Every year, a thousand Belgians are told that they have cervical cancer, anal cancer or another HPV-related cancer. That number can be significantly reduced if we vaccinate and screen better, says Willy Poppe, gynecologist at UZ Leuven.
Ann De Boeck15 November 2023, 03:00
What is HPV again?
“HPV is the abbreviation for the human papillomavirus, of which about two hundred different types circulate among the population. About forty types appear around the genitals, and by extension also the anus, mouth and throat. They are mainly transmitted through sexual contact. To become infected, the virus must reach the bottom layer of the mucous membranes. These mucous membranes must therefore be slightly injured, for example by friction. In other words, you will not become infected by holding a handle or using someone else’s towel.”
How dangerous is HPV?
“In 90 percent of cases, our immune system clears the virus itself. In the remaining 10 percent, the virus remains and settles in the cells of the person in question, for example in the cervix. There, the virus disrupts the activity of the cells, causing them to transform into cancer cells in the making. A few years later cancer may develop. About a thousand Belgians are confronted with this every year.
“The vast majority of men and women who have HPV appear to be carriers without visible symptoms or complaints. Although some do, for example, get warts around the genitals, anus or in the mouth.”
So also men? Isn’t HPV mainly associated with cervical cancer?
“In the past we have indeed made the mistake of only focusing on women. We only talked about the prevention of cervical cancer. While the same viruses can also cause cancer in other places, such as the penis, throat, mouth or anus. We now know that about 40 percent of HPV cancers have nothing to do with the cervix.”
Together with other experts, you sound the alarm bells. If we want to eradicate HPV cancers, we have to step up our game, according to a white paper. What must we do?
“Complete eradication is currently impossible, but we can make a big impact. Most HPV cancers are completely preventable with a vaccine. The vaccine that is currently offered in the first year of secondary school protects against nine major HPV types. In Flanders, the coverage of this vaccine is quite high: 92 percent of girls and 86 percent of boys are vaccinated through the CLB. However, this is lower in Wallonia and Brussels. Moreover, there is still an entire generation in Flanders that has not had the opportunity to be vaccinated. The financial threshold is high for these people. The government only provides reimbursement up to the age of 18. One dose costs 130 euros, while you need three. That is why we argue for repayment up to 26 years.”
What if it’s already too late?
“Six in ten HPV-related cancers emerge in the cervix. We have known for a long time that the traditional smear taken by the GP or gynecologist – which is placed under a microscope – does not detect all these infections. About 30 to 40 percent goes unnoticed. A modern HPV test, in which the smear is analyzed for the presence of HPV in a laboratory, does remove almost all infections. Yet the vast majority of smears in Belgium are still analyzed in the old way.
“An HPV test costs 30 to 40 euros, but unlike a smear test, it is still not reimbursed in Belgium. That has to change. The advantage is that an HPV test only needs to be repeated every five years or longer if the result is negative, while a traditional smear test is recommended every three years.”
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2023-11-15 02:00:21
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