The human papillomavirus infection (HPV) is the most common sexually transmitted infection in Spain. It is estimated that more than 80% of the sexually active population will contract the infection at some point in their lives, via direct contact either oral or genital2,3. Worldwide, this virus is related to approximately 5% of all tumours in both men and women5,6. In men, it is particularly significant in cases of penile or oropharynx cancer, while in women it is frequently associated with vulva, vagina and cervical cancer.
Currently, more than 200 serotypes have been identified within the broad family of HPV infections1,2, although professionals tend to distinguish between low and high risk strains, according to Dr. Rafael José Navarro Ávila, specialist with the Gynaecological Oncology Service at MD Anderson Cancer Center Madrid – Hospiten. “The low-risk viruses are generally associated with the development of genital warts and/or oropharyngeal condylomata. Meanwhile high-risk viruses are responsible for approximately 70% of premalignant lesions1,2, cervical cancer and other oncological pathologies such as vulva, vagina, penile, anal and oropharynx tumours”, explained the expert, who highlighted that “the most aggressive HPV infections are classified as numbers 16, followed by 181,2”.
This pathology is asymptomatic and patients will not show any signs, making prevention crucial. Primary vaccination will act as an early means of prevention, protecting the person before the problem arises. Meanwhile secondary prevention takes place in adults through cytology tests and gynaecological check-ups.
“From the age of 35 onwards, an early diagnosis test is recommended every five years, as we have seen that cytology is not always 100% effective. In this way we can obtain better results and stratify the risk, adjust the specific follow-up procedures depending on the type of HPV”, indicated the specialist, who went on to emphasise that “in most cases, although a woman contracts the infection, their immune system will eliminate the virus”.
However, as he pointed out, the risk of developing a pathology will increase as the virus becomes chronic. “The lapse of time between contracting the infection and developing cancer can be up to 20 years. It is essential to bear this in mind, given that before it becomes chronic, there is plenty of opportunity to conduct tests, receive an early diagnose and treat it in time”, he concluded.
Primary vaccination in girls and boys
Vaccination is the principal form of prevention. According to data published by the World Health Organisation (WHO), those countries that began to vaccinate girls in 2007, saw an 83% drop in diagnoses of HPV 16 and 187. In addition, new diagnoses of high-level precancerous lesions fell by 51%7. Within the European Union, 77% of member states currently vaccinate against the virus8, although only 48% provide it for both males and females8.
In Spain, the recommendation to include the vaccination in the calendar for girls aged between 11 and 14 came into force in 20079. It was not until 2018 that it was proposed to extend this to boys as well as girls10. However, this measure did not receive official approval until 20234.
Since then, the HPV vaccination has been a compulsory inclusion for boys and girls between the ages of 10 and 12, a significant step given that, as Dr. Navarro emphasises, HPV “is not a pathology confined only to women”.