Human papillomavirus (HPV) infections are responsible for several cancers. There is, however, a vaccine, intended for adolescents – boys and girls -, but which the French have not yet widely adopted.
Faced with certain cases, Jean-Luc Prétet is “displeased”. This professor of carcinogenesis associated with human papillomaviruses (HPV) at the University of Burgundy-Franche-Comté says he receives “unfortunately sometimes calls from patients with high-grade lesions or cancers that need to be operated on”. “Some young women could have been vaccinated against HPV when they were younger,” he comments to BFMTV.com.
“It’s terrible to think that we have an effective prevention tool but that it is not widely used. Terrible to think that we could avoid all these cancers.”
Because HPVs – which are transmitted by contact with mucous membranes or skin, almost exclusively during sexual intercourse with or without penetration – can be particularly dangerous. It is the most common sexually transmitted infection in the world: eight out of ten men and women will be exposed to it during their lifetime.
Each year, some 6,300 cases of HPV-related cancers are diagnosed in France, in both men and women. Cancers that cause 2,900 deaths, recalls The League Against Cancer.
And yet, there is a vaccine, especially for teenagers. But more than a quarter of parents are not in favor of vaccinating their children against human papillomavirus (HPV), reveals an Opinionway survey for La Ligue contre le cancer, on the occasion of European Vaccination Week, which ends this Sunday.
Today, vaccination coverage remains largely insufficient, it is even declining. In 2020, only 41% of adolescent girls had received a dose by age 15 and a third a full vaccination schedule by age 16 (vaccination has been recommended for girls since 2007). Very far from the 60% target set by the Cancer Plan.
As for boys, although the vaccine is also for them – it has been recommended since 2019 and reimbursed since 2021 – the proportion of vaccinated is almost insignificant.
For Jean-Luc Prétet, also director of the National Papillomavirus Reference Center, the population is not sufficiently informed about HPV. He calls for a stronger political commitment, “perhaps this will have to go through an obligation to vaccinate”. What the Opinionway study confirms: HPV is still unknown to more than half of parents and a third of them are not convinced of the interest of this vaccination.
“When we detect it, it’s too late”
However, it makes it possible to prevent infections by the most frequent papillomaviruses, responsible, in women, for 70 to 90% of cancers of the cervix of the uterus, says health insurance. HPV infections can also reach the ENT sphere, the anus, the vulva, the vagina and the penis and develop cancer there.
Laurence Rouloff, 41, president of the Akuma Association, based in Haute-Garonne, developed HPV in the ENT sphere – transmitted by her mother at birth – then in the cervix.
“My whole life has revolved around that,” she confides to BFMTV.com. “I’ve had it. I’ve had surgery at least once a year since I was 5, sometimes up to four times in the same year. And at 14, I only had 5% left my trachea to breathe. I almost passed out.”
Laurence Rouloff regularly intervenes in the colleges of her region to raise young people’s awareness of HPV and the possibility of getting vaccinated. “It is a virus that cannot be seen, felt or detected, except for the cervix,” she insists. “You can’t know if you’ve been infected. It can lay dormant for several years and when you detect it, it’s too late.”
“Parents need to understand that vaccinating their children is a chance, it’s about their future.”
Vaccination from 11 to 19 years old
As Vaccination info service reminds us, HPV infections are most often symptomless. While in most cases the virus is eliminated naturally in one to two years, in 10% of cases it can lead to the formation of lesions. “The evolution is slow between HPV infection, the appearance of precancerous lesions, and that of cancer”, points out the High Authority for Health. It can take ten to twenty years.
If French parents are suspicious, the vaccine has nevertheless proven itself abroad. In Sweden, precancerous lesions fell by 75% in young vaccinated girls. In Australia, where a large vaccination campaign was launched, the proportion of people infected with HPV fell from 23% to 1.5%.
After fluctuating recommendations at its beginnings – in particular on the fact that young people should not have started their sexual life – the vaccine is intended for all girls and all boys aged 11 to 14 years old. However, it is possible to benefit from it in catch-up, from 15 to 19 years of age, with three doses instead of two.
For men who have sex with men, vaccination is also recommended up to the age of 26 to prevent precancerous anal lesions, anal cancers and condyloma (also called genital warts).
A point on which insists Jean-Luc Prétet, the director of the National Papillomavirus Reference Center: “You have to vaccinate boys, whether to protect themselves but also in a public health approach.”
“I would have liked to be vaccinated”
This is why Audrey, a 39-year-old writer, has already warned her son that he will be vaccinated. “He’s only 8 and a half years old but I’m on the job,” she testifies for BFMTV.com. This young woman knows how much vaccination can save lives: she still has the effects of whooping cough, contracted when she was younger, a disease against which she had not been vaccinated.
“Several of my friends have developed cancers linked to an HPV infection. I myself would have liked to be vaccinated, I tried to do so but it was too late. I don’t want my son to catch this virus or pass it on to his or her future companion. And I don’t plan on missing the date.”
Several vaccines exist but the High Authority for Health recommends Gardasil 9 for a first injection. “It protects against 90% of HPV-related cancers,” explains Jean-Luc Prétet. “It is more protective than the others. It protects against seven high-risk carcinogenic HPVs, over a dozen high-risk HPVs, and against two condyloma.”