2024-03-12 00:02:29
HPV is the cause not only of annoying warts, but also of cancer that is killing young women
The incidence of cancer is increasing all over the world, and there are many reasons for this: from the deteriorating environment to the spread of screening. At the same time, there is a vaccine against one of the very aggressive types of tumors, from which young women and even men die most often. Two types of HPV, the human papillomavirus, have been shown to cause cervical cancer. They can also become the cause of a number of other oncologies. We talked with doctors about whether it is worth getting vaccinated against HPV. We also found out who will receive the vaccine for free in the Novosibirsk region, and when it will finally be included in the National Vaccination Calendar, which will make it available to everyone.
What is HPV and what does cervical cancer have to do with it?
HPV is human papillomavirus. Now, according to WHO, approximately 200 types of this virus have been identified, of which only about 40 attack mucous membranes. The rest appear on the skin – for example, in the form of warts. HPV can be divided into two large groups: high and low oncogenic risk.
Most often, cervical cancer is caused by HPV serotypes 16 and 18. People transmit HPV to each other mainly through sexual contact, and the use of condoms is not a guarantee that infection will not occur. Condylomas can also be in places not protected by barrier contraception. HPV is also transmitted through oral sex.
According to WHO, HPV infection causes about 5% of all cancers in the world. More than 600 thousand cases of cancer in women are registered annually due to this virus.
— Very high neglect: they mostly come with the third and fourth stages. Patients with this diagnosis often die: every three minutes, one woman in the world dies from cervical cancer. The main cause of death is renal failure: the ureters are compressed, patients stop urinating, explained Sergei Krasilnikov, oncologist, doctor of medical sciences, professor.
According to various sources, 17–18 women die every day from cervical cancer in Russia.
Cervical and ovarian cancer accounted for 6.8% of cases in 2022 in NSO
The doctor explained in a separate article how exactly to detect cervical cancer and what examinations need to be performed. Since HPV is a virus, vaccinations have been developed that can protect women from cancer.
“For me, as a surgeon who regularly operates on patients with cervical cancer, there is no question at all whether to be vaccinated or not. How can you not use your chance to protect yourself from such a disease? My opinion is that, of course, you should get vaccinated. There are a lot of cases of cervical cancer today, and the scary thing is not that many of them are advanced, but it should be noted that only stage 1-2 cervical cancer is operable, and even then these are quite crippling operations, after which a woman, like usually can no longer give birth. The scary thing is that the majority of patients with this cancer diagnosis are young girls: 22, 24, 25 years old,” listed Mikhail Krylyshkin, oncologist surgeon at the National Medical Research Center named after. ak. E. N. Meshalkina.
The specialist added that cervical cancer can occur at 70 years of age, but most patients with cancer of this location are under 30 years of age.
Vaccination against cancer
HPV vaccination is not currently included in the National Calendar of Preventive Vaccinations in Russia.
Data on HPV infection is not fully collected, so it is impossible to say exactly how many people are carriers. In 2010, based on a meta-analysis, WHO reported that 12% of women in the world have HPV. This was established in scrapings from the cervix. In Africa, the virus was found in every fifth woman. Among men in the world at that time, the prevalence of HPV was higher – 21%. 14 years have passed since then. Some doctors now say that HPV of one type or another can be found in 80% of the world’s population.
In 2020, WHO adopted the “Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem.” It set three main goals, including full HPV vaccination of 90% of girls by age 15.
In Russia, you can now choose one of two vaccinations: Cervarix or Gardasil. The first is bivalent, protects against HPV serotypes 16 and 18, the second is quadrivalent against HPV types 6, 11, 16, 18. A nine-valent vaccine is being prepared for registration, but it is not yet possible to make it in Russia. Scientists are adding new types, since HPV can cause not only cervical cancer, but also other cancers. Our scientists are now developing their own vaccines.
HPV vaccination in Russia is not included in the National Calendar of Preventive Vaccinations. This means that it can only be done for free under a regional program or you can spend a lot of money at a private medical center. It was previously reported that the vaccine should be included in the calendar as early as 2024, but by order of the Government of the Russian Federation No. 343-r from February 15, 2023, the deadline was moved to 2026.
How to get vaccinated for free
Only a few regions of Russia have their own free HPV vaccination programs. In addition to Moscow and the Moscow region, this also operates in the Novosibirsk region.
— The program has age restrictions. You need to get vaccinated before the start of sexual activity, noted Rem Volkov, chief obstetrician-gynecologist of the Novosibirsk region. — Vaccination is very important. There is no data on the need for revaccination yet, because the vaccine has been used not so long ago, about 25 years. We should be proud that the Novosibirsk region has such a program; none of our neighbors can boast of this.
Not everyone will be vaccinated for free. There are certain criteria.
— Vaccination can be done for free at your place of residence in a children’s clinic upon referral from a gynecologist or pediatrician. Girls aged 9–13 years from high-risk groups are subject to vaccination against the human papillomavirus,” Lyudmila Piven, head of the gynecological department of the Novosibirsk Regional Hospital, chief pediatric gynecologist of the Siberian Federal District, obstetrician-gynecologist, explained to the NHS correspondent. — The vaccination course consists of two doses, 6 months apart.
The specialist reported that for 2024, 400 doses of Gardasil have been purchased for 200 girls, and 1,200 doses of Cervarix for 600 girls.
How much does it cost to get HPV vaccinations?
In Novosibirsk, you can most often find proposals for vaccination with Gardasil. Cervarix can also be found, but it is quite rare and protects against only two types of HPV.
The recommended course of vaccination consists of 3 doses and is carried out at intervals of 2 months. If prescribed by a doctor, vaccination can be carried out in two doses with an interval of six months.
On average, private clinics in Novosibirsk offer to supply the vaccine for 12,000 per dose. In this case, you will also need to be examined by a pediatrician for admission to the procedure. As a result, you will have to pay from 24 to 36 thousand rubles or more for the full course.
Should boys be vaccinated? What other cancers can HPV cause?
HPV does not only cause cervical cancer. Every year, according to WHO, it leads to cancer in more than 69 thousand men.
— HPV infection is also responsible for a certain proportion of cancers of the anus, vulva, vagina, penis, head and neck (most often localized in the oropharynx). HPV types 16 and 18, which cause cervical cancer, are associated with 85% of HPV-associated head and neck cancers and 87% of anal cancers, which are the second and third most common cancers. – says the WHO report.
Doctors say that HPV vaccination should also be carried out in boys before sexual activity in order to reduce the risk of cancer in them too.
Last year, Sergei Fursov, chief physician of the regional oncology clinic and chief oncologist of the Novosibirsk region, explained why the growing incidence of oncologists is not surprising, as well as the fact that every fifth patient comes for help already at the 4th stage, and why oncology clinics are opening in Novosibirsk .
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