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The International HPV Awareness Day (March 4) is the day dedicated to raising awareness of HPV infections, an acronym that collects the different strains of Human papilloma virus.
Against this virus, potentially responsible for over 6500 cases of cancer in Italy every year, it is necessary to focus on the prevention and early diagnosis of cervical lesions. Two simple weapons that, with education and knowledge, can help all women (and not just them) to stay healthy. The goal is to ensure that our country follows what is happening in Australia.
“Australia by 2035 will become the first country in the world to eliminate tumors caused by HPV while Canada will reach the target in 2040 – explains Walter Ricciardi, President of the Mission Board for Cancer of the European Commission. On paper, we already have all the tools to be the first European country to permanently eradicate these cancers. In fact, the Essential Levels of Assistance already provide for free vaccination during the twelfth year of age for both male and female adolescents and Pap-test and HPV screening, as well as the possibility of treating these tumors. An ambitious goal but achievable through a better and homogeneous organization and management of available resources and information by the Institutions on prevention programs “.
A virus to know
The Papilloma Virus, or HPV (acronym for Human Papillomavirus), is very widespread, almost always causing a completely asymptomatic viral infection destined to go unnoticed, without bringing consequences. They know each other well 100 types of human papillomaviruses, most of which cause non-serious diseases, such as skin warts.
Transmission of HPV occurs primarily through sexual intercourse. Scientific data says that about eight out of ten women contract the virus during sexual activity. Fortunately, in most cases the organism gets rid of it spontaneously within a few months without danger to future health.
The Papilloma virus is indeed a sneaky enemy: it can affect about eighty percent of sexually active people without their knowledge, because it does not give symptoms and the immune system can get rid of it naturally. But this does not always occur and more or less in twenty percent of cases the “enemy” persists and over the years can develop cellular alterations which, if neglected, can cause neoplastic lesions.
“There are over 6,500 cancers that every year in Italy are caused by the Papillomavirus – says Saverio Cinieri, President-elect of the Italian Medical Oncology Association (AIOM). Covid-19 is compromising the primary and secondary prevention of these forms of cancer. For this reason, the screening exams must restart after the interruptions recorded during 2020. In addition, vaccinations must be relaunched because it is estimated that over 1 million adolescents not covered by the risk of contracting precancerous lesions or neoplasms of the uterine cervix, anus , penis, vulva or vagina. Before the outbreak of the pandemic, in our country, the average vaccination coverage for HPV was 60% and therefore well below the optimal threshold of 95% envisaged by the National Vaccine Prevention Plan. However, it is a discreet figure, especially when compared to those recorded in other European countries ”.
We focus on screening
According to Eleonora Preti, expert in HPV-related pathologies of the Preventive Gynecology Unit of the IEO (European Institute of Oncology) “We have been an effective vaccine against HPV and the latest nonavalent version, can reduce the incidence of virus-related cancers by 90%. But to achieve this goal, vaccination coverage must be obtained for the entire candidate population ”.
“Unfortunately, our national coverage, even before Covid, was at most 70% in females and around 60% in males, while the estimated coverage targets were 95%. With the Covid blockade we now risk moving further away from the goal “.
But that’s not enough: alongside the anti-HPV vaccination, screening with Pap tests and HPV tests has also been slowed down, as our national studies show. The AOGOI (Association of Italian Hospital Obstetricians Gynecologists) made a comparison between the first 5 months of 2020 and the same period of 2019 regarding the number and percentage of tests performed in less, the estimate of initial lesions of the uterine cervix (CIN2 +) did not diagnosed because of the delay, and the number of standard months of delay accumulated. The screening tests performed fewer than in 2019 totaled 371,273 (55.3%).
“It is important that the message is passed that prevention is not a deferrable or even an accessory act, – concludes Preti – In addition to almost all cervical cancers, 70% of vaginal cancers are attributable to the HPV virus. 16% of cancers of the vulva, 87% of those of the anus, 29% of those of the penis, 25% of those of the pharynx and about 20% of the oropharynx. If we got full vaccination coverage, thanks to the now known “herd effect” cervical cancer would disappear and other HPV-related cancers would drastically reduce their incidence ”.
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