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While immunisations help you avoid or limit the effects of an infection, the vaccine for HPV - Human Papilloma Virus - aims to prevent some cancers induced by the virus. Given at the right time, the vaccine reduces the risk, especially of cancer of the cervix, which is the most frequent form of cancer among young women. Available since 2003 in the US, this vaccine needs to be better known around the world.HPV is a common virus transmitted through intimate sexual contact, even in the absence of sexual intercourse. Improved viral detection among cancer patients demonstrated that most cervical cancers are caused by specific strains of sexually transmitted HPV infections.There are about 40 different strains of these, and at least half of sexually active individuals are exposed to HPV. Two main strains - both highrisk - have been linked to several cancers, including cervix, vulva, vagina, penis and anus, while lowrisk ones cause genital warts.There is no cure for HPV, and due to its prevalence, immunisation is recommended before becoming sexually active. Vaccination won't cure an existing infection, but it will prevent other types.Using a condom greatly reduces but does eliminate the risk.For most women, HPV infection is destroyed by the body's immune system, but in others the infection is persistent and can lead to precancer lesions and ultimately cancer. This can take 10 years. Smoking doubles the risk of cervical cancer.Considering the specifics of HPV infection, the vaccine is recommended for girls ages 11 and 12 and is now part of the routine childhoodvaccines schedule. Girls and women ages 13 to 26 who haven't received the vaccine or haven't completed the full series should catch up. For women above 26, the vaccine is no longer recommended. Any of the two available vaccines are given in a series of three injections over six months. One of the two vaccines is effective in preventing genital warts and can be give to males ages nine to 26.HPV infection can't be detected in a clinical examination, but DNA testing will find it. This isn't intended as a routine test, but can be beneficial for cancer screening in older women and to clarify some types of "unclear" pap smears.HPV vaccination is better than 95 per cent effective in preventing the effects of the highrisk HPV infections, but it doesn't diminish the need for regular pap tests. The two current vaccines do not protect against all cervical cancers. Pap screening is known to save lives by detecting early, easytotreat precancerous lesions. Most women, even those who received the HPV vaccine while young, should start having pap tests at age 21 and need to have them every other year.
Dr Gerard Lalande is managing director of CEOHealth, which provides medical referrals for expatriates and customised executive medical checkups in Thailand. He can be contacted at gerard.lalande@ceohealth.com.
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