site, which typically lasts less than a day. Ongoing monitoring since 2006 and more than 270 million doses administered indicate that there is no evidence of a link between serious health outcomes and HPV vaccination.