HPV: Let’s Prevent the Main Cause of Cervical Cancer

85% of People Will Get HPV During Their Lifetime: Let’s Prevent the Leading Cause of Cervical Cancer.

The human papillomavirus (HPV) is a sexually transmitted viral infection that increasingly impacts women in Puerto Rico. According to the Centers for Disease Control and Prevention (CDC), 85% of people will get an HPV infection during their lifetime, and it’s estimated that this virus is responsible for more than 90% of cervical cancers.

Currently, Puerto Rico has the highest incidence of cervical cancer out of all U.S. states and territories (PR: 11.7 vs. U.S.: 7.4 per 100,000 inhabitants). In addition, between 2001-2017, the incidence of cervical cancer increased from 9.2 to 13.0 per every 100,000 women, and from 2001 to 2010, the increase was more marked among women under age 35, as well as those between the ages of 35 and 64.

HPV’s Health Impact

Although HPV infections usually disappear on their own, some cases can lead to complications:

Genital warts
Cancer of the cervix, vulva, vagina, anus and oropharyngeal regions (back of the throat, base of the tongue and tonsils)
Recurrent respiratory papillomatosis (formation of warts in the airways)

Supporting Prevention

HPV vaccination for men and women are one of the most effective strategies for preventing several types of cancer, including cervical cancer. Healthcare providers are also key players in prevention. Educating at-risk patients and clarifying doubts during each intervention can make a difference. Some recommendations include:

Discussing available vaccine alternatives s to prevent HPV and promote patient involvement in making the best decision. Through the Advisory Committee on Immunization Practices (ACIP), the CDC recommends administering the vaccine on a schedule of two (2) or three (3) doses, depending on the person’s age.

Children and adolescents between the ages of 9 and 14: The vaccine should be administered on a two-dose schedule.
Adolescents and adults between the ages of 15 and 45: The vaccine should be administered on a three-dose schedule.

Two-Dose Schedule Ages 9 to 14	Three-Dose Schedule Ages 15 to 45
The second dose should be administered 6 to 12 months after the first dose (0, 6–12 schedule).	The second dose should be administered 1 to 2 months after the first dose. The third dose should be administered 6 months after the first dose (0, 1 2, 6 schedule).

The ACIP has added other consideration:

HPV vaccination is recommended for those under the age of 26 who are not adequately vaccinated.
HPV vaccinations are not recommended for all adults over the age of 26. Instead, shared clinical decisions regarding HPV vaccination is recommended for some adults ages 27 to 45 who are not adequately vaccinated.
No pre-vaccination HPV testing (i.e., Pap smear or HPV screening) is recommended for vaccination.
Recommendations for children and adults ages 9 to 26 and older, and for adults ages 26 and older, apply to everyone, regardless of risk factors associated with HPV.
For pregnant women, HPV vaccination should be delayed until after the pregnancy. However, pregnancy screenings are not required prior to vaccination.
Women who are breastfeeding may get the HPV vaccine.

Encourage patients to get their HPV and Pap screenings to detect changes in cervical cells, and follow up on their results.

Provide orientation on options to prevent an HPV infection:
1. Using condoms and/or oral protection
2. Minimizing the number of sexual partners
3. Getting the HPV vaccine

HPV doesn’t just affect women. Cancers of the mouth, throat, penis, anus and genital warts are associated with HPV in men. It’s important to encourage patients to ask questions and provide information that will help them learn more about HPV and associated diseases, which are preventable. Education, proper screening, and timely preventive measures are all tools to help patients achieve optimal health.

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