ROBERT PIERCE
• Leader & Times
Genital human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, and the International Agency for Research on Cancer found 13 HPV types can cause cervical cancer.
In general, HPV is thought to be responsible for more than 90 percent of anal and cervical cancers, about 70 percent of vaginal and vulvar cancers and 60 percent of penile cancers.
Cancers in the back of the throat are often caused by tobacco and alcohol, but studies show about 60 to 70 percent of cancers of the throat may be linked to HPV.
The Centers for Disease Control said when the body’s immune system cannot get rid of an HPV infection with oncogenic, or cancer-causing types, it can linger over time and turn normal cells into abnormal cells and then cancer.
The CDC likewise said about 10 percent of women with HPV infection on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer.
Kansas Pharmacists Association Director of Practice Development Amanda Applegate said some types of HPV cause skin warts, and those are transmitted by touch and not necessarily by sexual encounters. She said there are also many types of the virus that can be spread in other ways.
The types of HPV concerning to KPA and the Immunize Kansas Coalition, though, are those that cause cancer. Applegate said this was the primary driver behind the creation of an HPV vaccination.
“The skin warts on their own won’t necessarily cause problems, but it’s the development of cancer that does,” she said.
Of the more than 200 types of HPV, Applegate said there are only about 15 known to cause cancer, and these are the types immunizations have been designed to target.
“What happens with that is it actually gets in there and sticks around in those areas and can cause mutations in the cells around it,” she said. “There are other types of virus that increase your risk for cancer, but in this particular case with HPV, the specifically dangerous types actually cause cancer.”
As with most sexually transmitted infections, Applegate said cancer-causing HPV can be prevented in a few ways.
“Limiting the number of sexual partners, wearing protection can help, but really, the best way to prevent HPV infection and subsequent cancers is going to be vaccination with the HPV vaccine,” she said.
Applegate emphasized HPV cannot be transmitted through items such as toilet seats, pools or hot tubs.
“We certainly don’t want to scare people,” she said. “We’re certainly not looking to prevent sex, but getting vaccinated is something that can protect somebody who may not be having sex now, but may in the future after they get married. It’s certainly the long-term protection that is really important.”
Applegate said while there are multiple cancer types that can be caused by HPV, cervical cancer is the most common.
“There are the ways to screen for cervical cancer, but there are other types of cancer such as penial cancer, anal cancer and oral cancer that are also caused by that,” she said.
Applegate said it is recommended children age 9 to 12 should get an HPV immunization, and the pharmacist knows first hand how well getting vaccinated works.
“When this immunization first came out, I was older than the recommended age of 9 to 12,” she said. “At that point, I was in college, and my mom was already a cancer survivor. As soon as that vaccination came out, she got me to a physician and got me that vaccine series right away. She knew if there was anything she could do as a parent to protect her child from experiencing cancer, she needed to make that happen.”
Applegate said while many think of cancer as something that happens to somebody else, they likewise would not want to go through cancer, nor would they want their children to go through it.
“If there’s anything you can do to prevent cancer, a lot of people would be ‘Sign me up,’ which is why we always talk about vaccination in those terms,” she said.
Applegate said girls age 10 and 11 first received the HPV vaccine in 2006, and with those ladies now entering their 30s, this is the time to see the percentages of those populations who got cancer and did not.
“One of the best things we can see right now is cervical pre-cancer rates or the number of women have bad results on a pap smear, those rates are dropping,” she said. “They’ve actually dropped by 50 percent in 18 to 20-year olds between a couple years after that vaccine was introduced and 2015. We see this as a very effective vaccination at preventing cancer.”
Many vaccines such as those for influenza are changed on a yearly basis, but since the introduction of the HPV immunization, Applegate said only a couple of changes have been made.
“When that vaccine was first introduced, it targeted four types, and the current vaccine actually targets nine of those 15 types,” she said. “That current vaccine has been around about 10 years now to prevent nine of those 15 types.”
As for testing for cancer-causing HPV, Applegate said the best and most routine way is for women to get pap smears.
Applegate said studies other countries are looking at using fewer vaccinations for HPV, and that is something being looked at in the U.S. as well. She said children who start vaccinations before their 15th birthday will likely only receive two immunizations, but treatments after that will most likely require a third vaccination to be effective. She added the HPV vaccine is not required, but it is recommended for ages 9 to 12.
In 2018, the CDC documented a high HPV burden of infection in the U.S., with 42 million persons infected with disease-associated HPV and 13 million persons acquiring a new infection.
“Although most infections clear, some disease-associated HPV type infections progress to disease,” a 2021 report from the American Sexually Transmitted Diseases Association said. “The HPV burden highlights the need for continued monitoring of HPV-associated cancers, cervical cancer screening and HPV vaccination to track and prevent disease.”
