Mum & Child

HPV: What women should know about the cancer-causing virus

The recent introduction of the HPV vaccine has raised hopes for immunisation against cervical cancer and, for the first time, in the history of humanity, the eradication of this malignant disease. This new opportunity has changed many current views on cervical cancer prevention, control, diagnosis, and treatment.

Cervical cancer is an uncommon complication of HPV, a common sexually transmitted infection that is also linked to throat and anal cancers.

Unfortunately, “About 80 to 90 per cent of young girls will have HPV within a year of their sexual debut, and their bodies will clear off the infection. However, the infection will persist in about 10 per cent because their immunity is low or due to the presence of cofactors like smoking and contraceptive pills,” said Professor Isaac Adewole, a gynaecologist and former Nigerian health minister.

There are about 100 types of HPV, and not all of them are known to lead to cancer. The few that can lead to cervical cancer include types 16, 18, 33, 35, 41, and 63. So, individuals with these high-risk types need to be followed up to ensure they do not end up with cervical cancer.

Dr Oludare Morhason-Bello, a gynaecologist at the University College Hospital (UCH), Ibadan, and the principal investigator of a new cervical cancer screening project in Nigeria, said studies in Nigeria have detected HPV in other parts of the body, like the anus and the throat.

“A lot of people now engage in oral sex, putting them at risk of developing an oral HPV infection. In fact, 1 in 10 sexually active Nigerians that we collected samples from in Ibadan had an HPV infection. Among sex workers, it was 1 in 5.

“Any woman who has had sex once is at risk of having HPV, so it is expected that at least women should be regularly screened for cervical cancer, and the best detection method is HPV testing. Therefore, if we can deploy this technology and the result can be out within an hour, then we can quickly decide whether the woman will need further assessment and possible treatment if required.”

Dr Morhason-Bello declared that currently, the greatest challenge to preventing cervical cancer cases in low- and medium-income countries is poor access to screening services since women who are already sexually active people may not benefit from the protection the HPV vaccine offers against the cancer.

The Director of the Centre for Global Oncology at Northwestern University in Chicago, Professor Lifang Hou, declared that women are vulnerable to many things, including cancer, thus the need to educate them on the scientific means of preventing cervical cancer.

“They need to understand the harm HPV can cause to the woman’s cervix, the anus, and the throat. They have to take the HPV test; in fact, those with HIV have a higher risk for HPV and therefore cervical cancer. If they don’t know they have HPV, it can develop into real cancer. Once cancer develops, it is really hard to cure,” she said.

Still, Professor Adewole said that the HPV vaccine and early detection significantly lower the risk of cervical cancer. The HPV vaccine will prevent girls from contracting the disease in the near future. These also make it one of the most preventable forms of cancer.

HPV testing is the World Health Organization’s recommended standard for screening for cervical cancer.

While the HPV tests look for HPV infection in a sample of cells collected from the cervix, the other screening options, which are the pap smear and the visual inspection assay (VIA) test, look for pre-cancerous changes in the cells of the cervix that can develop into cervical cancer.

Professor Adewole stated, “Rather than wait for the pre-cancerous changes in the cells of the cervix, we can now pick up the HPV infection, which occurs much earlier. Now, we will also be able to determine whether it is the type of HPV with a higher chance of turning into cancer.”

He declared that Nigeria is keying into the international agenda to stem cervical cancer even as it has commenced vaccination of young people, starting in 16 states in the first phase and 14 states in the next phase.

Adewole added, “We want them vaccinated before they are 14, and then we will be able to make sure that at least 90 per cent of girls are vaccinated with the HPV vaccine by the age of 15; 70 per cent of women are screened using a high-performance test 10 years apart, and at least 90 per cent of women with pre-cancer are treated, and 90 per cent of women with invasive cancer are managed.”

Ideally, if there are resources, both young boys and girls should be vaccinated against HPV.

However, he stated, “If all girls are vaccinated, then it will also protect the boys because once the girls are protected; if the boys meet these girls, there cannot be any infection.”

Furthermore, Professor Adewole assured of the safety of the HPV vaccine, declaring that it has been in use in developed countries for over 15 years and has not been found to cause any harm.

Findings published by the Centres for Disease Control in the U.S. said that the HPV vaccine has brought down the occurrence of cervical cancer by 64 per cent in females between the ages of 14 and 19 years and by 34 per cent in young women aged 20 and 24 years.

Nonetheless, the vaccine is most effective before a person is ever exposed to HPV. But older teens and younger adults who are not yet vaccinated can benefit from it as well. Combined with regular screening, the vaccine is part of a strong cervical cancer safety net.

Also, receiving the HPV vaccine at ages 9 to 14 reduces, but does not eliminate, the risk of contracting one of the series of the virus. However, it does target some of the specific sources that create increased cervical cancer risk.

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