Persistent infection with oncogenic HPV types is a prerequisite for the development of cervical cancer, which every year affects about 500,000 women and causes about 260,000 deaths worldwide. It affects the cervix – the entrance to the uterus. It is caused by the human papillomavirus, or HPV, which is sexually transmitted. There are over a hundred types of human papillomavirus, and 14 of them are known to cause this type of cancer. Only two of them – HPV 16 and HPV 18 are responsible for more than 70% of cervical cancer cases. They enter the cell on the surface of the cervix, where they can remain for several years without causing harm. Then, for no apparent reason, it can begin to attack cells and cause visible changes in the body. The purpose of prevention is precisely this – to detect these changes, which, if detected early enough, can be successfully treated and thus prevent the development of cancer. But if there is no timely therapy, the cancer develops and ends fatally. Other manifestations of HPV infection include vaginal cancer and cancer of the vulva, penis and anus, as well as the head and neck in some rarer cases. Human papillomavirus types 6 and 11 cause anogenital warts and recurrent respiratory papillomatosis. NEWS_MORE_BOX The HPV virus is very common and spreads easily through sexual contact. Half of the world’s population will be infected at some stage in their lives. It can take decades before cervical cancer develops, although most people become infected soon after becoming sexually active. Both men and women can become its victims. However, the infection, as well as the first stages of the disease, are often completely asymptomatic, and people do not even know that they are carriers of the virus. Nowadays, most women are examined regularly to find out if they have any signs of infection, seen as changes in the lining of the cervix, which can lead to cancer. These are the so-called smears. Although most girls do not become sexually active until they are 16, it is important that they receive protection early enough. A good time for this is in their early teenage years, so getting the HPV vaccine will protect them for the future. Routine immunization is recommended at the age of 12 – then the greatest benefit is derived from the preparation. If it is placed after the young woman has started having sex, it is advisable to do a pap smear beforehand. It is important to know that the vaccine can also be administered to older women, but it gives lower immunity, because with increasing age the body becomes more lazy in the production of antibodies. In quite a few internet pages one could find publications according to which cervical cancer is not always caused by a virus and vaccination provides little protection against it.because it works against two types of human papillomavirus, and there are several of them, that it is too early to vaccinate 12-year-old girls, or that the vaccine causes autoimmune and chronic diseases, and even that it could lead to sterility. It is also speculated that the drug is too new and not sufficiently studied. But what are the facts? In 1983, Prof. Herald zur Hausen’s team identified HPV 16 DNA from cervical cancer lesions, and a year later HPV 18 DNA. In 1996, the World Health Organization officially recognized the link between the virus and this type crab. HPV vaccines have been proven to protect against the two virus types that most often cause cervical cancer – 16 and 18. Their innovative design allows them to exhibit cross-efficacy and also protect against oncogenic types that are not included in their original composition. According to the official opinion of the Global Expert Safety Council, HPV vaccines do not contain the DNA of the virus, so they cannot cause disease. 4 years after the last safety review of 170 million doses distributed worldwide in an increasing number of countries with national immunization programs, the World Health Organization’s Expert Panel remains calm about the tolerability profile of the preparations. All clinical studies of the two HPV vaccines, bivalent and quadrivalent, demonstrate their excellent safety profile. After their insertion, only a few complaints have been registered so far, most often related to swelling and redness at the injection site, which is a typical side effect of all other vaccines. They subside spontaneously and after a short time. A full list of potential side effects can be found in the patient leaflet that comes with each pack. Studies show that immunizing 12-year-old girls gets the most benefit from the preparation, which provides stronger and longer-lasting protection. Vaccination effectively prevents the development of changed cells in the cervix caused by the types of HPV included in the vaccines. This applies to women who are not currently infected with these viruses. However, they will not protect those women who at the time of vaccination have HPV 16 or 18. Also, the vaccines will not protect against the development of cancer caused by all other potentially carcinogenic types of HPV. Existing vaccines are administered as three intramuscular injections, according to a schedule, over 6 months. Their use leads to protection against disease caused by these types for at least 5 years, the time for which the women in the clinical trials conducted so far have been followed. These studies are ongoing, so it is not yet possible to say how long the protective effect of the vaccines lasts. Of course men can’t get cervical cancer, they can pass HPV to their partner. Because it is not yet known whether the vaccines will effectively protect against HPV infection in boys or men,in Bulgaria, their vaccination cannot be recommended for now. The HPV vaccine reduces the risk of cervical cancer, but does not eliminate it. Even if you have been vaccinated, it is extremely important to continue with regular preventive cervical examinations.