THECervical cancer, also known as cervical cancer, after breast cancer, is the second most common cancer among womenwith around 2500 diagnoses per year. The good news is that It can be prevented through the HPV vaccine. Nevertheless vaccination coverage in most European countries, including Italy, remains well below the target set by the WHO. This involves reaching 95% coverage by 2030. Worldwide January is Cervical Cancer Awareness Month. Let’s find out then thanks to the Ministry of Healthwhich screenings are suitable for each age.
Prevention as a priority
Since 2009 theWorld Health Organization he identified prevention of cervical cancer and other HPV-associated pathologies such as a public health priority. However, based on the latest available data from the Ministry of Health relating to 2022, the national vaccination coverage for HPV in twelve-year-olds it is equal to 38.78% among girls and 31.81% among boyswhile in the fifteen year old group it reaches 69.32% in females and 44% in males. Furthermore, at the regional level no region achieved 95% coverage in all cohorts considered.
Cervical cancer: the causes
According to the Ministry of Health, «Cancer of the uterine cervix or neck of the uterus it is caused by a persistent human papillomavirus infection (HPV), transmitted sexually and very frequent, especially in young people. Most infections regress spontaneously. If the infection persists over time, precancerous lesions form in the cervix, which can develop into cancer. The risk of cancer strongly depends on some well-identified types of HPV viruses, but is favored by: poor access to preventionnumber of partners, young age at the beginning of sexual activity, immunosuppressive states, cigarette smoking and hormonal contraception”. The good news is that it can be prevented either thanks to vaccination against the Papillomavirusboth through early diagnosis with Pap tests and HPV-DNA tests.
Prevention: because it also concerns men
«The 12th year (11th to 12th birthday) is the recommended age to carry out the anti-HPV vaccination to both girls and boys”, continues the Ministry. Prevention, in fact, also involves the male sexas men can also become infected with HPV. «It often progresses asymptomatically and this makes diagnosis more difficult. Even without obvious symptoms, however, humans can transmit HPV through sexual contactthus increasing the risk of cervical cancer in women. Furthermore, in some cases HPV infection can cause infection in humans genital warts, precancerous lesions, anal cancer, oropharyngeal tumors».
Cervical cancer: the importance of prevention
To diagnose cervical cancer early, it is important to adhere to the screening programs offered by your local health authority. «The tests for the early diagnosis of cervical cancer are the Pap test and the HPV-DNA test. The test used so far is the Pap test, offered every 3 years to women aged between 25 and 64. Since recent scientific evidence has shown that Above the age of 30, the HPV-DNA test carried out every 5 years is more cost-effectiveall the Regions are working to adopt the model based on the HPV-DNA test. The new screening test is based on testing for high-risk HPV infection. The sampling is similar to that of the Pap test».
Pap Test or HPV-DNA Test?
«The exam must be carried out no earlier than 30 years of age and be repeated at intervals of no less than 5 years in case of negativity. If the HPV test results If positive, the woman will have to undergo a Pap test which then becomes a completion testalso called triage test, because it selects women who have cellular changes and who need to undergo colposcopy. However, if the Pap test does not show any significant changes, the woman will repeat the HPV test after one year. From 25 to 30 years of age the reference test remains the Pap test to be carried out every three years. This choice is due to the fact that at a young age the probability of having an HPV infection is very high without it assuming clinical importance.”
Cervical cancer: why two different tests?
«Scientific studies have shown that The HPV test is more effective than the PAP test in finding cervical lesions (and is therefore more protective) in women after 30 years. Furthermore, the HPV test finds these lesions earlierso it is sufficient to repeat it every five years. Under this age, however, HPV infections are very frequent, but in most cases they regress on their own, so the HPV DNA test would lead to finding, and treating, lesions that would have disappeared spontaneously anyway. For this reason, between 25 and 29 years of age the PAP test remains the main and most effective test”.