The human papillomavirus (HPV) is the most common sexually transmitted disease (STD) and is spread through sexual intercourse, as well as genital skin-to-skin contact.
Thankfully most HPV infections don’t result in any symptoms and the infection is cleared naturally by the immune system. However, some forms of the virus can cause warts, genital warts and certain cancers. It’s responsible for almost all cervical cancers and can lead to rare cancers including in the vulva, vagina, throat, anus and penis.
The Centers for Disease Control and Prevention (CDC) in the USA estimates that more than 90 percent and 80 percent, respectively, of sexually active men and women will be infected with at least one type of HPV at some point in their lives. Around one-half of these infections are with a high-risk HPV type, or strain, which can cause cancer. Low-risk HPV types cause warts. According to the CDC, high-risk HPV types cause approximately 5 percent of all cancers worldwide.
Take note that not everyone who is infected with a cancer-causing strain of HPV will necessarily develop cancer. Most importantly, most HPV infections that lead to cancer can be prevented with the HPV vaccine that can be administered to both boys and girls.
HPV and cervical cancer
“80 percent of women will have been infected with HPV by the age of 50,” confirms Dr Leneque Lindeque, a gynaecologist based in Ballito, KwaZulu-Natal. Thirteen HPV strains have been shown to cause cervical cancer and of these, HPV strains 16 and 18 account for roughly 70 percent of the global cervical cancer caseload.
In South Africa, a woman's lifetime risk of cervical cancer is 1 in 43, making it the second most common cancer for women in the country, according to the Cancer Association of South Africa (CANSA).
While Pap smears (a test which identifies if there is any abnormal cell growth in a woman's cervix) play a vital role in detecting pre-cancerous lesions, the HPV vaccines, which were approved for use in South Africa by the Medicines Controls Council in 2008, can actually prevent cervical cancer.
Early HPV vaccination is key
There are currently two HPV vaccines on the market, explains Dr Lindeque. "A vaccine called Gardasil immunises patients against HPV 16 and 18, the cancer-forming viruses, and 6 and 11, which cause genital warts. A vaccine called Cervarix immunises patients against HPV 16 and 18, and has some cross-protection of some other high-risk HP viruses that cause cancer."
For either vaccine to be effective, it needs to be administered before an individual has been exposed to strains 16 or 18 of the virus. It is for this reason that the ideal age for girls and boys to receive the vaccine is between the ages of 9 and 11, which is likely to be before they become sexually active.
"There is no upper age limit, but the general recommendation is up to the age of 26 for women," says Dr Lindeque. "The ideal time for the most effective results of HPV vaccines is before the person has been infected with any of the viruses." For men, the upper age limit is 21.
Why do boys need to be vaccinated?
When it comes to HPV, cervical cancer gets all the press, but the virus can also cause rare cancers such as those of the anus and rectum, mouth/throat and penis. There are no screening tests for these cancers, so they are often only caught at a later stage. Hence vaccinating boys could save their lives.
An added benefit of vaccinating boys against HPV is that once vaccinated, they won't be carriers of the virus, thus reducing the risk for any future partners too.
HPV vaccines are safe and effective
Despite undergoing stringent testing, vaccines seem to attract an undue level of controversy. However, before a vaccine is deemed safe for public use, it needs to undergo rigorous laboratory testing, animal testing and trials on human volunteers. Long-term follow-up tests are conducted to ensure safety and effectiveness.
"There has been broad media excitement about the side effects of the vaccines, but the bottom line is that they are safe," says Dr Lindeque. "The most common side effect is that of swelling at the site of the injection."
Don't forgo Pap smears!
While an HPV vaccine can greatly reduce a woman's risk of developing cervical cancer, it doesn't negate it entirely. Remember, there are 13 strains of HPV that can cause cervical cancer, so regular Pap smears are still essential.
"Pap smears are still necessary after the vaccines as cervical cancers can still form in these patients on rare occasions. A woman's first Pap smear should be at the age of 21 or a year after sexual debut," advises Dr Lindeque.
How Clicks Clinics can help you with the HPV vaccine
HPV vaccines are available at all Clicks Clinics without the need of a doctor’s prescription. To make an appointment at a Clicks Clinic, call 0860 254 257 or visit Clicks Clinics online.
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