Drastically REDUCE the cases of cervical cancer (and not only) caused by HPV, the human papillomavirus, until they disappear, is not a utopia but an achievable goal. How to do? Let’s get vaccinated. Everyone. The awareness campaign “Have you booked right?”, created by MSD and authorized by the Ministry of Health, reminds us of this. Started now in 2021, today it is also enriched with a TV commercial, with the aim of increasing correct information for the prevention of HPV-related diseases.
hpv and cancer
Papillomavirus infection (Hpv- Human Papilloma Virus) is the most frequent sexually transmitted infection. Classified as the second pathogen responsible for cancer in the world, the papilloma virus can cause various types of tumors, and – it should be emphasized – not only female: in addition to those of the cervix, vagina and vulva, it is also responsible for neoplasms of the anus, penis, oral cavity, pharynx and larynx. In Italy over 6,500 cases each year are attributed to chronic infections of oncogenic HPV strains.
Cervical cancer, in particular, is now the fifth most common cancer globally, with an estimated incidence rate by age for 2020 of 13.3 per 100,000 women. It causes hundreds of thousands of deaths every year and has a strong impact in health and socio-economic terms. In Italy in 2022 there were 2,400 diagnoses, all due to HPV infections.
HPV, still too few children vaccinated
by Letizia Gabaglio
Prevention: it is possible
However, preventing HPV-related oncological diseases is possible thanks to the synergy between primary and secondary prevention. With undoubted advantages for public health, but also for the health service in terms of cost reduction. Suffice it to say that the total direct costs related to HPV infections can be estimated at over 542 million euros a year.
“Today we can count on important scientific evidence that demonstrates how we could completely eliminate cervical cancer, a goal that WHO has set for 2030”, underlines Rosa De Vincenzo, of the Gemelli Polyclinic Foundation, IRCCS, Oncological Gynecology, Vice President of the National Society of Colposcopy and Cervico-Vaginal Pathology. “However, it is necessary to increase the level of knowledge of the pathology and raise awareness of the importance of primary and secondary prevention, improving the levels of vaccination coverage, encouraging adherence to screening programs and increasing the number of diagnoses and early therapeutic interventions. The diagnosis of micro-invasive or early stage cervical cancer, in fact, today allows conservative treatments, of “fertility sparing”, to be carried out to maintain procreative capacity”.
The campaign “You have booked right?”
As the expert points out, confusing information and false myths still circulate about the papillomavirus, so correct counseling on this infection remains essential. “If we really want to defeat these tumors, it is necessary to inform and involve the population more and more and, in particular, young people and their parents – he adds – It is a fundamental task not only of Public Health at national and regional level, but also of all health professionals who come into contact with patients and their families”.
Therefore, campaigns such as “You booked right?” are welcome. The project already started in 2021 with a rich planning on social media channels, to which radio communications through national broadcasters were added in 2022. And today there is also a TV commercial, broadcast on Sky, Mediaset and Discovery channels. In addition to the wide range of content available on the various channels, there is also a portal – www.haiprenotatovero.it – full of useful and immediate information on HPV-related diseases and prevention opportunities. The contents of the site have been evaluated by experts from the Ministry of Health who have authorized the campaign.
Vaccination and screening to defeat HPV
“The data on the level of information and awareness of the younger generations are disappointing, as are the data on non-adherence to screening programs “, adds Roberta Siliquini, President of SItI (Italian Society of Hygiene, Preventive Medicine and Public Health). “All of this adds to the delays caused by the pandemic, which have cut vaccination and screening adherence levels in half.”
The National Oncology Plan, recently approved by the State-Regions Conference, incorporates the HPV vaccination coverage and screening objectives of Europe’s Beating Cancer Plan for 2025, but also expects the new National Vaccine Prevention Plan to incorporate them. These public health measures allow the drastic reduction of the incidence of these neoplasms through the synergy of two fundamental measures: the achievement of high levels of vaccination coverage and adherence to screening.
“In 2021 the European Commission published Europe’s Beating Cancer Plan. By 2025, 90% of Member States will have to protect 90% of girls and significantly increase immunization in boys. Cervical screening must be offered to 90% of eligible women and 90% of patients with invasive forms must always receive timely treatments and follow-ups in highly specialized centres”, explains Saverio Cinieri, National President of AIOM/Italian Association of Medical Oncology. In Italy we have a healthcare system that has all the potential to respond in a coordinated way to this triple challenge”. Develop synergistic and integrated pathways for taking charge of the disease as a whole, ranging from primary prevention (vaccination, promotion of behaviors aimed at reducing the risk of contracting HPV infection) to secondary prevention (screening and early diagnosis), up to the reduction of losses to follow up and the improvement of the quality of life of people affected by the neoplasm.
“Between 2019 and 2021 we went from 39% to 23% in the rate of adhesion to the Pap or HPV test”, adds Cinieri. “To recover this gap, and more generally to reach the 90% threshold, new organizational models of the regional screening programs must be identified and the support IT systems must be implemented. Also for vaccinations we went from 66% to 32% in eleven year olds and from 54% to 26% in eleven year olds. It is necessary to recover quickly in order not to risk having an increase in cases in the near future ”.
A lesson against HPV
by Sara Carmignani
The role of the family doctor
“The information and awareness of young people and parents on the subject of cancer prevention must also be the task of the family doctor”, concludes Silvestro Scotti, National Secretary General FIMMG / Italian Federation of Family Doctors, who speaks of an active role of the clinician in promoting information and “recovery” actions for vaccinations and screenings, above all for subjects who are fragile due to pathology or vulnerable due to their socio-economic condition. Furthermore, the experience of Covid-19 has brought to full maturity the process of involving general practitioners in the prevention network who, however, do not yet have the IT tools in all Regions to truly be online with public health“.
A commitment in the present to protect the future
Preventing HPV tumors is a great achievement of science, but there is still a lot of work to be done in terms of awareness and perception of the risk that these serious diseases can cause in people’s lives, especially in that of young women and new generations. “I am really proud to be able to say that, once again, Msd is alongside the Italian public health. A fundamental synergy to eliminate papillomavirus tumors”, declares Nicoletta Luppi, President and CEO of MSD Italia. “Covid-19 has had a major impact on primary and secondary prevention. In many Regions, efforts are being made to recover the screenings and vaccinations postponed during the toughest phase of the pandemic. For this reason, today, it is important to raise awareness and correctly inform, also leveraging on the use of the large-scale communication tool par excellence, TV. A synergistic communication that embraces all communication channels: TV, social media and radio. Together they represent a pervasive tool for their ability to make an important message such as that of prevention ‘memorable’. We firmly believe that correct information in the right channels is a powerful tool for prevention”.