BY VACCINATING 8 out of 10 adolescents against human papillomavirus, nearly one million cases of oropharyngeal cancer could be prevented in men in the next 50 years in the United States. The calculation, obtained with mathematical models made to this based on the characteristics of the virus, researchers from the Health Science Center of the University of Texas at Houston did, who published the results in The Lancet Regional Health-Americas. The Texan study is based on US data and figures, it is therefore a projection that is valid, in terms of absolute numbers, only overseas, but the significance of the research is exportable everywhere in terms of the impact of anti-Hpv vaccination on health, mortality and on deaths that could be avoided by extending the number of vaccinated people.
Away from goals
“Ours is the first study to develop and validate a comprehensive mathematical modeling of the natural history of oral HPV infection and its progression to oropharyngeal cancer,” explained senior author Ashish A. Deshmukh, professor associate with the Department of Management, Policy and Community Health and co-director of the Center for Health Services Research at the Health School of Public Health in Houston: “Achieving the goal of 80% vaccination coverage by 2025 and its maintenance could lead to the prevention of 934,000 cases of oropharyngeal cancer and the elimination of this form of cancer by the end of 2070. ”But the current HPV vaccination rate in the US is 54%, a value – the researchers calculated – which, if kept stable over time, could prevent 792,000 cases of cancer by the end of the century, but not lead to the eradication of the disease.
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Act now
“This work is a clear and important reminder that in order to prevent avoidable suffering and death from HPV-related cancer in the future, we must act by protecting adolescents now,” summarized the findings Gary M. Clifford, study co-author and deputy. Head of the Early Diagnosis, Prevention and Infections Section of IARC, the United Nations International Agency for Research on Cancer. But “now”, in covid time, is a complicated concept. During the peak of the pandemic, HPV vaccination rates plummeted by more than 50% in the US, a decline which, according to the authors of the publication, could be responsible for 6,200 additional cases of male oropharyngeal cancer over the course of the year. century. Hence the invitation to increase the number of vaccinated people: reassuring parents about the safety of vaccinations, increasing the commitment of health professionals to recommend anti-HPV and correcting the false information that circulates on the web. The choice of age for vaccination (11-12 years for females and males in Italy) is not accidental: the goal is to intervene with immunization before the start of sexual activity, given that the path of transmission of the virus is sexual contact, vaginal anal or oral.
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The situation in Italy
Every year in our country almost 6,500 cases of cancer are attributable to HPV: 2,365 to the uterine cervix, 1,200 to the vulva, 200 to the vagina, 300 to the anus, 500 to the penis and 1,900 to the oropharynx (in males and females overall) : the oropharynx represents for Italian men the site in which the greatest number of Hpv-related tumors develop: 40% to be exact.
The pandemic is holding back the fight against HPV
Against the human papilloma virus we have three vaccines available, which fall within the Lea, the essential levels of assistance: that against strains 16 and 18, which alone are responsible for about 70% of cases of cervical cancer in women ( and it is against these that the first HPV vaccine, available since 2006, was developed. A quadrivalent that also protects against strains 6 and 11, associated with 90% of cases of warts and, since 2017, a third vaccine, called 9-valent, which in addition to strains 6, 11, 16 and 18 also protects against serotypes 31-33-45-52-58. This vaccine could prevent approximately 90% of HPV-related cancers.
HPV Awareness Day, a Manifesto to eliminate papillomavirus tumors
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How did things go with us in the annus horribilis of the pandemic? Let’s say immediately that even before Covid the coverage of vaccination against HPV in adolescents was below the optimal threshold of 95% provided for by the National Vaccine Prevention Plan, but the pandemic caused delays in vaccination programs, causing a decrease further: about half of adolescents, today, also due to Covid, did not receive the vaccination in 2020. From the data for last year published by the Ministry of Health recently, it appears that vaccination coverage in girls born in 2007 is 58% and in boys 46%, and much lower for the 2008 cohort (30% per cycle business suit). We still don’t know what this means in terms of absolute numbers of avoidable and non-avoided cancers in the future.
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