Being infected with HPV (human papillomavirus) can make many girls restless.
"How did you get infected?"
"Will it become cancerous?"
These questions pop up in my head from time to time.
Regarding the relationship between HPV and cervical cancer, these are the truths you should understand as soon as possible.
Truth 1
High-risk HPV+ persistent infection with cervical cancer
To date, cervical cancer is the only cancer with a clear cause.
There are more than two hundred members of the HPV virus family, and more than a dozen of them are known to be closely related to cervical cancer, which is a high-risk type of HPV:
In addition to the common 16 and 18 types, there are also 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68.
According to statistics, more than 99.7% of cervical cancers are associated with high-risk HPV infection [1].
In fact, infection with HPV does not necessarily mean that you will have cancer, and most women can automatically turn negative.
Only persistent infection with high-risk HPV can cause a normal cervix to progress toward precancerous lesions or even cervical cancer, a process that can take decades [2].
Truth 2
The overall infection rate of high-risk HPV in Chinese women is about 19%
At present, China is still one of the countries with a high incidence of cervical cancer.
An analysis of HPV test results for nearly 2.5 million women in 29 provinces found that the HPV infection rate was 19.1%, equivalent to 1 in 5 women [3].
Truth 3
Women who have sex are at high risk of contracting the HPV virus
HPV is mainly transmitted through "sex", and epidemiological surveys show that 80% of women have been infected with HPV at least once in their lifetime, so it is not necessary to be ashamed of it [4].
For young girls, having sex too early is not a wise choice. The earlier the time of the first sexual life and the more sexual partners you change, the more the virus likes you, and may not be one.
Truth 4
HPV infection is asymptomatic and requires screening to detect
HPV infection, even in some women who have already developed lesions and become cancerous, does not produce any symptoms.
It will only silently take root in the female cervix, and then expand the territory like a "scoundrel", passing ten, ten hundred, assimilating the normal tissues around it, and becoming the cradle of cervical cancer.
However, when you go to the doctor with symptoms such as intercourse bleeding, there are often lesions and even cancer that have developed.
This is also why women who have sex must be screened for cervical cancer regularly.
Truth 5
Cervical cancer screening (HPV testing, TCT) should be done regularly, but it is not necessary to do it every year
The latest WHO guidelines recommend that the first choice for cervical cancer screening is no longer cytology (TCT), but HPV testing, and further testing if HPV-positive is confirmed [5].
Of course, if there are economic conditions, HPV and TCT together, the results of the examination will be more accurate.
However, screening does not need to be done every year, which not only increases the financial burden, but also increases psychological stress.
For women who are not infected with HPV, a 2- to 3-year interval can be followed, and for women who are already infected with HPV but have a negative cytology, a two-year re-examination is sufficient [5].
Of course, if the lesion is treated, the screening interval depends on the situation.
Truth 6
High-risk HPV infection or cytological abnormalities are found and colposcopy is required
Colposcopy is a "magnifying glass" for finding cervical lesions, which can visually display suspicious lesions that are invisible to the naked eye to our eyes through color rendering, magnification, etc., so as to facilitate the pathological diagnosis after sampling by doctors.
Whether to do colposcopy requires doctor judgment, such as HPV or TCT abnormalities, seeing suspicious signs such as bleeding and drainage, and only needing follow-up after lesion treatment.
It is a definitive diagnostic tool rather than a routine means of cervical cancer screening [6].
Truth 7
The screening rate of cervical cancer in remote areas of the mainland is only 16%, and insufficient screening is an important reason for the high incidence and mortality of cervical cancer
The implementation of cervical cancer screening has greatly reduced the incidence and mortality of cervical cancer, but in developing countries, screening prevalence is still low.
At present, the cervical cancer screening coverage rate in China is only 19%, which is even lower in remote areas, which is far from 83% in the United States [7,8].
Truth 8
Precancerous and early cervical cancer can be cured
More than 50% to 60% of low-grade precancerous lesions can be achieved negative by strengthening autoimmunity within 6 to 24 months, and even high-grade lesions and early cervical cancer can be cured by surgery [9].
Truth 9
The HPV vaccine can prevent cervical cancer, but has no therapeutic effect on people who are already infected
Although cancer is terrible, cervical cancer can be prevented by vaccination.
Vaccines currently available in China include domestic bivalent, imported bivalent, imported quadrivalent and nine-valent.
Bivalent and quadrivalent vaccines can prevent 70% of cervical cancer, and nine valents can prevent 92% of cervical cancer.
Truth 10
Regular screening should still be adhered to after HPV vaccination
Despite the high rate of protection against hpvic vaccines, it does not work for a small number of people. In order to be foolproof, cervical cancer screening should be done regularly.
bibliography
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[2] Gravitt PE. The known unknowns of HPV natural history[J]. JClin Invest, 2011, 121(12): 4593 4599. DOI: 10.1172 /JCI57149.
[3] Zhengyu Zeng, R Marshall Austin,Lin Wang,et al. Nationwide Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection in China: Analysis of 2,458,227 Test Results From 29 Chinese Provinces, American Journal of Clinical Pathology, 2021;aqab181, https://doi.org/10.1093/ajcp/aqab181
[4] Shan Wei,Zhang Tao,Zhang Tiejun,Zhao Genming. Epidemiological status of human papillomavirus (HPV) infection in women in mainland China[J].Chinese Journal of Disease Control,2017,21(01):89-93.
[5] World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem [EB/OL]. [2021‐07‐14]. https://www. who. int/ publications/i/item/9789240014107.
[6] Chen Fei, You Zhixue, Sui Long, Li Shuang, Liu Jun, Liu Aijun, Zhang Wenhua, Bi Hui, Geng Li, Zhao Yun, Wu Dan, Li Fang, Chen Limei, Duan Xianzhi, Zhang Shulan, Zhang Guonan, Lang Jinghe. Chinese Expert Consensus on Colposcopy Application[J].Chinese Journal of Obstetrics and Gynecology,2020,55(07):443-449.
[7] HOME C.Cancer screening-United States,2010［J］.MMWRMorb Mortal Wkly Rep,2012，61( 3) : 41-58．
[8] DI J,RUTHERFORD S,CHU C.Review of the cervical cancer burden and population-based cervical cancer screening in China［J］.Asian Pac J Cancer P,2015,16( 17) : 7401-7407．
[9] Shan Wei,Zhang Tao,Zhang Tiejun,Zhao Genming. Epidemiological status of human papillomavirus (HPV) infection in women in mainland China[J].Chinese Journal of Disease Control,2017,21(01):89-93.
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