HPV: get vaccinated to prevent cervical cancer

Human papillomavirus (HPV) can cause cervical cancer – the second most prevalent cancer among women after breast cancer. A Mediclinic expert explains why vaccination is your best defence.

The HPV virus spreads via direct contact, and roughly 99% of South Africa’s cervical cancer diagnosis is directly linked to the virus. It’s considered a sexually transmitted disease because most cervical HPV is transmitted sexually. However, you can contract HPV from hand contamination on urinals and toilets too.

Having multiple sexual partners increases the chances of contracting the virus. Other risk factors include early onset of sexual activity and conditions such as HIV that compromise your immune system. Chemotherapy can also increase the risk of getting the virus.

Dr Douglas Seton, an obstetrician and gynaecologist at Mediclinic Klein Karoo, says because so many cases of cervical cancer are linked to HPV, the cancer can be almost eradicated from society by taking simple steps. “Where there is a programme of adequate education and effective screening, there is no reason to fear HPV,” he explains.

More than 150 different strains of the virus exist, and Dr Seton points out that 10% of these are directly related to cancerous conversion. These are the ones gynaecologists are most concerned about since they’re commonly asymptomatic. The other strains cause physical deformations like growths and genital warts. To treat these deformations, your gynaecologist will choose the best course of action – whether it’s medication, topical cream, or surgery.

Dr Seton estimates that the infections can take between three and five years to turn cancerous. He adds that about 85% of infections resolve spontaneously within a year. Since the virus can be asymptomatic, the best way to detect it is via Pap smear. He recommends a smear at least every three years, and one year after engaging with a new sexual partner.

Fighting the virus

The best way of combatting the virus, according to Dr Seton, is via:

• Sexual education at schools
• Encouraging barrier-type contraceptive (condoms)
• Vaccination

The most fool proof is vaccination, Dr Seton adds, and there are two options: “The bivalent version is provided by the State and protects only against cervical cancer. The quadrivalent version, which protects against genital warts and cancer, is the prominent one used in the private sector.”

When the State vaccine was rolled out in 2014, it was met with some resistance. Parents were concerned by reports of side-effects, including the development of autoimmune diseases like lupus. But Dr Seton says there have been no statistically significant side-effects or contraindications to this vaccine.

Some parents were also appalled that the vaccine was only targeted at girls, wondering why boys weren’t included. Dr Seton explains that the virus is either asymptomatic in men, or shows up as genital warts. Very rarely, it can cause penile cancer. For females though, there is a greater chance of trauma during sexual intercourse, which can worsen infection. Virus particles can also be carried further to sensitive areas via sperm. This is why, he says, girls were targeted with the vaccine.

Dr Seton believes vaccination is the key to eradicating cervical cancer. However, more work needs to be done for a prevention programme to be successful. “Vaccination should be encouraged at every turn as everyone who is sexually active is at risk,” he says.