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Letter from CANSA Urging Parents to Support Human Papilloma Virus (HPV) Vaccination Programme in Schools

Dear Parent / Guardian

The Integrated School Health Programme with the joint efforts of the Departments of Health, Basic Education and Social Development has a Human Papilloma Virus (HPV) Vaccination Programme running in South Africa. The vaccine is provided free of charge every year to girls between Grade 4 and 7 (9 to 12 years of age) in all government schools.

HPV vaccination can be a cost-effective strategy in the lowering of cervical cancer risk among women in South Africa.

HPV is a very common virus. The virus lives on the skin and can be transmitted through skin-to-skin contact. HPV viruses No 16 and 18 are responsible for most (about 70%) HPV-related cancers. Some of the other high-risk HPV types is responsible for the remainder of cervical cancer cases. Some strains of HPV cause genital warts in men and women. Close to 80% of cervical cancers are caused by HPV.

Cervical Cancer is cancer of the cervix (the entrance or neck of the womb, situated at the top of the vagina). This cancer is currently second on the list of female cancers and is also responsible for the second most cancer deaths among women. It is a cancer that can be prevented and responds well to treatment when diagnosed early.

The Cancer Association of South Africa (CANSA) wishes to advise parents / guardians to get their daughters vaccinated for HPV, to ensure that they can lower their risk from getting cervical cancer. CANSA is also asking parents / guardians to consider the health and the future of their girl child. Parents / guardians can do this by signing the consent form and return it in good time back to the school.

Parents / guardians who make it possible for their girl child to be vaccinated with the HPV vaccine are making sure that their girl child’s risk is reduced against HPV infection and the possibility of getting cervical cancer.

Parents / guardians are encouraged to contact CANSA should they require additional information about cervical cancer and the HPV vaccination by visiting the CANSA Website at www.cansa.org.za or phoning CANSA on the toll-free line 0800 22 66 22.

CANSA wishes to encourage parents to ensure their own peace of mind by assisting in protecting their girl child against cervical cancer.

Sincerely

Elize Joubert
CEO Cancer Association of South Africa (CANSA)

What is HPV?

  • HPV stands for human papillomavirus and is a very common virus. There are more than 100 strains of the virus, most of them do not cause cancer.
  • About 7 in every 10 people will have HPV infection at some point in their lifetime.
  • The virus lives on your skin and can be transmitted through skin-to-skin or sexual contact. Because HPV lives on your skin, condoms do not fully protect you from it.
  • Over 100 types of HPV have been identified, and more than 30 of these infect the genital mucosa, 1 5 of which are oncogenic or cancer causing. HPV 16 and HPV 18 are the highest-risk types known to cause about 70% of all cervical cancers.
  • Some strains of HPV cause genital warts in men and women. These warts will usually show up a few months after you are exposed to HPV. They can be treated with prescription medication or removed. If they are left untreated, they may disappear by themselves, or they could grow in size or number.
  • Other strains of HPV are known as high risk. In women, these strains can cause cancers of the cervix, vagina, vulva, and anus, as well as head and neck cancers. Almost all cases of cervical cancers are caused by the HPV virus.
  • In men, high risk strains of HPV can cause penile, anal and head and neck cancers.How do you test for HPV infection? There are 3 different types of screening tests currently available: conventional (Pap) test and liquid based cytology (LBC) for infections of the cervix – visual inspection with Acetic Acid (VIA) – HPV testing for high-risk HPV types.
  • Knowing if you are positive for HPV will allow your doctor to determine the next steps in your treatment plan.
  • About 70% of cervical cancers are caused by HPV.
  • The HPV vaccination protects girls from being infected by HPV and thus reduces the risk of developing HPV related cervical cancer later in life.
  • If you have HPV, there is a very good chance it won’t be a long-term problem for you. Your immune system will attack the virus and it will likely be gone within two years.
  • The Integrated School Health Programme through the joint efforts with the Departments of Health, Basic Education and Social Development have a HPV (Human Papilloma Virus), vaccination programme running in South Africa. The vaccine is given free of charge every year to girls between Grade 4 and 7 (9 to 12 years of age) in all government schools.

Myths and Facts about HPV

Myth: Only women can get HPV.

Fact: HPV is common among both men and women. About 80% of people will get an HPV infection at some point in their lives.
In most cases, HPV goes away on its own. When it remains, it can lead to genital warts and several types of cancer. This includes cervical cancer, anal cancer, penile cancer, vaginal cancer, vulvar cancer and oropharyngeal cancer (tonsils and base of tongue).


Myth: People with HPV show symptoms.

Fact: Most people with HPV do not know they’re infected and never develop symptoms or health problems from it.
In 90% of cases, your immune system fights off the infection within two years.


Myth: HPV is not common, and it only affects people who have multiple partners, so I should not worry about the HPV vaccine or Pap test.

Fact: HPV infection is widespread, it affects 80% of men and women approximately.


Myth: You must have sexual intercourse to get HPV.

Fact: HPV is spread by intimate skin-to-skin contact. While most cases are sexually transmitted, people who have not had intercourse can become infected. Using condoms helps, but they do not completely protect you against the virus. They do not cover all of the genital skin.


Myth: If you have HPV, you will develop cervical cancer.

Fact: There are more than 100 strains of HPV virus in which some are high risk for cervical cancer, and some are not. Generally, the body’s immune system clears the virus itself within two years. Only in some cases it does not clear from the body and cause abnormal cell changes in the cervix that you cannot see or feel.


Myth: There are treatments for HPV.

Fact: There is no cure or treatment for the HPV virus. But there are ways to treat HPV-related health problems, such as precancerous lesions and genital warts.


Myth: HPV interferes with pregnancy.

Fact: In the majority of cases, having HPV does not impact a woman’s ability to become pregnant. If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Regular screening can find these, and your doctor can treat them.
Becoming pregnant after receiving the HPV vaccine is safe. The vaccine does not affect a foetus.


Myth: An HPV infection means someone wasn’t faithful.

Fact: An HPV infection may remain dormant and cause zero symptoms for weeks, months, even years. Because sexual partners often share the virus between each other, it’s hard to know who transmitted the virus to whom. It’s very difficult to trace the original infection back to its origin.


Myth: The HPV vaccine protects you for life.

Fact: The vaccine is effective for at least 10 years. But doctors are optimistic that it will provide more long-lasting protection.
If further study shows the vaccine is losing its effectiveness, a booster vaccine may be required.


Myth: The HPV vaccine causes teens and preteens to become sexually active.

Fact: No research links the HPV vaccine to increases in sexual activity. Boys and girls who get the vaccine do not have sex earlier than those who have not received the vaccine. Also, they do not have more partners after they become sexually active.


Myth: The HPV vaccine may cause medical side effects.

Fact: The HPV vaccine is a safe drug and doesn’t contribute to any serious health issues. Like any vaccine or medicine, the vaccine may cause mild reactions. The most common are pain or redness in the arm where the shot is given.


Myth: You got the HPV vaccine, so you can skip your Pap test.

Fact: Absolutely not. Because no vaccine prevents all types of HPV that can cause cervical cancer, vaccinated women aged 21 to 29 should still receive Pap tests every three years. Women aged 30 to 64 also should get a Pap test and an HPV test every five years. The HPV test checks your cervix for the virus that can cause abnormal cells that lead to cervical cancer. It may show that more frequent screening is needed. Women aged 65 or older should discuss their individual need for screening with their doctor.


Myth: Only girls should receive the HPV vaccine.

Fact: The HPV vaccine protects against high-risk types of HPV that can cause cancer. Both boys and girls aged 11 to 12 should receive the vaccine. That’s when the immune system is at its best to respond to the vaccine.


Myth: the HPV Vaccine can be administered at any age.

Fact: In October 2018, the US Food and Drug Administration (FDA) announced it had expanded the approved age for the HPV vaccine up to age 45 for women and men. In June 2019, a key advisory committee for the US Centers for Disease Control and Prevention (CDC) recommended the vaccine for all men and women up to age 26.

How to Prevent HPV

  • Get vaccinated for HPV.
  • Using condoms correctly every time you have sex can help reduce the risk of HPV, however, condoms do not cover all of the genital skin, so they are not 100 percent effective in protecting against the spread of HPV.
  • A person with genital warts should not have sex until the warts are removed. This might help reduce the risk of spreading HPV.

How to Manage an HPV Diagnosis

  • If you have HPV the risk of cancer is very small but should be taken seriously.
  • Make sure you follow up with your doctor on the next steps and try to keep things in perspective. If you have HPV, there’s a very good chance it won’t be a long-term problem for you.
  • Of the millions of cases of HPV diagnosed every year, only a small number result in cancer.
  • The majority of HPV infections are asymptomatic (no symptoms) and can be cleared by the immune system. However, persistence of particular strains of the virus is associated with the development of benign genital warts as well as certain cancers.
  • An HPV DNA negative result indicates that you do not have an HPV strain that is linked to the development of cervical cancer. As a result, the overall risk for cervical cancer is low and no additional testing is required for 5 years (unless factors such as changes in sexual partners occur within this time frame or one is infected with HIV etc).
  • An HPV DNA positive result indicates that you do have an HPV strain that is linked to the development of cervical cancer. Further testing is required to determine the level of advancement of the infection.
  • Result management guidelines will differ according to the resources available to the health practitioner. However, the South African HPV Advisory Board recommends the following procedures:
    a) Women who test positive for HPV 16 and 18 should undergo a colposcopy and/or biopsy. A colposcopy is an examination procedure that magnifies the cervix so physicians can take a better look at abnormal cells and take biopsies if needed.
    b) Women who test positive for other high-risk strains of HPV should have a Pap test as a follow-up to determine the morphological state of their cells and identify any precancerous lesions.

How to Talk to Your Partner about HPV

  • Talking with your partner may cause more anxiety and concern than the diagnosis itself.
  • Educate Yourself – Take time to learn more about your diagnosis. Find out whether your strain is considered to be high or low risk.
  • You didn’t do anything wrong – Don’t feel tempted to apologize for your diagnosis. HPV is very common, and if you’re sexually active, it’s one of the risks you face. It doesn’t mean that you or your partner (or previous partners) did anything wrong.
  • Partners tend to share strains of the virus between them, which means it’s almost impossible to know where the infection started.
  • Talk at the right time – Don’t blindside your partner with the news at an inopportune time, such as while you’re grocery shopping or running Saturday morning errands. Schedule some time for just the two of you, free from distraction and obligation.
  • If you’re worried about answering your partner’s questions, you can ask for your partner to join you at a doctor’s appointment. There, you can share your news, and your doctor can help explain what has happened and what will happen moving forward.
  • Discuss your future – An HPV diagnosis shouldn’t be the end of your relationship. If your partner is upset or angry about the diagnosis, remind yourself that you’ve done nothing wrong. It may take some time for your partner to absorb the news and process what it means for your future together.
  • Although HPV doesn’t have a cure, its symptoms are treatable. Staying on top of your health, watching for new symptoms, and treating things as they occur can help the two of you live a healthy, normal life.

Managing Warts

  • Some strains of HPV causes warts, which are unsightly growths on the skin. Warts are very common and aren’t serious or dangerous, but they aren’t pretty and can spread.
  • Genital warts in females need treatment because they can lead to cervical cancer.
  • Warts look different on different parts of the body. Common warts look like little rough cauliflowers and often occur on hands, arms, and legs. Periungual warts occur around fingernails. Flat warts, slightly raised and flesh colored, occur on the face, knees, and elbows of children and young women. Genital warts occur on genital and rectal areas and are often transmitted sexually. Plantar warts occur on bottoms of feet.
  • Common warts can first be treated by a solution of salicylic and lactic acids. The solution is put on the wart each night, and the next morning dead skin is peeled off.
  • Plantar warts can be treated with 40% salicylic acid plasters that are placed on the warts and removed weekly so dead skin can be taken off.
  • Genital warts almost always need a doctor’s care. The health care provider will use a blistering agent to remove the wart. Sexual partners will also need to be examined.

DOs and DON’Ts in Managing Warts:

  • DO treat warts early.
  • DO wash hands after touching your warts but try not to touch them.DO use salicylic acid solution on common warts and salicylic acid plasters on plantar warts as directed.
  • DO call your health care provider if your warts aren’t better after several weeks of treatment.
  • DO call your health care provider if you have genital warts.
  • DON’T bite fingernails, pick cuticles, or soak hands for long periods.
  • DON’T pick at, dig at, or pull-on warts.
  • DON’T cut or scrape warts.
  • DON’T let other body parts come in contact with warts.
  • DON’T shave or cut hair over warts.

Cervical Cancer

  • Cervical cancer is one of the most common cancers in women. It starts in the cervix, located at the lower part of the uterus. When detected early, or in the pre-cancer stage, treatment can be highly successful.
  • Cervical cancer is the second most common cancer among Asian, Coloured and White women in South Africa while it is the most common cancer among Black women.
  • Cervical cancer ranks as the leading cause of female cancer deaths in South Africa, particularly affecting women in the reproductive age group from 15 to 44 years.
  • Persistent infection of certain high-risk types of the human papillomavirus (HPV) are known to be the primary cause of cervical cancer.
  • Cervical cancer can usually be prevented if women are screened regularly for cervical cancer. When it is found early and treated, cervical cancer is highly curable.
  • When it is found early and treated, cervical cancer is highly curable almost all (70%) cervical cancer is caused by oncogenic HPV.
  • Routine cervical cancer screening (PAP smear) is one of the most important steps you can take to identify your risk.
  • A Pap smear is done to check for changes in the cells of a woman’s cervix. The test can identify any abnormalities or infections that may be found in the cells. The advantages of going for regular pap smear check-ups is that the earlier the disease is detected, the quicker the treatment may be implemented.
  • All women should receive cervical cancer screening, regardless of sexual orientation (i.e., women who identify as lesbian, bisexual, intersex, or heterosexual)
  • You may also be able to lower your risk by not smoking, delayed start of sexual activity, and using condoms during sex, is also recommended.

Myth vs Fact

Myth: Cervical cancer is hereditary.

Fact: Cervical cancer is not hereditary like breast cancer and ovarian cancer. It is caused by HPV infection. To save your child from the infection, make sure they get the HPV vaccine. If you are too old to get HPV vaccine, then make sure you get regular HPV and Pap tests.


Myth: The cause of cervical cancer is unknown.

Fact: Most of the cervical cancers are caused by the HPV virus which is a sexually transmitted infection.


Myth: I don’t need to get screened because I don’t have any symptoms.

Fact: A screening test is done to find out if there is any abnormal thing going on in the body in the people who are not having any symptoms. When there are symptoms, then the diagnostic test is done to find out the cause of the symptoms. An abnormal cervical cell does not cause any symptoms earlier, but they can be detected during the screening.


Myth: Pap smear test can help in the diagnosis of other gynaecological cancers, example: ovarian cancer.

Fact: The cervical Pap Smear Test does not test for other gynaecological cancers.


Myth: A Pap test is enough for protecting women against cervical cancer.

Fact: Just a Pap test is not enough to protect women against cervical cancer. For any women aged 30 and older, an HPV test along with a Pap smear test increases chances of obtaining an early diagnosis.


Myth: Cervical cancer is fatal.

Fact: Cervical cancer can be cured if detected and treated at an early stage.


Myth: Cervical cancer is contagious.

Fact: Cancer cannot be transmitted from one individual to another – it is not infectious. HPV infection, on the other hand, is contagious and is spread by skin-to-skin contact and sexual contact.

Sources:

Additional Information

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