Have you set your health goals for 2024? Start the new year by preventing HPV infection

In the new year, we all need to start anew!

Have you put up your 2024 Flag?

Read a good book, learn a new skill,

Advanced growth gives your dreams a new look.

Develop a side business and learn financial management.

Smart life makes wealth brand new.

Don't forget the most important thing,

Take care of yourself and keep health with you!

Because staying healthy can help you achieve more small goals.

Let’s start the new year’s health flag by preventing HPV infection!

Understanding HPV

HPV, also known as human papillomavirus in Chinese, can live on the skin and mucous membranes1. The infected sites include the mouth, throat, penis skin, vulva, anus, vagina, cervix and rectum (Note 1, 2). Currently, there are more than 200 known types (Note 1), which are divided into high-risk and low-risk types according to their carcinogenicity (Note 1).

HPV infection rates are high, and the age of infection is bimodal:

1. A study based on the US population showed (Note 4) that a: Among people who have at least one heterosexual partner, the average probability of a woman being infected with HPV in her lifetime is 84.6%.

2. A multicenter, population-based study in China showed (Note 5) that b: The HPV infection rate among Chinese women showed a "bimodal" distribution by age: the first peak was at "17-24 years old" and the second peak was at "40-44 years old".

HPV is spread in many ways:

1. Sexual behavior is the main way to be infected with HPV, but not the only way (Note 1).

2. HPV can be transmitted from mother to child and through direct contact, such as skin-to-mucous membrane contact (Note 1). When hands come into contact with HPV-contaminated objects, the virus may be brought into the reproductive organs when going to the toilet or bathing. Or the reproductive organs may be infected when they come into contact with HPV-contaminated bath towels, underwear, etc. (Note 6).

Chinese women should pay special attention to HPV16/52/58

The 2023 ICO/IARC Global and Chinese HPV-related Disease Report shows7: About 98% of cervical cancer in Chinese women is caused by high-risk HPV. The top three high-risk HPV infections among Chinese women with normal cervical cytology are HPV52/16/58, and compared with the world, the infection rate of HPV52/58 among Chinese women with normal cervical cytology is nearly twice that of the world.

Almost all cervical cancers (99.7%) are related to HPV infection (Note 2, 8).

1. High incidence of cervical cancer

The 2023 ICO/IARC China HPV and Related Diseases Report shows that in 2020, the incidence and mortality of cervical cancer ranked third among female tumors among women aged 15 to 44 in China (Note 7)

2. Cervical cancer is getting younger

In recent years, the incidence of cervical cancer has been on the rise (Note 9), and the age of cervical cancer onset has been getting younger (Note 9). A study on the epidemiology of cervical cancer showed that the youngest age for diagnosis of cervical cancer can be as young as 17 years old (Note 10), c.

Three levels of prevention of cervical cancer

HPV vaccination is an effective way to prevent HPV infection (Note 11): The 2023 China Cervical Cancer Comprehensive Prevention and Control Guidelines propose that preventive HPV vaccination is the first step in the three-level prevention strategy for cervical cancer9

HPV vaccine is available to adolescent and adult females of appropriate age

Advantages of HPV vaccination for underage girls:

WHO recommends that girls aged 9-14 who have not had sexual intercourse should be the first target of vaccination (Note 12). Young age can easily stimulate a better immune response and help adolescent girls get better protection (Notes 11, 13-16).

HPV vaccination can have a better preventive effect if girls of appropriate age are vaccinated before their first sexual intercourse (notes 17, 18).

Importance of HPV vaccination for adult women:

The Comprehensive Prevention and Control Guidelines for Cervical Cancer issued by the Women's Health Branch of the Chinese Preventive Medicine Association states: "For women who have already engaged in sexual activity, research experiments have shown that HPV vaccination also has a good protective effect9."

HPV vaccines are not only effective for women who have never been infected with HPV. Because the vaccine is multivalent, even if you are infected with one HPV type, the vaccine can also prevent lesions caused by infection with other HPV types covered by the vaccine (Note 19).

Types of HPV vaccines

Currently, all women aged 9-45 can choose the 9/4/2-valent HPV vaccine (Note 20-24) as needed.

There are multiple official booking channels for HPV vaccines

1. Offline appointment: Go to the community health hospital, public hospital and other vaccination sites in your area for consultation and appointment.

2. Make an appointment by phone: Search for the phone number of the local community health hospital and inquire about how to make an appointment for the HPV vaccine.

3. Online appointment: You can search whether local community hospitals, public hospitals and other vaccination sites have online appointment platforms. If so, you can make an appointment online.

In the new year, set a new small goal:

May all women stay away from HPV infection.

Become a healthier, freer and more confident self.

In 2024, we will all be the protagonists with a new look!

1. Expert consensus on immune prevention of human papillomavirus-related diseases such as cervical cancer. Chinese Journal of Preventive Medicine. 2019

2. Qiao Youlin. Current status of epidemiological research on human papillomavirus infection and cervical cancer in Chinese women and prospects for vaccine prevention. Chinese Journal of Epidemiology. 2007

3. Teng Qiuli, Niu Maoyuan, Liu Yuying, et al. The harm of HPV infection to men and the protection of HPV vaccination to men[J]. Chinese Journal of Immunology, 2022(004):038.

4. Chesson HW, Dunne EF, Hariri S, et al. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014; 41(11):660–664.

a. Study design: To understand the probability of HPV infection, the probability of HPV infection was estimated for two age groups: from first sexual intercourse to 44 years old; and from 45 to 70 years old. The probability of HPV infection in the first age group was studied based on the number of sexual partners until the age of 44 and the HPV infection status of sexual partners, and the HPV infection rate in the second age group was calculated using the estimated value of the HPV infection probability per year. People who had no opposite-sex partner before the age of 44 were excluded from the study.

5. Wu EQ, Liu B, Cui JF, et al. Prevalence of type-specific human papillomavirus and pap results in Chinese women: a multi-center, population-based cross-sectional study. Cancer Causes Control. 2013

b Study design: A multicenter, population-based study conducted in China in 2006-2007. HPV testing data of cervical exfoliated cells from 4215 women aged 17-54 years from five regions were collected to estimate the disease burden of HPV infection in sexually active women in China.

6. Wang Linhong, Zhao Gengli. Comprehensive prevention and control guidelines for cervical cancer (1st edition)[M]. Beijing: People's Medical Publishing House. 2017.8

7. Bruni L, et al. ICO/IARC Information Center on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in China. Summary Report 10 March 2023.

8. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999 Sep;189(1):12-9.
9. Chinese Preventive Medicine Association Women's Health Branch. Comprehensive Prevention and Control Guidelines for Cervical Cancer (2nd Edition)[M]. Beijing: People's Medical Publishing House. 2023

10. Zhang Jingfei, Wang Tong, Wu Minghui, et al. Epidemiological status and clinical characteristics of 1399 cases of cervical cancer in Beijing. Chinese Journal of Medicine. 2011;91(43):3058-3061.

c. Research design: A stratified cluster sampling method was used to select 2 tertiary specialized hospitals, 10 general tertiary hospitals, and 10 suburban secondary hospitals in Beijing. A total of 1399 medical records of cervical invasive pain from 1990 to 2009 were retrospectively investigated. The years were divided into 4 groups of 5 years, and the clinical characteristics of each group were statistically analyzed.

11. Chinese Society of Gynecologic Oncology, Chinese Society of Eugenics, Colposcopy and Cervical Pathology, Martin, et al. Chinese expert consensus on the clinical application of human papillomavirus vaccine[J]. Journal of Peking Union Medical College, 2021, 12(2): 189-201.

12.Human papillomavirus vaccines: WHO position paper, December 2022:
https://www.who.int/publications/i/item/who-wer9750-645-672

13. Zhu F, Li J, Hu Y, et al. Immunogenicity and safety of the HPV-16/18 AS04-adjuvanted vaccine in healthy Chinese girls and women aged 9 to 45 years. Hum Vaccin Immunother. 2014;10(7):1795-1806. doi:10.4161/hv.28702

14.Li R, Li Y, Radley D, et al. Safety and immunogenicity of a vaccine targeting human papillomavirus types 6, 11, 16 and 18: a randomized, double-blind, placebo-controlled trial in Chinese males and females. Vaccine. 2012;30(28):4284-4291. doi:10.1016/j.vaccine.2012.02.079

15.Hu YM, Guo M, Li CG, et al. Immunogenicity nonin -feriority study of 2 doses and 3 doses of an Escherichia coliproduced HPV bivalent vaccine in girls vs. 3 doses in young women[J]. Sci China Life Sci, 2020, 63: 582-591

16. Lei JY, Ploner A, Elstrom KM, et al. PV Vaccination and the Risk of Invasive CervicalCancer [J]. N Engl J Med, 2020, 383: 1340-1348

17. Human papillomavirus vaccines: WHO position paper, October 2014. Wkly Epidemiol Rec. 2014 Oct 24;89(43):465-91. English, French. PMID: 25346960.

18.Schiller JT, Castellsagué

19. Wei Lihui, Qiao Youlin. 100 Questions and Answers on Preventing Cervical Cancer[M]. Beijing: People's Medical Publishing House. 2018

20. Instructions for use of 9-valent human papillomavirus vaccine (brewer's yeast)

21. Instructions for use of quadrivalent human papillomavirus vaccine (brewer's yeast)

22. Instructions for use of bivalent human papillomavirus adsorbed vaccine

23. Bivalent Human Papillomavirus Vaccine (Escherichia coli) Instructions

24. Instructions for use of bivalent human papillomavirus vaccine (Pichia pastoris)

If you want to learn more about the disease, please consult a healthcare professional.