A Q Human
papillomavirus
(HPV)
Q
&
A
GUIDE
CancerAware Nigeria
HPV Q & A GUIDE
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Vaccination against the high risk human papillomavirus significantly decreases the risk of infection with this virus that can increase the risk of cervical cancer. The vaccination is safe and countries that have introduced a vaccination strategy have seen a significant fall in the rate of pre-cancerous abnormalities and cervical cancer.
DR. ADEOLA OLAITAN Consultant Gynae-Oncologist, UCLH, London CancerAware Nigeria Medical Expert
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HPV Q & A GUIDE
THIS Q & A GUIDE COVERS: -
What is HPV?
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How does an individual get HPV?
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How does HPV lead to Cancer?
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What is the HPV vaccine?
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Who should get the HPV vaccine?
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How effective and safe is the HPV vaccine?
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I’ve had the HPV Vaccine, do I still need to be screened?
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How do I get tested for HPV?
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If I get HPV will I get cancer?
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HPV Q & A GUIDE
What is HPV?
H
uman papillomavirus (HPV) is a very common virus. There are over 200 types of HPV.
They are categorised into low-risk and high-risk HPV as some types are likely to cause more complications than others. Some of the high risk HPV can cause several types of cancers such as cervical cancer and cancers of the penis, anus, vagina, vulva and throat. Around 8 out of 10 people, male and female will be infected with the HPV virus at some point in their lives, however most people will clear the infection without even knowing they had it. Some HPV infections, however, can persist for many years. Persistent infections with high-risk HPV types can lead to cell changes that, if untreated, may progress to cancer.
How does an individual get HPV? HPV is usually spread through skin-to-skin contact. The HPV types that infect the genital region, anus and throat are spread through sexual contact. Anyone who is or has been sexually active in the past can get HPV, even if they have had only one partner.
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HPV Q & A GUIDE
How does HPV lead to Cancer?
When an individual is exposed to HPV, the immune system usually prevents the virus from doing serious harm and clears the infection. However, in some cases, HPV infections can lead to certain types of cancer in men and women. For some individuals that have a ‘high-risk’ HPV infection for a long time, the virus can damage DNA and cause cells to start dividing and growing out of control. These people are more likely to go on to develop cancer. Cervical cancer is the most common cancer linked to HPV infection. Other types of cancers that may be caused by HPV include vaginal, vulval, penile, anal, mouth and throat cancers. In 2018, HPV was responsible for 48.4% of cancer cases caused by infections in Africa.
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HPV Q & A GUIDE
What is the HPV vaccine? The HPV vaccine prevents infection by certain types of human papillomavirus. There are three HPV vaccines (bivalent, quadrivalent, and nonavalent) available in the global market to protect against some types of the human papillomavirus types. These are Cervarix, Gardasil and Gardasil 9. Although the World Health Organisation recommends that countries should include routine HPV vaccination in their national immunisation programmes, Nigeria presently has no national HPV immunisation programme. The HPV vaccine is only available at a few private and public health centres and at a cost. CancerAware Nigeria has an ongoing advocacy campaign to have the Government of Nigeria introduce the HPV vaccine into the routine immunisation schedule so eligible girls can access it for free.
Who should get the HPV Vaccine? Because the HPV vaccine prevents infections, it works best when individuals get it before they become sexually active and are exposed to the virus. Several countries have different recommendations on the age at which the HPV vaccine is best taken. In many countries, it is recommended for girls and boys from age 9. Recently in the United States, Gardasil 9 was approved for up to age 45. The National Strategic Plan for the Prevention and Control of Cancer of the Cervix in Nigeria (2017 2021) proposed that in Nigeria, girls between the ages of 9 and 13 should receive the HPV vaccine.
How effective and safe is the HPV vaccine? A recent 2020 research study by the London School of Hygiene & Tropical Medicine suggests HPV vaccination provides even greater health benefits and is more cost-effective than was previously estimated. The HPV vaccines have been extensively and independently evaluated and all scientific evidence shows 6
HPV Q & A GUIDE
they are extremely safe. The World Health Organisation (WHO) and virtually all countries in the world now recommend HPV vaccination with over 200 million doses distributed globally.
I've had the HPV vaccine, do I still need to be screened? While the vaccine significantly reduces your risk of HPV-related cancers including cervical cancer, women who have had the HPV vaccine still need to have cervical screening. HPV vaccination is not a substitute for cervical screening tests.
How do I get tested for HPV? HPV testing of samples taken from the cervix may be available for some women as part of their cervical screening. Cervical screening tests look for changes in cells in the cervix of a woman. If there are certain changes in those cells, the doctor may ask the lab to check for the HPV virus. If a woman is over age 30 and their cervical screening test is normal, the doctor may still test for HPV. This is referred to as “co-testing.� There is no HPV testing for men, and there are no blood tests for HPV.
If I get HPV will I get cancer? Only a small percentage of individuals who get HPV develop cancer, so having HPV does not mean that you will get cancer. However, it is important to reduce the risk of getting HPV by being vaccinated and women should get screened regularly for cervical cancer.
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HPV Q & A GUIDE
References Ask About HPV, 2020, If I get HPV, will I get cancer, accessed 1 March 2020, <https://www.askabouthpv.org/faq-young> Cancer Research UK, 2019, Does HPV cause cancer, accessed 1 March 2020, <https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/infectionseg-hpv-and-cancer/does-hpv-cause-ca ncer> Grulich A, Jin F, Conway E, Stein A, Hocking J. Cancers attributable to human papillomavirus infection. Sex Heal. 7(3), 244-252 (2010) International Agency for Research on Cancer, 2020, Cancers attributable to infections, a ccessed 1 March 2020, <https://gco.iarc.fr/causes/infections/home> International Agency for Research on Cancer. IARC Monograph 100B: Biological Agents - Human Papillomaviruses (2012) Joâ&#x20AC;&#x2122;s Cervical Cancer Trust, 2017, Human papillomavirus, accessed 1 March 2020, <http://www.jostrust.org.uk> Kaja M Abbas, Kevin van Zandvoort, Marc Brisson, Mark Jit.2020, Effects of updated demography, disability weights, and cervical cancer burden on estimates of human papillomavirus vaccination impact at the global, regional, and national levels: a PRIME modelling study. Lancet Global Health. DOI:10.1016/ S2214-109X(20)30022X World Health Organisation, 2019, Human papillomavirus (HPV) and cervical cancer, a ccessed 1 March 2020 , < https://www.who.int/en/news-room/factsheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer> The information included in the publication was correct at the time of going to press. We plan to review publications after a year however updates may happen more frequently.
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HPV Q & A GUIDE
#14000REASONS CAMPAIGN
# 1 4 0 0 0 R E A S O N S
HPV Vaccination Campaign Around 1 4 0 0 0 Women are diagnosed with Cervical Cancer each year in Nigeria. We are calling on the Government of Nigeria to make the HPV Vaccine available so eligible girls can access it.
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U S
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Lend Your Voice to the Campaign in 3 steps 1. 2. 3.
Sign the Petition at c a n c e r a w a r e . o r g . n g / r e a s o n s Follow the #14000Reasons hashtag on Social Media Share with your contacts.
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HPV Q & A GUIDE
The production of this Q& A guide was supported by OAK Foundation, Switzerland.
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