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Low HPV Vaccine Awareness Hinders Cancer Prevention Efforts in Poland

HEALTH & MEDICINELow HPV Vaccine Awareness Hinders Cancer Prevention Efforts in Poland

According to the study “Polish Women and Men and Diseases and Health,” of all diseases, Poles are most afraid of cancer. Therefore, if there were an effective vaccine against cancer, a significant majority of those surveyed would want to avail themselves of it. However, the vaccine against the Human Papillomavirus (HPV), the only one that prevents diseases such as cervical or throat cancer, does not enjoy great popularity. One reason is the lack of awareness about the connection between the virus and cancer. Experts suggest that first, the target group needs to be educated so that the vaccination can gain acceptance, and then persuade people to get vaccinated.

“The conducted research indicates that the knowledge of Polish women and men about the HPV virus and HPV vaccination is not very high. Of course, a large group, three-quarters of those surveyed, had heard about the HPV virus. However, when we delved deeper into the research, it turned out that although they had heard about it, there were significant problems with knowledge about how the virus is transmitted, what diseases it causes,” says Dr. Tomasz Sobierajski, MD, Ph.D., and Assoc. Prof. at the University of Warsaw, co-author of the study.

The study “Polish Women and Men and HPV Vaccination: Knowledge, Attitudes, Practices,” conducted by the Patient Rights and Health Education Institute and the Socio-Medical Research Center at the University of Warsaw, reveals that while over 70% had heard of the Human Papillomavirus (HPV), one in four respondents (27%) couldn’t name any diseases it could cause.

“Usually, viruses, not only HPV, have a certain oncogenic potential. When scientists found that the HPV virus has oncogenic properties, they started looking into which diseases it significantly affects. It turned out to be cervical cancer. Now, over 90% of cervical cancer cases are caused by HPV infections. First, there must be an infection, and then, over the years, it can lead to cancer,” says Dr. Monika Wanke-Rytt, MD, Chair of the Infection Control Team at the University Clinical Hospital.

HPV is one of the most oncogenic viruses globally. Cancers caused by this virus account for about 5% of newly diagnosed cancers worldwide. Among respondents who could identify diseases caused by HPV (73% of those surveyed), the most commonly mentioned were cervical cancer (43%), herpes (20%), vulvar cancer and penile cancer (15% each), and anal cancer (11%). Less than 10% of respondents linked HPV infection to the development of oropharyngeal cancers, yet oncogenic HPV types can be responsible for throat, laryngeal, esophageal, or tonsil cancers. Overall, HPV is responsible for half of head and neck cancers.

“Only half of the respondents had heard of the HPV vaccine, and it was notably more often women than men. This is not surprising because for a long time, this vaccination was primarily aimed at girls and women,” says Dr. Tomasz Sobierajski.

Both women and men can be infected with the virus, regardless of age. It’s estimated that up to 80% of the population will come into contact with HPV during their lifetime, and vaccination is the only effective method to fight it. However, despite the fact that, as indicated in the report “Polish Women and Men and Diseases and Health,” the majority of Poles (85%) would want to get vaccinated against cancer if a vaccine were available, their interest in the HPV vaccine is not reflected. Only half of the respondents had heard of this vaccine, and 22% said they wouldn’t want to avail themselves of it.

“The problem of why we don’t get vaccinated is very broad and applies to vaccinations in general, not just HPV vaccination. It’s definitely related to education,” notes Prof. Sobierajski.

Among those who declared they wouldn’t want to get vaccinated against HPV or those who weren’t sure if they wanted to, the most common reasons were insufficient knowledge about vaccination (29%) or HPV itself (25%), as well as concerns about adverse vaccine reactions (21%).

“If I know that a certain percentage of people have no idea what the HPV virus is, then talking about vaccination makes no sense because there’s a lack of educational basis. We need to educate our target group about vaccination first, so that the vaccination can gain acceptance,” evaluates Dr. Monika Wanke-Rytt.

Currently, HPV vaccination is recommended during adolescence, before the first contact with the virus, which often occurs during sexual activity. Since June 2023, free, recommended but not mandatory HPV vaccinations have been available for girls and boys aged 11 to 14 in Poland. However, this is not just a pediatric vaccination. According to the latest recommendations, it can be administered to all adults, even mature adults, who are sexually active.

“We have two vaccines on the market: a bivalent one protecting against two viruses and a nine-valent one, which protects against nine HPV viruses. These two vaccines are part of the vaccination program for specific birth cohorts. After reaching the age that allows us to get vaccinated for free, we can still get vaccinated, but then the cost and reimbursement rules change,” explains Dr. Wanke-Rytt.

So far, only about 22% of eligible teenagers have benefited from free vaccinations under the program. For comparison, in Belgium, up to 93% of children are vaccinated, and in Spain, it’s about 80%. In Australia, where universal vaccination began over 20 years ago, cancers caused by HPV may soon be completely eradicated. In Poland, according to the assumptions of the National Oncological Strategy, at least 60% of the target population should be vaccinated by the end of 2028.

“We were the last country in the European Union to introduce reimbursed HPV vaccinations. Fortunately, since last year, they have been available, albeit for a limited group of 11-, 12-, and 13-year-olds, depending on the birth cohort, but this is of great importance. We know that the more reimbursed vaccinations are, the greater the willingness to get vaccinated,” explains Dr. Sobierajski.

According to experts, the willingness to get vaccinated could also be increased by facilitating the organization of the entire process. Currently, work is underway to introduce universal HPV vaccination in schools.

“Less than 15% of Primary Health Care Units (POZ) even offer HPV vaccination because the process of ordering and occupying slots in vaccination centers was so complicated that it simply didn’t pay off for clinics. For example, a POZ must demonstrate that a specific day is for HPV vaccinations and cannot schedule other patients on that day, which blocks access to healthcare,” explains the WUM expert.

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