Particular strains of Human Papillomavirus (HPV), such as high-risk types can cause changes in cell DNA, leading to various cancers. Consequently, protecting against HPV infections, through vaccination is critical and can reduce the risk of HPV related cancer development (1). The HPV vaccine is safe and effective, and is primarily used for young girls, but is also recommended for boys aged 12-13 (1,2).
- Human Papillomavirus (HPV) and its link to cancer
- Vaccine impact studies
- Urine as sample type to monitor HPV vaccine effectiveness
HPV infections affect the skin and/or lining of cells inside the body. In most people, the infection causes no harm, and disappears naturally overtime. However, HPV strains such as HPV16 and 18 are known to be a major cause of cervical cancer in women. A high percentage of penile and anal cancers have also been linked to HPV16 (3). In certain high-risk groups, such as men who have sex with men (MSM) as well as HIV-positive individuals, an even higher prevalence of anal infections are related to HPV (4).
Vaccines are one of the most effective ways to prevent disease, and work by training the body’s immune system to fight an infection. The benefits of HPV vaccination for women in cervical cancer prevention is well-researched. National HPV vaccination programs are implemented in many high-income countries since 2010 (5). Developing countries, such as Bhutan (2010) and Rwanda (2011) were also among the first countries in Asia and Africa respectively to roll-out HPV vaccination programs for school girls (5).
However, in several developing countries, HPV vaccines are still not widely available, and many women are unaware of their benefits (6). Therefore, vaccine impact studies that highlight the benefits and potential of vaccination on a population could help create more awareness and reach a wider group.
In this regard, urine, as a sample type offers an easy and simple approach. A lot of evidence shows that HPV DNA can be found in urine, in particular in first-void urine (first 20ml of urine flow) (7). Using this knowledge further, researchers carried out studies in Bhutan and Rwanda to monitor the effectiveness of HPV vaccination (5,8).
HPV urine surveys were conducted in both countries with around 1,000 girls. Participants self-collected a urine sample using Novosanis’ urine-capturing device, Colli-Pee®, suited to capture first-void urine. The results concluded that HPV presence in urine was associated with sexual activity. In both Bhutan and Rwanda HPV6/11/16/18 prevalence was lower in vaccinated than in unvaccinated participants (5), highlighting the importance of vaccination.
Despite the potential benefits, HPV vaccination in boys is currently only available in a few countries, including Australia, Canada, USA, UK, Austria and Belgium (1,9,10). While research is ongoing to understand the overall impact of extending HPV vaccination programs across all genders, it has the potential to reduce the burden of HPV as well as prevent many HPV-linked conditions, especially in high-risk groups (3,9).
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3) PubMed PMID: 30016957
4) PubMed PMID: 28530369
5) PubMed PMID: 26991686
6) PubMed PMID: 21718495
7) PubMed PMID: 25664398
8) PubMed PMID: 29571973
9) PubMed PMID: 30152370