Doctors have known for a long time now that the human papillomavirus (HPV) can cause cancer. In fact, more 33,700 cases of cancer per year are linked to the virus.
Luckily, more than 90 percent of those cancers (roughly 31,200) are preventable in people who get the HPV vaccine, which was first introduced in 2006 under the name Gardasil. Cervical cancer is the most common cancer linked to the HPV virus.READ MORE
According to the U.S. Centers for Disease Control and Prevention (CDC), rates of CIN2+ (which are high-grade cervical lesions that can become cancer, and are used to measure HPV vaccine impact) declined from 216,000 women in 2008 to 196,000 women in 2016. Over two-thirds of these lesions were linked to one of the nine strains of HPV that the Gardasil 9 vaccine targets.
This decline in CIN2+ incidence is a telling sign that the HPV vaccine is working. And the fact that the decline occurred in women ages 18 to 24 is proof that, when it comes to getting the HPV vaccine, the earlier the better. In 2008, 55% of CIN2+ cases were in this younger age group, and in 2016, this rate dropped to 36%.
The CDC currently recommends that all children ages 11 to 12 (both male and female) get two shots of the HPV vaccine six to 12 months apart. Because HPV is usually transmitted during sex, the early age recommendation is meant to ensure the virus is prevented before children are sexually active. HPV is primarily spread by sexual contact, and the cancers it causes are often in intimate parts of the body.
That’s why some people object to the vaccine. They believe it will encourage sexual activity early on.
“There are no data to support that,” Dr. Jonathan Berek, Director of the Stanford Women’s Cancer Center told SurvivorNet. “Some people call it a ‘sex vaccine,’ but that’s not true. It’s an anti-cancer vaccine.”
Nonetheless, some religious conservatives have objected to using any treatment that may seem to endorse casual sex, or sexual activity some people consider taboo, such as oral and anal sex. The HPV vaccine was an issue in the 2008 presidential election, with some conservatives objecting to the government encouraging parents to get their children vaccinated for HPV.
Is the HPV Vaccine Safe?
Dr. Berek added that the HPV vaccine is incredibly safe, and has very few side effects. The notion (propagated by some “antivaxxers” that the HPV vaccine causes autism is a myth, he says; the only side effects reported with the HPV vaccine are local and mild pain and redness in the area where the vaccine is injected (usually the arm).
“The truth is that hundreds of thousands of young boys and girls over the years have been successfully vaccinated, and they don’t have any side effects or problems,” Dr. Jessica Geiger, a medical oncologist at the Cleveland Clinic Cancer Center told SurvivorNet. And for parents who choose not to vaccinate their children for HPV because they fear it will encourage sex at an early age, Dr. Geiger added, “It is unreasonable to think that just because your child is not engaging in sexual activity now that they won’t later in life, and there’s a very high chance that they actually will be exposed to the virus.”
Who Can Contract HPV?
Dr. Geiger is right about the very high chance of being exposed to the virus; in the U.S., roughly 80% of sexually active people are infected with HPV at some point in their lives. Most of the time, the immune system successfully clears the HPV on its own and the person never experiences health problems or symptoms.
“The important thing to know about HPV is that there are many different strains, and only a couple of them tend to be more cancer-inducing,” Dr. Allen Ho, Director of the Head and Neck Cancer Program at Cedars-Sinai Medical Center told SurvivorNet. (There are over 100 strains of HPV, 14 of which have been linked to various cancers.)
But in roughly six to seven percent of the population, the immune system does not fight off the virus, and the HPV remains dormant. It’s these cases that can ultimately cause cancer.
What Types of Cancers are Linked to HPV?
Although cervical cancer is the most common cancer associated with HPV, it’s not the only one. Cancers of the vagina, vulva, penis, anus, and the back of the throat have all been linked to strains of HPV, too.
Lillian Kreppel, who was diagnosed with anal cancer in 2017, recently spoke with SurvivorNet about the misconceptions surrounding HPV—which she discovered to be the initial cause of her anal cancer.
“People need to know that HPV can cause these cancers,” she said. “They need to know about the vaccine for their children, for their grandchildren, for their nieces and nephews. We need to do a big education and awareness push.”
The HPV Vaccine Wasn’t Around When I Was a Kid. Is it Too Late to Lower My Risk?
While the HPV vaccine is more effective when given at age 11 or 12, there’s a large percentage of the population that never had this option. When the vaccine was first approved in 2006, most people had already been sexually active for years.
This could explain why, in the new CDC report on CIN2+ rates, the encouraging decline in incidence for women between the ages of 18 and 29 was not mirrored in the population over 30.
But because there are so many strains of HPV, it’s possible that some sexually active people who were never vaccinated still haven’t been exposed to every strain of HPV linked to cancer. Recognizing this, the U.S. Food and Drug Administration (FDA) recently approved Gardasil for people up to age 45.
So, yes, it’s still possible to get the HPV vaccine at an older age. But it’s far more effective—and CDC-recommended—for use in children.
“I think it’s really important,” Dr. Heather Yeo, Assistant Professor of Surgery and Healthcare Policy and Research at Weill Cornell Medical College told SurvivorNet. Dr. Yeo shared that both her daughter and son recently completed their HPV vaccination cycles. “I would recommend that anyone who has an eligible teenager makes sure that they get the vaccine.”