Last year they were registered in Italy 395 thousand new cancer diagnoses – 208 thousand in men and 187 thousand in women – with a increase of 18 thousand cases compared to the previous year. A sign that is anything but comforting. One way of intervening – in addition to reducing the delay in diagnosis and managing risk factors – is also, in available cases, promoting vaccinations against infections known to be associated with the development of tumors: «These include vaccination against human papilloma virus (HPV)responsible for cervical cancer and other related pathological conditions and neoplasms” he explains Elsa Vioraformer head of the obstetric-gynecological ultrasound and prenatal diagnosis structure of the Sant'Anna hospital in Turin and past president of the Association of Italian hospital obstetricians-gynecologists and with Carlo Maria Stigliano, national secretary of Aogoi.
To draw an updated scenario of the situation in our country we must start from the data on cervical screening (Pap test or HPV test) which, after a significant slowdown during 2020 – a direct consequence of the pandemic – are fortunately recovering. «The most recent available data refers to 2021: if we look at the number of people invited to undergo screening for cervical cancer compared to the total number of those eligible, the coverage was equal to88.3% – explains the expert – a threshold that is very close to the 90% set by the European Union as the objective to be achieved by the year 2025. Not only that, in 2022 there was a further improvement in coverage compared to 2021, in particular way in the regions of the North, the South and in the islands. The greater coverage is undoubtedly attributable to the greater extension of invitations to the population but also to the transition from PAP tests to HPV tests starting from the age of 30″. The HPV test is indeed more sensitive than the Pap test (which however has greater specificity) and allows early identification of women at high risk of developing a cancerous lesion.
Human papillomaviruses (HPVs) are small, widespread viruses that can sometimes cause health problems but are often harmless. There are many types of this virus, which can infect the skin or mucous membranes and which differ in their DNA content. They are divided into types “low risk” (such as, for example, HPV 6 and 11) and types “high risk” (such as, for example, HPV 16, 18, 31, 33, 45, 52, 58 and others).
The former are responsible for the formation of genital warts, known as florid warts or condylomata acuminata, but the most common infections are precisely those with the high-risk types, responsible for the formation of pre-tumor lesions And tumors. A genital HPV infection can persist for a long time without causing any harm. A latent infection can be reactivated in the event of a decline in immune defenses and therefore persistence or progression can occur for various reasons. It is not the presence but precisely the persistence of HPV infection of the lower genital tract for several years which can lead to the development of a precancerous lesion.
On the occasion of International HPV Day (which falls on 4th March), the digital platform for health management Doctolib.it takes stock of the screening situation for papilloma virus and on the vaccination campaign in Italy. Similar reasoning to that for screening also applies to vaccination coverage anti-HPV which saw a significant slowdown during 2020, due to the emergency management of healthcare, as revealed by the Ministry of Health data updated to 2022 for the 1997-2009 birth cohorts. «At the end of 2021, the average figure of girls who received 3 doses of anti-HPV drug, thus completing the vaccination cycle, is equal to over 64% for the years of birth considered. A positive situation but still far from optimal. Above all, there is a strong decrease which corresponds precisely to 2020: the percentage of those vaccinated with 3 doses in the 2007 cohort is in fact equal to 66%while in the 2009 cohort the figure drops to 32%with a decrease of over 30 percentage points.”
It is essential, therefore, that the campaign resumes at a rapid pace, in all regions, filling this gap: to do this it is also necessary to raise awareness among younger people. «We need to spread knowledge of the risks linked to sexually transmitted diseases and inform about the great opportunity represented by the anti-HPV vaccination for the prevention of important pathologies in both sexes, in particular tumors resulting from this infection which, although very common, remains dangerous. , even for males – explains Viora – among men and boys, the awareness of the risk of contracting HPV infections and developing benign or malignant pathologies is still scarcely widespread while, on the other hand, there has recently been a significant increase in HPV-related tumors in male individuals, affecting areas such as the anus, penis and oropharynx.”
The situation of anti-HPV vaccination campaign among males it is in fact quite complex. «In Italy, in those born between 1997 and 2009, the vaccination coverage situation has seen a more than marked improvement, starting from minimum coverage percentages among children born in 1997/1998 – respectively equal to 0.49% And 0.62% of vaccinated with 3 doses – reaching peaks of over 54% among those born in 2006. With an average figure for all birth cohorts considered equal to almost 19%. However, even for boys there is a similar decrease to that which affected girls in the same birth courts, with the percentage of those vaccinated with 3 doses falling among those born in 2009 to 27% compared to 44% of those born in 2008 and more 54% of those born in 2007″.
The expert's handbook with three “golden rules”
Below are some simple precautions from Vlora e Doctolib.it to adequately protect yourself from HPV and better manage the infection, if contracted:
1. HPV infection is not only dangerous for women. It is essential that awareness of the possibility of preventing the most serious consequences of HPV infection also grows among people men and between Boys in particular. Vaccination is also useful to them, personally and not only to protect their partners!
2. Screening remains essential for women. Pap tests and HPV tests are very important allies for the prevention of cancer of the cervix and lower genital tract. The health facilities invite young women between the ages of 25 and 30 to have a Pap test every 3 years, while the HPV test is expected from 30 to 65.. This is in the absence of pathologies or particular indications from the doctor. Outside of the organized and free screening, the gynecologist will establish the possible usefulness or necessity of carrying out closer checks, obviously foreseen in the case of treatments or specific situations.
3. Let's overcome the stigma: for people, especially younger people, to access the anti-HPV vaccination, it is essential that they receive it the right support in the family and social context in which they are inserted. Talking openly about HPV and sexually transmitted diseases, at home and at school, is essential to overcome fear and apprehension and guide boys and girls towards a more protected sexual life.
How to prevent papillomavirus with the 90-70-90 strategy
HPV or Papilloma Virus: everything you need to know
Source: Vanity Fair
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