Papilloma virus: 8 out of 10 adults infected once in their life, but less than half of young people get vaccinated

About 80% of sexually active people have been infected with HPV (Human Papilloma Virus) at least once in their lifetime. Approximately 200 strains have been identified, some of which are oncogenic and can therefore cause tumours of the cervix, oropharyngeal cavity, head-neck and ano-genital tract. Every year in Italy, the papilloma virus causes 7,500 neoplasms. Transmission occurs in 95% of cases through intimate relations, although there is a quota of contagion attributable to other, albeit residual, ways in which one comes into contact with the pathogenic agent, for example, if one uses public toilets. It is a problem that concerns the health of women and men that requires a multidisciplinary approach, greater awareness of the vaccination available for adolescents and access to screening, currently reserved only for the female population, as emerged during the round table 'Clinical mirrors - HPV: recognise, include, intervene', held in the Senate a few days ago with the participation of the main scientific societies in the sector and of patients, specialists and researchers.

'For many years,' explains Professor Vittorio Unfer, EGOI President and Professor of Obstetrics at UniCamillus University - International University of Health and Medical Sciences, 'HPV infection was exclusively associated with cervical cancer. Instead, science has proven that men can also develop condylomas as well as precancerous lesions and carcinomas of the penis, anus, and oral cavity, which are also HPV-related, in 50%, 88%, and 26-30% of cases, respectively'. Men and women, therefore, can be a reservoir of infection for their partners.

An Italian study, published in late 2024 in the scientific journal Urology, showed that 56% of Italian males are HPV positive. Of these, 20% are infected in the oral cavity and 13% in the anus. To protect the health of the youngest, there is a ninth valid HPV vaccination - against the nine most common types of human papilloma virus that can cause cancer. "It is a proven resource in the prevention of precancerous lesions and related cancers. Administration is recommended in pre-adolescence, ideally from the age of 11, before potential contact with the virus. It is essential to intensify information and awareness-raising activities aimed at young people and their families,' emphasises Professor Unfer. On this fundamental tool of prevention and protection, the scientific community hopes for a step change to reach the coverage targets recommended by the World Health Organisation (WHO) and the National Vaccine Plan.

'HPV vaccination,' Unfer adds, 'declined dramatically during the pandemic. Only in 2023 does it return to pre-Covid vaccination coverage levels: 45.39% in girls turning 12 in the year of the survey (2011 cohort in 2023). In 2024, the trend continues to increase: 51.18% of girls turning 12 in 2024, i.e. 5.79% more than in 2023'. The same trend is observed for boys. Thus, a dramatic drop in the year 2022 and a return to pre-Covid vaccination coverage levels: 39.35% in boys in the youngest cohort (2011), who would turn 12 in 2023. In 2024, the progressive improvement in individual cohort coverage continues, with coverage of 44.65% in the youngest cohort (2012). "Despite this recovery, however, to date no cohort reaches the 95% coverage target set by the National Vaccine Prevention Plan," the gynaecologist specifies.

In most cases, the infection is eliminated by the immune system. When, however, the virus remains in the body for more than 12 months, we speak of persistence, a condition that has so far been studied mainly in women. "This step is crucial because persistence, which occurs in 10-15% of cases in women, is the main risk factor for the development of pre-cancerous lesions and, over time, cancers of the cervix or other areas affected by HPV. The guidelines in persistent infection with positivity to a high-risk strain recommend referral for a second-level check-up with colposcopy. 'If no lesion or a low-grade lesion - LSIL or CIN1- is found, refer for follow-up at 12 months,' Unfer explains.