HPV Vaccines and Cervical Screening
What is HPV?
Human papillomavirus (HPV) is a type of virus that is spread by direct contact such as skin rubbing or sexual contact, including oral sex. Over 170 different types of HPV have been found. Some of them cause warts on the hands, feet, genital region, anal region, and even the throat. Others are more dangerous and can cause cancers of the cervix, vulva, vagina, penis, anus, and head and neck. Almost all cancers of the cervix are caused by HPV infection, which makes prevention very important.
HPV infection is very common. One does not need to have sex with many people to get the virus; it can happen the first time someone has sex. Most people will get an HPV infection in their life, although many will not realise they got it.
A wart on a finger
How does one prevent HPV infection?
Vaccination is the most effective way to prevent HPV infection. The main problem with this is that there are many types of HPV virus, and vaccines will normally only protect against the more common types and may not offer full protection.
In Malta, girls aged 12-14 years are offered two doses of the bivalent vaccine (Cevarix) for free. This protects against the two most common cancer-causing types of HPV - types 16 and 18.
However, there are other types of HPV that can cause cancer which Cevarix does not cover. In Malta one can privately obtain the vaccine Gardasil 9 which protects against nine types of HPV and offers better protection against warts and cancer.
Update: As of 2020, Gardasil 9 is offered to girls in Malta aged 12 years for free, replacing Cevarix.
Young females (up to 15 years old) usually require only two HPV vaccines, with the second dose given after six months. Those older than 15 years usually require three HPV vaccines over six months, with a second dose given after one or two months and a third dose given after six months from the first.
Gardasil 9 costs around EUR 150 per dose so the total cost of immunisation is around EUR 450. One could also opt for Cevarix privately which costs around EUR 80 per dose, so the total cost of immunisation would be around EUR 240.
HPV vaccines can also be given to boys and men up until the age of 26 years.
HPV vaccines are safe. There was a myth that they cause infertility but this has been proven false by scientific studies.
During sex, condoms offer some protection against HPV infection.
Another strategy to prevent cervical cancer is to screen the cervix (known in Maltese as l-għonq ta' l-utru) for abnormal cells and HPV infection.
In Malta, the national screening programme invites all women aged 25-35 years to have their first cervical test. The test is then repeated every three years until the age of 50 years, following which it is repeated every five years.
The cervical test is a simple procedure. You are asked to undress from the waist down and a speculum is used to open the vagina. A brush like device is then used to gently obtain some cells from the cervix, and these cells are sent off for testing.
Cervical screening helps prevent 75% of all cervical cancers. More information on the screening programme in Malta can be found here:
Watch this video by the NHS (UK) on cervical screening: