HPV Prevention in Colombia 2024
Human Papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide, and Colombia is no exception. As we move towards 2024, the country faces crucial challenges in HPV control and prevention, especially considering its impact on public health, high prevalence in the young population, and its strong association with cervical cancer.
HPV: A public health problem in Colombia
HPV is a virus that affects the mucous membranes and the skin, and is transmitted mainly through sexual contact. There are more than 100 types of HPV, of which at least 14 are of high oncogenic risk, that is, they have the capacity to cause cancer. Among the cancers most associated with this virus is cervical cancer, which remains one of the main causes of mortality in women in many countries, including Colombia.
In Colombia, the incidence of HPV infections and cervical cancer is a cause for concern. According to the National Cancer Institute, cervical cancer is the second most common type of cancer among women in the country, with a high prevalence in rural areas and areas with limited access to health services. Although the country has implemented various strategies to combat this disease, the burden remains significant.
HPV Prevention: The Role of Vaccination
One of the most effective tools for HPV prevention is vaccination. In Colombia, the HPV vaccine has been available since 2012, when a free vaccination program was implemented targeting girls aged 9 to 17 years. This program was designed to protect against the most dangerous HPV types, specifically types 16 and 18, responsible for approximately 70% of cervical cancer cases.
Despite the availability of the vaccine, coverage has been a challenge. The vaccination campaign faced difficulties in the mid-2010s, when controversies arose over possible side effects of the vaccine, leading to a decline in the vaccination rate. Since then, the Colombian government, together with international health organizations, has worked to restore confidence in the vaccine through information campaigns that underline its safety and efficacy.
By 2024, vaccination efforts have been revitalized. Colombia’s Ministry of Health and Social Protection has intensified awareness campaigns, focusing not only on vaccinating girls, but also expanding coverage to boys. Including boys is crucial, as they can also transmit the virus and are at risk of developing HPV-associated cancers, such as penile, anal, and oropharyngeal cancer.
The goal for 2024 is to achieve 90% vaccination coverage among the adolescent population, which would represent a major step forward in the fight against cervical cancer and other HPV-related diseases.
Diagnosis and screening: Key strategies
Early diagnosis of HPV and monitoring for precancerous lesions are essential to prevent the development of cervical cancer. In Colombia, screening for HPV and cervical lesions is primarily done through the Pap test (or cervical cytology). This test has been the standard screening tool for many years, allowing for the early identification of abnormal cells that could progress to cancer.
However, the Pap test has certain limitations, as it depends on the quality of the sample and the laboratory personnel to interpret the results. In response to these limitations, HPV DNA testing has begun to be implemented in recent years, allowing for more accurate detection of high-risk HPV types before visible cellular changes appear.
As we approach 2024, HPV DNA testing is gaining ground as a more reliable and less human-error-prone option than conventional cytology. This test can be performed on a self-diagnostic basis, meaning that women can collect samples at home and send them to the laboratory. This represents a significant advantage, especially in rural areas where barriers to accessing health services are higher.
Challenges in access to screening tests
Despite the availability of more accurate tests, screening coverage remains uneven. Access to health services and screening tests in rural and disadvantaged areas of Colombia is limited, which increases the risk of women in these areas developing cervical cancer without having received an early diagnosis. In addition, younger women often do not access screening programs because they are not in priority groups for testing, which could lead to underdiagnosis of HPV infections.
To address these disparities, the Ministry of Health has implemented mobile screening strategies, where medical units travel to remote areas to offer screening tests. In addition, education programs on the importance of routine screening for HPV and precancerous lesions are being strengthened.
The impact of HPV on men's health
Although HPV is best known for its impact on women's health, it is also a significant concern for men. In Colombia, HPV-related oropharyngeal cancer cases have increased in recent years, underscoring the importance of vaccination in both sexes. This type of cancer affects the back of the throat, tonsils, and base of the tongue, and often goes undetected until it is in advanced stages.
In addition, HPV can also cause penile and anal cancer in men, although these are less common. Lack of awareness about these risks among the male population has hampered efforts to promote vaccination among boys. However, recent efforts have begun to change this narrative, and vaccination among boys is expected to increase significantly by 2024.
As Colombia moves towards 2024, there are several challenges that must be addressed to improve HPV control and reduce the incidence of associated cancers. One of the biggest challenges is inequality in access to health care and prevention, especially in rural and marginalized communities. Socioeconomic disparities, lack of medical infrastructure, and misinformation are obstacles that prevent greater access to vaccination and diagnosis.
Another major barrier is persistent mistrust in vaccines, fueled by myths and misinformation on social media. Despite scientific evidence supporting the safety and efficacy of the HPV vaccine, some groups continue to promote unfounded theories about its side effects. Education and communication campaigns are key to combating this problem, and public information strategies are expected to be even more intense in 2024.
On the other hand, the opportunities are also significant. The introduction of new technologies for HPV diagnosis, such as high-throughput DNA tests, and increasing vaccination coverage in both sexes are crucial steps towards better prevention. Furthermore, integrating sexual and reproductive health services with HPV education programmes can improve awareness and encourage preventive behaviours in the young population.
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