Virtually all cervical cancers are associated with the human papillomavirus (HPV). In this report by SADE OGUNTOLA, experts say this is a cancer that is both preventable through vaccination and regular testing and treatment.
Cancer is a subject of enormous complexity, it is one many dread to talk about. Now imagine this: a vaccine that can actually prevent cervical cancer, the second most common cancer in women that is caused by human papillomavirus, or HPV.
In recent years, experts have developed potent HPV vaccines against cancers associated with HPV such as cancer of the cervix, vaginal, throat, tongue, anus and penis.
Ironically, many Nigerians, regardless of sex, age and social status, may have been exposed to HPV. The good news is there’s a vaccine for HPV which can prevent the majority of these cancers.
“Cancer of the cervix is highly preventable. Use of HPV vaccine is just an aspect of the primary prevention methods for this cancer,” said Dr Tosin Awolude, a consultant obstetric and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State.
HPV vaccination is recommended for both male and female, and women irrespective of their age can get vaccinated against the virus that causes cancer.
Basically, there are over 100 types of HPV, but only 40 will affect the genital tract. About 15 of these 40 types that affect the genital tract cause cancer.
Specifically, HPV types 16 & 18 account for about 80 per cent of cervical cancer cases. These HPV types can cause cancers of the penis in men as well. HPV can also cause cancers of the mouth, throat and anus in both men and women.
What does the vaccine do?
HPV infection is spread through sexual contact or skin-to-skin contact. Its infection is very common. And so, the higher the number of sexual partners one has, the more the likelihood of contracting more types of HPV and developing cancer as a result.
For maximum benefits, Dr Awolude said the HPV vaccination is recommended for girls that have never had sexual intercourse.
According to him, “in Nigeria, it is recommended for girls between the ages of nine and 14 years. This is based on Nigeria’s National Demographic Health Survey (NDHS) data that the average age of sexual debut for girls is about 15 years.
“It is to be given before their first sexual intercourse because the vaccine does not cure the virus; it only prevents its acquisition.”
Safety of the vaccine
Two vaccines, Gardasil and Cervarix, are available. These vaccines can prevent most cases of cervical cancer, if they’re exposed to the virus, which is when it works best.
In addition, these vaccines can prevent vaginal and vulvar cancer in women, while Gardasil can prevent genital warts and anal cancer in women and men.
When to vaccinate
Girls between ages nine and 14 need to take two doses of the vaccine and those above 15, including women of child bearing ages, are required to take three doses.
According to Dr Awolude, “these vaccines are safe and effective. Aside common reactions people may experience with injections, such as pain at the injection point, adverse reactions to the vaccine are very rare.”
Research has shown that receiving the vaccine at a young age isn’t linked to an earlier start of sexual activity. Also, response to the vaccine is better at younger ages than it is at older ages.
According to findings published by the Centres for Disease Control in the U.S., HPV vaccine brought down the occurrence of cervical cancer by 64 per cent in females between the ages 14 and 19 years, and by 34 per cent between young women aged 20 and 24 years.
Moreover, Dr Awolude added that abstinence from sex and keeping to one sexual partner were also important in preventing contracting HPV, and thus some cancers.
“Abstinence from sex, especially when the girl is below 18 years, is also preventive. Their genital tract is still developing and as such it can easily be infected by any organism, including HPV.
“In addition, those who are sexually active need to keep to one partner because HPV, the organism that causes the cancer, is sexually transmitted majorly. The more the number of sexual partners, the higher the risk of getting exposed to many more strains of the virus and as such the higher the risk of developing cancer.”
Regular screening protective
In women that are sexually active, Dr Awolude said that regularly screening for the virus or looking for signs of its infection through a pap test, HPV test or visual inspection of the cervix after applying acetic acid can help to ensure that the cancer is detected early and treated appropriately.
“It is only in 10 per cent of cases that the virus persists. It is the persistency of the virus that will cause the changes on the cervix that will then lead to cancer later in life.
“It takes no less than 15 years before it develops to cancer. So we have ample time to detect it. And that is why cervical cancer screening, also a secondary preventive measure, is important so that they can detect and prevent or treat cervical cancer early.”
Dr Awolude assured that in couple of months, individuals will also be able to access HPV test, which is the most sensitive form of cervical cancer screening at the UCH, Ibadan.
Head, Centralised Immunisation clinic, University College Hospital, Mrs Edith Adejokun, stated that every minute a woman is diagnosed of cervical cancer and every two minutes, a woman dies from the cancer, thus the need for individuals to be more proactive about their healthy by getting vaccinated.
Adejokun, an assistant director of Public Health, declared that women of child bearing ages, who are tested and free of HPV and having a normal cervix, can also be vaccinated against cervical cancer.
She stated that for girls below 14 years, the second dose is taken six months after the first dose while girls above 14 years take the three doses on day one, four weeks and sixth months.
Adejokun said the vaccine is available at UCH, Ibadan, and clients can just access it at the hospital’s Centralised Immunisation clinic, without any prior registration as a patient of the hospital.
According to her, the vaccination card that will be issued also affords the bearer in case the person travels to another town to get the other doses in other hospitals, if the person so wish.
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