Cervical Cancer: Human papillomavirus (HPV) infection is known to cause cervical cancer, and evidence suggests that HPV also has a role in head and neck cancers as well as other anogenital malignancies such as anus, vulva, vagina, and penis.
HPV infection is a Sexually transmitted infection. HPV is a group of more than 200 viruses divided into two categories: low-risk and high-risk. High-risk HPVs cause most of the cancers. Within months to a few years of starting a sexual life, almost everyone who engages in sexual activity has an HPV infection. For the most part, our immune system eradicates HPV infections. However, the virus can cause cancer if it remains in the body for an extended period of time. Both men and women can avoid cancer by receiving the HPV vaccination.
Cervical cancer is known to be caused by human papillomavirus (HPV) infection, and there is mounting evidence that HPV also plays a significant role in head and neck cancers and other anogenital malignancies, including anus, vulva, vagina, and penis.
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According to Globocan 2020, cervical cancer is the second most frequent disease in India, accounting for approximately one-fifth of the cancer's global burden with an estimated 1, 23,907 new cases and 77, 348 deaths annually. With dismal survival chances, almost 75% of patients are detected at a locally advanced clinical stage.
When and to whom should the HPV vaccine be administered?
The target age range for the HPV vaccination is 9–14 years old with doses at 0 and 6 months. Immunisation for catch-up (15–26 years) comes in three doses: 0, 1, and 6 months. 0–2–6 months (nonavalent & quadrivalent)
For older demographics (27–45 years old), three doses are recommended: 0, 2, 6 months (quadrivalent & nonavalent) & 0, 1, 6 months (bivalent). Women who have engaged in sexual activity and are older than 26 should get counselling about the value of screening and the decreased efficacy of older age groups. It's important for all countries to strengthen their HPV vaccination programmes, expedite implementation and reverse the declines in coverage.
WHO now recommends a schedule of:
The HPV vaccination does not cure pre-existing conditions or infections; rather, it prevents new HPV infections. While not necessarily all of the HPV kinds that are the goal of vaccination, the majority of sexually active adults have already been exposed to HPV. Having a new sexual relationship increases your risk of contracting HPV again at any age. Long-term, mutually monogamous partners are unlikely to contract HPV again. "Before the Sexual Debut" is the best time to receive the immunisation.
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It's time to take action against cervical cancer since it's one that we can truly eradicate.
Aiming to eradicate cancer might have appeared unattainable a few years ago, but we can achieve that goal with today's evidence-based technologies; they just need to be accepted and widely available. A plan to eradicate cervical cancer globally was accepted by the World Health Organisation in 2020. To eliminate cervical cancer, a nation needs to achieve and sustain an incidence rate of less than 4 per 100,000 women.
Vaccination: 90% of girls to be fully vaccinated with the HPV vaccine by the age of 15.
Screening: 70% of women will be screened using a high-performance test by 35 years of age and again by 45.
Treatment: 90% of women with pre-cancer treatment and 90% of women with invasive cancer managed with therapies.
It is recommended that all nations achieve the 90–70–90 targets by the year 2030 to begin eliminating cervical cancer in the next century.
It is possible to successfully control the threat of cervical cancer by raising awareness and dispelling myths and misconceptions. To combat HPV and cervical cancer, the government, non-governmental organisations, and other interested parties must band together. While there is a pressing need for advancements in screening, diagnosis, and treatment, mass immunisation against the human papillomavirus will greatly impact the disease's eradication.
-Dr. Pratima Raj, Associate Consultant – Gynaecologic Oncology, Manipal Hospital Old Airport Road