HPV vaccination: Your second best defence
Posted on 6 March 2019
HPV is the virus that causes cervical cancer – the second most prevalent cancer among women after breast cancer. Over 99% of all cervical cancers are caused by persistent infection of high-risk types of HPV. We chat to two Mediclinic experts about who should be vaccinated, when and why.
What is HPV?
HPV (Human Papillomavirus) is the most common sexually transmitted infection. Over 100 types of HPV have been identified, some of which cause harmless warts on the hands, legs or feet, and genitals. “Over 80% of women will acquire HPV in their lifetime, but in most cases, host immunity gets rid of it,” says Dr Percy Moodley, an Ob-Gyn at Mediclinic Victoria in Tongaat. “Approximately five types (16/18/45/31/33) are considered to cause cervical cancer.” Other types may cause cancers of the penis, throat and anus.
How is HPV transmitted?
“The virus is spread through skin-to-skin sexual contact and not by bodily fluids, which means sexual penetration does not have to take place,” Dr Moodley says. “Genital contact can be enough to contract the virus.”
What is the link between HPV and cervical cancer?
“Together the highest-risk strains 16 and 18 are responsible for over 70% of cervical cancers globally,” says Dr Moodley. The more a woman comes into contact with the virus, the greater her chances are of developing cervical cancer. Given that it takes approximately 10 to 20 years for cervical cancer to develop in women with normal immune systems, and much less (5 to 10 years) in women with weakened immune systems, it’s imperative to take preventative measures such as:
“Vaccination has the potential to prevent 70% of cervical cancers,” says Dr Moodley. He adds that it’s best to be vaccinated before becoming sexually active. “Ideally, all children between nine and 11 years old should be vaccinated,” he says. In South Africa, the two vaccinations, Cervarix® or Gardasil®, are offered free to schoolgirls (with their parent’s permission) at an interval of six months apart.
“Sexually active women up to age 26 are given three vaccinations. The second vaccine is usually given a month or two after the first, and the third vaccine six months later,” says Dr Stavros Stavrides, a specialist Ob-Gyn at Mediclinic Pietermaritzburg. HPV vaccination is currently not recommended for older women; the best way to prevent cervical cancer is to get a routine cervical cancer screening.
“Vaccination is not effective in women or men already infected with HPV,” says Dr Stavrides. “Pregnant women should not be vaccinated. That said, vaccination has not been associated with any adverse outcomes in pregnancy if mistakenly given to a woman who didn’t know she was pregnant.” Most medical aids cover vaccinations.
A Pap test can detect abnormal cells in a woman’s cervix. Although it doesn’t directly test for cancer or HPV, it can discover abnormal cell changes that are likely caused by HPV. Dr Stavrides recommends the following:
* Women under 30 should have an initial Pap test once they become sexually active, thereafter every three years. Although they do not need HPV screening, they may be tested in the presence of an abnormal Pap test result.
* Women between 30 and 65 should have a Pap test every three years and an HPV test every five years.
The only way to avoid HPV entirely is never to be sexually active. Practically speaking, the HPV vaccine, together with regular Pap tests, are your best defence against HPV and in many cases, cervical cancer.