HPV – cancers, warts and all

Last month, the International Papillomavirus Society held its global conference in Edinburgh. Its theme was ‘Equitable, Evidence-Based Approaches to HPV Disease’ and the experts’ messages were clear – the widest possible uptake of the HPV vaccine and cervical screening are critical to eliminating many preventable cancers and genital warts. Dr Claire Cameron, Consultant in Health Protection at Public Health Scotland (PHS), writes about the virus and how Scotland has committed to its eradication.

Human papillomaviruses (HPV) are very common. They form a group of around one hundred viruses that affect the skin and can cause a range of diseases. Many HPV infections don’t have symptoms, and may clear up without treatment, but certain types can cause cancers and genital warts.

Many people will have heard that HPV can cause cervical cancer, which mainly affects those aged 30 to 45 who are, or who have ever been, sexually active. The symptoms of cervical cancer are often unclear, and so preventing the disease is crucial.

HPV vaccination, offered to all young people in the first year of secondary school in Scotland, helps prevent the spread of the virus. Cervical screening, offered routinely from the age of 25 to 64, detects HPV infection. Together, vaccination and screening are powerful interventions that aim to eliminate cervical cancer in Scotland.

We’ve already made significant progress. In 2008, Scotland’s HPV vaccination programme started offering immunisation to girls at the age of 12-13 in schools. Since then, no cervical cancer cases have been detected in women who have been fully vaccinated as part of this programme. This heartening success shows that the aim of eliminating cervical cancer is realisable – but it will take time – and it’s important that we leave no one behind.

HPV also causes other cancers, including anogenital and head and neck cancers. These are less common but are equally significant for those affected. To increase everyone’s protection against these cancers, the HPV vaccination offer was extended to all young people in 2019, although boys are still around 4% less likely than girls to take up the offer.

Some communities are more vulnerable than others. This is why sexual health clinics have offered the HPV vaccination to people living with HIV, as well as gay, bisexual and other men who have sex with men, up to the age of 45, since 2017.

The HPV vaccination also helps to protect against genital warts, the most common viral sexually transmitted infection. Genital warts are not caused by the same viruses that cause warts on hands or feet. They often have no symptoms, but they can be itchy and painful and they may bleed.

We know that people living in more affluent areas are up to 20% more likely to take up vaccinations than those in our most deprived communities. It’s important that every individual, no matter where they live, is protected from the risks of HPV and that communities access healthcare equally. A disproportionate uptake of vaccinations and screening could delay Scotland’s progress in eliminating cervical cancer. This is why PHS is working with the Scottish Government and the Cervical Cancer Elimination Expert Group, as part of the overall Women’s Health Plan, to ensure that our efforts to eliminate the diseases caused by HPV are available to all and effective for all.

We know that the vaccinations and screening programmes are working and that they can help us achieve our elimination goals. Success is not certain though, until we overcome the significant challenge of inequalities. It’s now time to address situations that aren’t equal – ensuring that every person in every community in Scotland is free from the risks of HPV.

Further information

Dr Claire Cameron recorded a short video at the conference, where she shared her reflections from the day.

An exciting study from Public Health Scotland (PHS), in collaboration with the Universities of Strathclyde and Edinburgh, shows that no cervical cancer cases have been detected in fully vaccinated women following the human papillomavirus (HPV) immunisation at age 12-13 since the programme started in Scotland in 2008.

Enjoy highlights from the International Papillomavirus Conference, in Edinburgh, in 2024

The HPV Cancers Alliance supports the One Less Worry Campaign

More information on the HPV vaccine, cervical screening and genital warts is available on NHS Inform