The latest news from the world of HPV in March 2020.
HPV infections can be eliminated if both boys and girls are vaccinated
A Swedish-Finnish study published in The Journal of Infectious Diseases now shows that the most oncogenic HPV types can be eliminated, but only if both girls and boys are vaccinated. Both genders will be offered vaccination in Sweden as of 2020.
The researchers began a randomised study in 2007, inviting 80,000 young people between the ages of 12 and 15 from 250 schools in 33 towns to take part. In 11 towns, both boys and girls were given HPV vaccination, in another 11 towns only girls were vaccinated, and in 11 towns the participants were vaccinated against a totally different virus (control).
General HPV screening at the age of 19 showed that the vaccination of both genders prevented HPV infections in society much more effectively than the vaccination of girls only. A gender-neutral strategy was also effective at preventing HPV infections in unvaccinated girls.
NOMAN has long advocated for the extension of HPV vaccination programmes as a means of preventing 5% of cancer, and the unecessary suffering associated with it. This is yet further evidence that gender neutral HPV vaccination is our best means of protecting both sexes against cancer.
A Call to Action to Increase HPV Awareness & Vaccination Rates
HPV vaccine coverage is not high in the USA. With rates lying at around 50%, much lower than the goal of at least 80%, it is essential to educate and inform people of the benefits of the HPV vaccine. A study from Dr A Deshmukh and his team, published in JAMA Pediatrics, looked at the country-wide understanding of HPV, the HPV vaccine, and the links between HPV and the cancers it can cause. It looked at a mixture of men and women, over a large age range. It was found that men are less knowledgeable than women about HPV in general. Over 75% of all participants did not know about the links between HPV and oral, anal, and penile cancers, despite HPV causing over 90% of anal cancers. It was also reported that few vaccine-eligible people and received a recommendation of the HPV vaccine from their healthcare provider. The study has shown us how important it is to increase awareness and education about the HPV and its links to cancer, and the HPV vaccine in order to increase vaccine rates and stop preventable deaths.
New smear test in Scotland to screen for HPV
From the 16th of March, a new smear test is being introduced in Scotland, and it includes screening for HPV. Since HPV is the main cause of cervical cancer, this test will be more effective in catching the signs of the disease early, making it easier to treat. The screening will also only have to be done every five years, rather than three. Bringing HPV testing into the smear test will ultimately hopefully save lives. Any women with a detected HPV infection will then be monitored closely and treated if necessary, so it will be much less likely to develop into cervical cancer. Those who have been vaccinated against HPV should still ensure they go for regular screenings, as the vaccine does not cover all cancer-causing strains of HPV. It is hoped that the combination of HPV vaccination and regular screening will eliminate cervical cancer in Scotland permanently.
Single dose of HPV vaccine: call for evidence from the JCVI
The Joint Committee on Vaccination and Immunisation has made a call for evidence to support a review of the current HPV vaccination programme in the UK. The evidence in question would be in support of moving to a single-dose vaccinate schedule, in place of a two- or three-dose schedule. Strong evidence for a one-dose programme will be interesting and beneficial to a goal of worldwide vaccination for everyone. For example, lower income countries or countries with limited access to resources will have resources freed up to vaccinate both boys and girls without the need for extra vaccine supplies, and the need for only a limited amount of extra resources. A more widespread, simpler schedule could improve uptake worldwide and therefore reduce the many cancers caused by HPV. If ongoing trials and models provide strong evidence for a one-dose programme, the global cancer burden could be massively reduced.
Coronavirus outbreak means tough decisions for cancer patients, physicians
2020 has certainly already put a strain on the global medical community. The COVID-19 pandemic has meant that all sections of healthcare have had to make sacrifices to tackle the issue. This is no different for cancer wards. Hospitals are facing difficult decisions regarding surgeries, with many being made to make a decision on what is and isn’t “essential”. Cancer patients are doubly affected in this worrying time - they are both more at risk of facing complications due to COVID-19, and also may have surgeries or treatments postponed while hospitals adjust to new demands. With a plethora of complicated things to consider, such as outpatient treatment, risk of infection, and inpatient screenings, all medical centres are working to find the best balance to keep patients safe. While cancer treatment feels, of course, “essential”, there are some treatments which are more time sensitive than others. This will be a tough time on all patients and physicians alike, and everyone is working to do everything they can.
Microbiome May Identify Female Precancer Risk from HPV
Scientists from the Albert Einstein College of Medicine have found that a certain bacteria, Gardnerella, which can be found cervicovaginal microbiome, could be an indicator of women who are at risk of developing an HPV-related cancer. The study analysed women who participated in the Costa Rica HPV Vaccine Trial. It was found that Gardneralla bacteria were a biomarker for High Risk HPV infections that then can lead to cancer. These findings suggest that detections of Gardnerella and its effects could be used to identify women at risk. Furthering this, it may even be possible to manipulate the cervicovaginal microbiome, using the knowledge gained from these findings, to prevent HPV infections from progressing to cancer.
HPV tied to miscarriages and preterm births
Following a review of 38 past studies by the University of Montreal, it has been suggested that HPV infections during pregnancy may be linked to an increased risk of miscarriage or preterm birth. Those with HPV in pregnancy are twice as likely as those without HPV to have a miscarriage, and 50% more likely to give birth too early, before full-term. The team has concluded that the studies pooled together give strong evidence that there is a link between HPV and the premature breaking of water in pregnancy. While there is currently no direct cure for HPV, the HPV vaccination is the best method of prevention and protection against the virus, and against the complications it can cause in pregnancy. It is recommended that anyone not vaccinated discusses their options with their doctor.