Guest Lecture on HPV and the Global Fight Against Cancer

On International HPV Awareness Day, Deputy Vice-Chancellor and Head of UKZN’s College of Health Sciences, Professor Busisiwe Ncama, hosted a special guest lecture.

The University’s Head of Obstetrics and Gynaecology (O&G), Professor Motshedisi Sebitloane, presented on the topic: “HPV and the Global Fight Against Cancer: Educating, Vaccinating, and Screening for a Healthier Future”.

Sebitloane, who heads O&G at the University and the clinical departments of Victoria Mxenge Tertiary and Inkosi Albert Luthuli Central Hospitals (IALCH), serves on several local and international professional bodies, driven by her passion for women’s health and HIV.

Sebitloane praised the World Health Organization’s (WHO) strategy to eliminate cervical cancer, which includes 2030 targets of: 90% of girls fully vaccinated against human papillomavirus (HPV) by age 15, 70% of women screened with a high-precision test at ages 35 and 45, and 90% of women diagnosed with cervical disease receiving treatment and care. These efforts aim to reduce cervical cancer deaths globally by 30%.

HPV is a common sexually transmitted infection that affects the skin, genital area, and throat. It comprises a group of 200 known viruses, most of which are harmless. However, some high-risk types can cause genital warts or lead to cancer. Sebitloane said that was why screening efforts were essential in both high- and low-income countries irrespective of the latter facing challenges such as limited resources, lack of trained healthcare providers, cultural barriers and access to healthcare.

Sebitloane outlined key strategies to prevent HPV-related cancers, affirming that cervical cancer can be eliminated. She stressed the need for increased mobile clinics, community-based screening, the integration of HPV testing into routine healthcare, as well as the use of modalities proven effective in other countries such as Rwanda, which became one of the first African countries to launch a national HPV vaccination programme in 2011. South Africa introduced its first round of the nationwide HPV vaccination programme in April 2014, targeting girls aged 9 and 14 years in the poorest 80% of schools.

Sebitloane noted that Botswana launched its HPV vaccination programme in 2016, becoming one of the first southern African nations to do so. Australia introduced the first national HPV vaccination programme in 2007, followed by Canada the same year, targeting girls aged nine to 13, with a catch-up programme for older girls. She promoted non-gendered HPV vaccination school-going youth, and all at-risk adults for new HPV infection. Men can develop HPV-linked cancer of the mouth and throat, penis, or anus.

Key recommendations included cervical screening (Pap tests and HPV testing) as essential for early detection of pre-cancerous changes. Regular screening can reduce cervical cancer incidence by up to 80%. Screening should target women aged 30 to 65, with the WHO recommending HPV testing every five years for women aged 30 to 49.

Sebitloane cautioned that HPV-related pre-cancers and cancers were much more common in people living with HIV (PLWHIV). She said women living with HIV (WLHIV) are at higher risk of being infected with multiple subtypes of high-risk HPV, which tend to persist longer in the epithelium and treatment of HPV-related pre-cancer cancer lesions was more difficult in this population. ‘HPV vaccination is safe in PLWHIV and causes robust immune response. Antibody titers and seropositivity rates remain high enough over time.’

Sebitloane said educating the public about HPV through various channels and awareness campaigns remained essential.

Dr Atisha Maharaj, a gynae-oncologist at IALCH and honorary lecturer in O&G at UKZN, facilitated the guest lecture. She is also a member of national advisory committees on HPV and cervical cancer.

Words and photograph: Lunga Memela