HPV: The trojan horse that can be stopped with vaccination

Human papillomavirus (HPV) has of late been in the limelight as one of the principle causes of cervical cancers. It can be metaphorically compared to a Trojan horse that brings danger silently and sets off a chain of events that could culminate in cancer. But the good news is that the horse can now be stopped reasonably effectively by the HPV vaccination and regular screening.

What's HPV?

It is a large group of common viruses that have many subtypes. Some strains can reside as commensals in normal humans without causing an infection.

There are over 100 types of HPV, including strains of HPV that cause warts on hands and face. About 30 known strains can affect the genitals. HPV is so common that most people who aren’t vaccinated against HPV will most likely become infected at some point in their lives. Most may never know they have it.

HPV mainly spreads through intimate skin-to-skin contact from genital areas. It is largely thought to spread during oral, vaginal and anal sex with or without penetration. Many people who harbor the infection might not have symptoms; this is especially true for men. But that does not prevent them from transmitting it. In others, HPV causes genital warts.

Certain strains of the virus (high-risk strains) are known to cause chronic inflammation that might trigger local changes in the lining of the cervix. It can eventually lead to lesions termed cervical dysplasia that is often picked up on routine pap smears. Cervical dysplasia can eventually turn into cervical cancer. This usually presents with pain during intercourse or vaginal bleeding between periods.

HPV is also linked to cancers of the vagina, vulva, anus, penis and an increasing number of cancers involving the throat and mouth. This makes HPV vaccination relevant not only for girls but also for boys, many of whom can acquire and transmit the virus.

It is therefore very important for herd immunity to ensure boys also receive the vaccine after the age of 9. It is recommended to give two doses if children are vaccinated before 15 years of age, above which three doses are ideal. Extensive global monitoring has ensured vaccine is very safe.

What are the side-effects of the jab?

The most common side effects of the intramuscular injection are mild pain or swelling at the injection site, low-grade fever, or temporary fatigue. 

However, one very important piece of advice for all women is that even those who have been vaccinated must come for regular screening PAP smears.

The HPV vaccine provides more than 90 per cent protection against cancers caused by the virus, but it does not eliminate the risk. Other forms of cervical cancer require screening, so a routine PAP smear with HPV DNA is recommended every 5 years for women above the age of 30yrs.

As an oncologist, I have met countless women whose lives have been have been turned upside down by a diagnosis of cervical cancer. Many are mothers in their late thirties and forties, often the backbone of their families. They sometimes have to undergo surgery, radiotherapy and chemotherapy, enduring physical, emotional and financial difficulties. When I see them struggle, I reflect that every eligible adolescent vaccinated today represents one fewer family that may have to confront the pain of cancer tomorrow.

The fight against cancer no longer begins only in the operating theatre or oncology clinic. It begins in our homes, our schools and our vaccination centres. By embracing HPV vaccination, we can ensure that the next generation inherits not only longer lives, but healthier ones.

The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.