Why your daughter requires cervical cancer vaccination

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 the 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 obstetrics and gynaecologist, University College Hospital (UCH), Ibadan, Oyo State.

HPV vaccination has not been introduced in the vaccination schedule in Nigeria and is only available to people on personal arrangements. Programmes are set up to vaccinate girls on adhoc, irregular and usually private basis.

Screening alone may not be sufficient to prevent cervical cancer, so 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.

About 3.5 per cent of women in the general population are estimated to harbour cervical HPV-16 and 18 infections at a given time. Specifically, HPV types 16 & 18 account for about 80 per cent of cervical cancer cases.

This 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.

HPV infection is spread through sexual contact or skin-to-skin contact. Its infection is very common and most often acquired in young adults who engage in early sexual debut. 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.

“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,” he said.

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.

Girls between ages nine and 14 need to take two doses of the vaccine and those above 15, including women of childbearing ages, are required to take three doses.

Studies say that younger people have a stronger immune response to the vaccine and hence, it is prudent to give the vaccination before they are actually exposed to the virus.

In theory, vaccinating women against types of HPV also decreases the chance of their partners getting infected with diseases associated with HPV.

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 are 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,” he said.

In women that are sexually active, Dr Awolude said that regular 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 persistence of the virus that will cause the changes on the cervix that will then lead to cancer later in life.

• Risks associated with oral s3x

“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.

Former head, Centralised Immunisation clinic, University College Hospital, Ibadan, 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 health by getting vaccinated.

Adejokun, an assistant director of public health, declared that women of childbearing 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, after four weeks and after 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 wishes.

Mothers are role models for their daughters and can encourage them to adopt safe and preventive health practices. Awareness also then needs to be created among mothers with the aim of enlisting their deeper involvement in educating their daughters about cervical cancer prevention.