What if it was possible to eradicate the papillomavirus and certain cancers? Well, it is possible, some countries are on the way to meeting this challenge. How ? By vaccination. Vaccination still shunned in France, which displays one of the lowest coverage.
What diseases can the papillomavirus cause? How can France improve its prevention? On the occasion of World Cancer Day this Saturday, 20 Minutes addresses this major public health issue.
HPV causes many diseases
In reality, we should rather speak of papillomaviruses, or HPV. Highly contagious viruses that are transmitted sexually. There are many strains that can cause many conditions, ranging from genital warts, specific genital warts, to different types of cancer.
In France, “these viruses are responsible each year for 100,000 cases of benign genital warts and more than 30,000 cases of precancerous lesions ” that can progress to cancer, underlines the Academy of Medicine. And every year, “6,400 new cases of cancer are linked to human papillomaviruses (HPV), adds the National Cancer Institute (INCa). In the majority of cases, cancers linked to HPV infection concern the cervix (44%), anus (24%) and oropharynx (22%). If most cancers affect women, a quarter affects men”.
Particularly low vaccination coverage
So many diseases preventable thanks to the anti-HPV vaccination, open in France to adolescent girls since 2007 and extended to boys over the age of 11 since January 1, 2021. However, it is struggling to reach its target. “Young French people are among the least well vaccinated Europeans, both among girls (37% vaccination coverage) and among boys (6%), notes the think tank Terra Nova in a report published this week. A level very far from the objectives set by the National Sexual Health Strategy and the Cancer Plan”, which aim for coverage of “60% among adolescent girls aged 11 to 19 in 2023 and 80% by 2030”.
And the pandemic has made things worse. “In 2020, vaccination among young girls fell sharply: less than 274,000 doses, i.e. a drop of a third compared to the expected”, is alarmed by Health Insurance, which notes “a deficit of 103,000 doses over the first four months of 2021. This decline comes at a time when in France participation in this vaccination is already low compared to our European neighbors”.
However, “the opening of vaccination to boys is a very good step forward, built on a double argument of individual protection of boys, who may be confronted with certain cancers caused by HPV, and collective, in the face of the risk of contagion, decrypts Mélanie Heard, head of the health department of the Terra Nova think tank and author of the report. If HPV circulates among boys and vaccination only targets girls, all those who are not vaccinated risk contamination. We can therefore see how much curbing viral circulation is everyone’s business, and also involves the vaccination of boys ”.
A great educational effort to be made
For now, distrust seems to prevail, and several hypotheses can explain it. First, “many French men and women are unaware that there are cancers of the vagina, anus and ENT, caused by papillomaviruses, indicates Mélanie Heard. Then, for parents, the idea that prepubescent 11-year-olds are vaccinated before they start having sex can be a little confusing. And the fact that there are two public health programs for the same virus can be confusing: we have both a vaccination recommended for the youngest and a smear test prescribed followingwards for women, one not having to go without the other. This deserves a pedagogical effort”.
This must be driven by the public authorities. “However, until now, there has been a manifest absence of political will, continues Mélanie Heard: no pedagogy in schools or school vaccination program, and a very hesitant offer of vaccination in city medicine”. However, there is urgency: “cervical cancer is the fourth most common cancer in women and is caused in more than 95% of cases by the sexually transmitted human papillomavirus, recalls the World Organization Health (WHO)”.
But the situation might change. In early December, in a video regarding free condoms for young people posted on TikTok, Emmanuel Macron spoke of his desire “to go further on vaccination once morest certain viruses. I am thinking of the papillomavirus”. A message taken up Monday by the Minister of Health. In his wishes addressed to the vital forces of health, François Braun insisted on the importance in 2023 of reflecting on “the development of a new vaccination strategy, with an important place (…) for the development of vaccination once morest papillomavirus “. Political signals “Favorable, believes Mélanie Heard. I’m not sure that the word papillomavirus has ever been uttered by a president before.
A tool for eradication
If France is therefore late, other countries have launched massive vaccination campaigns. “In 2020, in Europe, coverage exceeded 75% in eleven countries including Portugal, Spain and the United Kingdom”, notes the Academy of Medicine. Far ahead of France, in twenty-seventh position. “In the most advanced countries, the improvement in vaccination coverage has been accompanied by vaccination campaigns in schools, and this is decisive”, insists Mélanie Heard.
“They have made it possible, in certain countries, to obtain vaccination rates of more than 70%”, confirmed the Academy of Medicine in a note published in the summer of 2022. This is the case of the United Kingdom which, with a rate of more than 76%, is on the way to eradicating cervical cancer. But also from Australia, one of the first countries to have deployed a mixed vaccination campaign – girls and boys – and massive, and which has shown a coverage of more than 80% for fifteen years, reports INCa. “Modeling makes it possible to envisage, thanks to the effectiveness of the vaccine, the almost complete disappearance of cancer of the cervix by 2034”.
