Question: There’s been a lot of talk about this HPV vaccine in recent years, but is it a good idea for us 40-plus to take it? I’ve recently left a long relationship and of course I dream of meeting someone new in the future, but I don’t think I’ll go on a lay tour right away. Plus I would never even dream of having unprotected sex. What do you recommend?
/Tiina
The doctor replies: Go for your check-ups
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Hello! You are probably not alone in being a little unsure about what applies. The recommendations for vaccination against HPV (human papillomavirus) have changed several times as research has progressed.
In Sweden, HPV vaccination began in 2012. The vaccine has since been improved and today protects against nine different virus strains, including the viruses that cause the majority of cervical cancer but also those that cause condyloma. Since 2020, boys are also vaccinated. In addition to stopping the spread of infection, it can prevent penile cancer. In both girls and boys, the vaccine also protects against cancer of the mouth, throat and rectum.
Since we in Sweden introduced screening already in the 60s and now also have good vaccines, cell changes can often be detected in time. Despite that, around 140-150 women die annually from cervical cancer. In large parts of Africa and even Asia, screening is lacking, which means that cervical cancer causes far more deaths there. We should therefore be very grateful for our screening and for the fact that little girls and boys can now be vaccinated.
We should therefore be very grateful for our screening.
In Sweden, we start going for check-ups at the age of 23. When you were 23, they still started with pap smears, it has now been replaced by HPV and you continue with pap smears if the virus is found. I assume you have sat all your exams?
Otherwise, my first call is to do a check. Cell changes and HPV infection are initially anonymous. Most often completely without symptoms. Once the symptoms start to appear, for example bleeding during intercourse, the changes may have become serious. It is through regular checks that we can detect changes in good time and treat them in a good way.
“Take the shot against HPV”
• HPV exists in several hundred different forms and can lead to warts in various places on the body, for example genital warts (condylomata). Some variants can also cause cell changes and cancer. HPV accounts for over 90 percent of all cases of cervical cancer.
• In 2021, Sweden’s Riksdag launched the campaign “Take a shot at HPV” with the goal of eradicating cervical cancer and we seem to be on the right track.
• Regular screening against cell changes is offered throughout the country, girls and boys are included in a vaccine program and all women born in 1994-1999 are offered free vaccination.
Source: Regional Cancer Centre
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I’m thinking that at your age, you’ve probably already had one or more HPV infections that have already healed on their own – assuming you’ve had unprotected sex throughout your life. We do not know why some people do not clear their HPV infection. On the other hand, we know that smokers and people with autoimmune diseases (also HIV-positive) have a harder time curing the infection. If you belong to a risk group, check yourself more often than the usual screening and vaccination is a good idea regardless of age to prevent cancer.
A vaccine recommendation for you is not as obvious as for a woman in her 20s, who has several decades of possible exposure to HPV ahead of her. The most important thing for you is to follow the screening program. Then any infection will still be detected in good time, whereupon you will receive good help and treatment.
DO YOU HAVE A QUESTION FOR SUSANNA ERICSSON?
Susanna Ericsson is a specialist in gynecology and obstetrics. She answers questions about everything related to women’s health. Email your question to [email protected] and write “Ask the doctor” in the subject line.
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Having said that, even if you don’t belong to a risk group, you can feel safe with a vaccination. New relationships are surely waiting around the corner and there are no guarantees that you won’t get HPV. If you can afford to pay for a vaccination, then in principle I think a vaccination is a good idea. Remember that even if you protect yourself during intercourse, you can get infected in other parts of the body.
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