Cancer: What you should know about Human Papillomavirus

Nigeria joined the rest of the world yesterday to commemorate this year’s World Cancer Day. Every year, a large number of men and women die from various forms of cancers and many more keep coming down with the disease. Some of these cancers are caused by the Human Papillomavirus (HPV). The burden of cancer in […]

Nigeria joined the rest of the world yesterday to commemorate this year’s World Cancer Day. Every year, a large number of men and women die from various forms of cancers and many more keep coming down with the disease. Some of these cancers are caused by the Human Papillomavirus (HPV).

The burden of cancer in the country is worsened by poor knowledge, misconception and inadequate treatment facilities and equipment. The commemoration of the day underscores the need for Nigerians to increase their awareness about the disease and boost efforts in protecting themselves.

A large number of cancer sufferers, particularly women, in the country are unaware that they are infected with the Human Papillomavirus until it gradually progresses into a deadly disease, especially for cervical cancers.

Medical experts advise that getting protected against this virus will go a long way in reducing the risks and burden of some cancers.

At a health facility recently, Mariam, a mother of five, told Daily Trust that she brought her two teenage daughters to the hospital to receive a HPV vaccine. The 45-year-old mother  said she lost her mother to cervical cancer  six years ago and following advice from doctors had  made it a habit to go for pap smears  at least once a year and to get her teenage daughters vaccinated against HPV.

“My boys are already grown up that is why I didn’t bring them for the vaccination,” she added.

According to Dr. Onwufor Uche, a consultant obstetrician/gynaecologist, Human Papillomavirus (HPV) is a DNA virus commonly acquired during sexual activity with an infected partner.

He said it could also be transmitted from mother to child during delivery and that recent studies have shown that it could also be transmitted through transfusion of infected blood.

He said: “Human Papillomavirus (HPV) is the commonest sexually transmitted infection worldwide with over 80% of persons having been infected at some time in their lives. Every year millions of persons get infected with rates of infection highest in young people because they engage in more risky sexual practices.

“Most cases of HPV infections are without symptoms with the immune system clearing the infectious agents. However, in some persons, persistence of infection increases the risks of cancers of the anus, mouth and penis (in men) and cancers of the cervix, vulva, vagina, anus and throat (in women). Between 60 – 100% of the above cancers are caused by persistent HPV infections.”

Dr. Onwufor, who is also the Executive Director, Gynae Care Research and Cancer Foundation, said there are over 170 types of HPV with about 40 of them affecting the genitals of humans.

He said HPV 6 & 11 which cause genital warts (growth around the genitals) are not cancerous but uncomfortable.

“Persistence of HPV infections is higher in persons initiating sex at an early age, smokers, with multiple sexual partners, delivering many times and those with diseases causing low immunity such as HIV,” the gynaecologist added.

He said presently there are tests available for Human Papillomavirus DNA screening. He however added that these tests are not universally available. Presence of some of the high risk HPV usually is a reason for continuous vigilance and checks against cervical cancers, he added.

According to the Centre for Disease Control (CDC) there are HPV tests that can be used to screen for cervical cancer. “These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years,” it said.

Human Papillomavirus (HPV) has been implicated in almost 100% of cases of cervical cancer. Worldwide, there are 500,000 new cases of cervical cancers with about 300,000 deaths worldwide.

While cervical cancer remains the second most common cause of cancer deaths in third world countries, death rates are declining in industrialised nations.

On ways HPV can be prevented, the medical expert said, in the last 12 years vaccines have become available against the virus. “Most of the vaccines protect against most of the strains of the virus that cause over 70% of cervical cancers. While the vaccines are targeted primarily against cervical cancers, they have been noted to give some level of protection against other HPV related cancers,” he said.

He added that presently in industrialised countries, there is a drive to vaccinate young girls against HPV before they become sexually active. This is aimed at immunising the girls and increasing their immunogenicity, he said, adding that it confers primary level of protection against cervical cancer.

He said: “In contrast, in Nigeria the Federal Government is still struggling with rolling out a demo programme for nationwide vaccination of girls in two selected states of the country. Most parents are not aware of the benefits of the vaccine for their young children.”

Asked if the vaccine is safe, he said the HPV vaccine is known to be safe, effective and can be administered over a six months period as 2 – 3 shots to ladies between 9 – 45 years and males between 9 – 26 years.

Dr Onwufor said the side-effects are mild and well tolerated, and that it is readily available in most tertiary hospitals and some private hospitals.

“Theoretically, if given early in life, HPV vaccination could reduce cervical cancer rates by up to 70%. Post vaccination women are counseled to continue routine cervical screening till they are 65 years,” he stated.

While saying that HPV related cancers are a huge burden worldwide with the cost of cancer management beyond the reach of most of the patients in sub-Saharan Africa, Onwufor advised that mass vaccinations of girls against HPV will greatly reduce the burden caused by the virus and enable people live healthy lives.

Also, the founder of Medicaid Cancer Foundation, Dr Zainab Shinkafi-Bagudu, has advised the Federal Ministry of Health and other stakeholders particularly the private sector to provide free cervical cancer vaccines for young boys and girls.

“One of the ways of reducing the incidence of cancer in Nigeria is to make available free cervical cancer vaccines for young girls and boys before they become sexually active.

“The models used for polio vaccination can be easily adapted,” Dr Bagudu who is also the wife of Kebbi State governor, advised during the second annual summit of the foundation.