A year ago, the World Health Organization (WHO) launched a campaign to prevent the spread and risks of HPV to encourage young men and women to get vaccinated. A virus called HPV causes hundreds of thousands of cancers every year.
In this context, we interviewed Dr. Oceane Sorel, a virologist working with the UN to disseminate popular and validated scientific data. He is particularly active on Instagram (@TheFrenchVirologist), where he helps with humor to combat misinformation.
What is HPV and how is it transmitted?
The human papillomavirus, also known as HPV, is a family of viruses that infects humans. There are more than 150 different types of HPV, about 40 of which are transmitted through sexual contact. Some (but not all!) Of these HPVs are said to be “high-risk oncogenic” and can cause cancers such as cervical, penile, anal, or oral cancer … Approximately 600,000 new cancers a year are caused by HPV worldwide, including cervical cancer.
HPV is highly contagious and is transmitted through contact with the skin or mucous membranes, especially with or without sex that penetrates during sexual contact. Simple skin-to-skin or genital contact is enough, so condoms do not provide complete protection against HPV infection.
How do I know if I have HPV, any signs of infection?
HPV infection is often asymptomatic and transient, which means that the immune system eventually clears the infection in most cases. Most men and women become infected with HPV in their lifetime. Some transient infections can cause damage to the cervix, but in 85 percent of cases, these abnormalities go away on their own after a few months or years when the immune system finally gets rid of the virus. In some cases, when high-risk oncogenic HPV remains in the body, it can cause cancer in women (mainly cervical cancer, but also cancers of the vagina, anus, or mouth) and men (cancers of the penis, anus, and mouth).
How can HPV lead to cervical cancer? Is it systematic?
In the context of persistent infection with oncogenic HPV, and when the immune system is unable to clear the infection, abnormal cells may appear in the cervix that can lead to pre-cancerous lesions and then turn into cancer. This progression is slow and takes several years (about 10 to 20 years between infection and the development of cancer).
What are the risk factors for developing cervical cancer?
The biggest risk factor is an infection with one or more of the 14 HPV types that can cause cancer. These include HPV 16 and 18, which cause about 70% of cervical cancers.
Other factors significantly increase the risk of developing cervical cancer, such as sexual intercourse at an early age, multiple sex partners, smoking, long-term use of oral contraceptives, impaired immune response, chlamydia infections, multiple full-term pregnancies…
How can cervical cancer be prevented and detected? How often should I test?
Since 2006, there have been vaccines recommended for young people to prevent HPV infections and thus protect them from developing cancers associated with these viruses. HPV vaccination is the primary method of prevention for cervical cancer, but it is not enough to prevent 100% of cervical cancers. Therefore, vaccination is not a substitute for cervical cancer screening.
In France, regular screening for cervical cancer by collecting a few cells and mucus from the cervix to detect virus (HPV test) or abnormal cells (cervical cytology, also called Pap test) is recommended for all women aged 25 to 65 years (vaccinated or unvaccinated). Contact your doctor for more information on test types and recommended intervals.
Why is the HPV test not recommended for women under the age of 30?
In France, cytological screening is recommended for women up to 25 years of age to detect abnormal cells. However, HPV testing before the age of 30 is not recommended because HPV infections are very common in adolescents. The peak of HPV infection is reached soon after sexual activity. However, most of these infections are transient and disappear after a few months when the immune system finally clears the infection. HPV testing in young women under the age of 30 would result in a significant number of unnecessary tests and potentially invasive treatments that could increase the risk of complications in future pregnancies when most of these infections would have healed on their own.
Are there several vaccines? Why are there different vaccines? How effective are they?
There are three vaccines: Cervarix, Gardasil and Gardasil9, all of which protect against HPV 16 and 18, which are responsible for most HPV-related cancers. Gardasil and Gardasil9 also protect against a number of HPV viruses that can cause genital warts. Finally, Gardasil9, which has replaced its predecessor in the Gardasil market, also targets other HPV viruses, which cause more than 20% of cervical cancers. When HPV vaccines are given before the first sexual contact, they prevent more than 90% of targeted HPV infections.
Who should be vaccinated and when?
In France, the High Health Authority recommends HPV vaccination:
– All children: girls and boys aged 11-14 years on a 2-dose schedule.
– It is possible for all adolescents and young adults aged 15 to 19 years to receive a 3-dose vaccination schedule.
– The vaccination recommendation can be extended to 26 years for men who have sex with men.
Does the vaccine have any known side effects?
The reported side effects of HPV vaccines are generally classic side effects of the onset of an immune response, such as pain at the injection site, fever, fatigue, etc. Recent studies have found no link between vaccination and the development of autoimmune diseases.
Is it possible to get HPV vaccine after the first sexual intercourse?
Yes, until a certain age. However, the effectiveness of the vaccine drops to 50-60% if given after the first sexual contact, as the peak of HPV infection is reached soon after sexual activity, so the importance of age at the time of vaccination is important.
Should I go for tests if I have been vaccinated?
Yes, vaccination is the primary layer of protection against cervical cancer, but no vaccine is 100% effective and vaccines do not protect against all types of oncogenic HPV and are therefore not enough to prevent all cervical cancers. In other words, vaccination is not a substitute for regular cervical cancer screening.
Should boys also be vaccinated?
HPV vaccination has recently been extended to boys in France and other countries around the world for a number of reasons. First, 4 out of ten HPV-related cancers occur in men, and vaccination can prevent most HPV-related cancers in men. In fact, in men, HPV infections can cause genital warts, cancer of the penis, anus, and mouth. In addition, vaccinating boys protects girls from HPV infection. Finally, gender-neutral vaccination can help prevent the spread of HPV in the population and may ultimately lead to the eradication of high-risk oncogenic HPVs.