I don't know when "HPV" began to quietly become popular on many media platforms as a keyword, and it has become one of the focus of private heated discussions among women. The "special" infection route of HPV, the "mysterious relationship" with cervical cancer, and the overwhelming HPV vaccine publicity on the market have made many women talk about HPV discoloration. In the domestic market, there was a phenomenon that HPV vaccine was "hard to find", and many people did not hesitate to go overseas for vaccination...... HPV has caused panic among many women.
Justifying HPV Infection
HPV is an abbreviation for Human Papilloma Virus. The virus mainly grows and multiplies in human squamous epithelial tissues (such as skin, perianal skin of the genital tract, oral cavity, etc.). The HPV family is very large, with more than 200 subtypes. HPV can be classified as high-risk and low-risk according to its likelihood of causing cancer. Among them, there are 13~14 high-risk types and 20~30 low-risk types. The relationship between HPV and cervical cancer leads to the fact that HPV infection is often "labeled" and "demonized". A correct understanding of HPV infection is the first step out of panic.
HPV infection ≠ inappropriate private life. HPV infection is so common that about half of all young women will have at least one HPV infection within 3 years of starting sex, and sexually active women have an 80% chance of contracting HPV in their lifetime.
HPV can occur even if you don't have sexual contact. It can be found in public bidet toilets, bathtubs, bath towels, towels and other products used by HPV carriers. No one can escape HPV forever.
HPV infection ≠ cervical cancer. Globally, about 10 out of every 100 women without cervical lesions are experiencing HPV infection. For most members of the HPV family, it takes 8~10 years or even longer from infection to pathogenesis, and in this process, 80% of them will be eliminated by the body's own immunity within 6~8 months. As a result, HPV infection and recovery often occur silently. After HPV infection, the body fails to clear the virus on its own, resulting in persistent HPV infection, which may develop into cervical cancer.
HPV infection, screening + prevention > treatment. Lang Jinghe, an academician of the Chinese Academy of Engineering and an expert in obstetrics and gynecology, said that cervical cancer is an accidental event of common HPV infection, but it is inevitable. Therefore, early screening and early treatment are powerful means to prevent cervical cancer.
A rational view of the HPV "vaccine fever"
HPV vaccination is considered to be the most important measure of primary prevention of cervical cancer so far. However, in the face of some chaos in the current domestic HPV vaccine, experts appealed: understand first, then act.
The "valence" of the HPV vaccine refers to the number of types of HPV that can be prevented, and the higher the price, the wider the range of diseases prevented, and the more expensive it is in general. Our common bivalent (2v), quadrivalent (4v) and 9-valent (9v) vaccines are designed for 2, 4 and 9 HPV types. 76% of cervical cancer patients in Chinese are caused by HPV16 and 7.8% by HPV18, that is, more than 80% of cervical cancer in China is caused by these two viruses. As a result, the bivalent HPV vaccine has a high infection prevention rate for the domestic population, reaching 84.5%, which is higher than the global average. If the aim is to prevent cervical cancer, the bivalent vaccine is sufficient. If the financial conditions allow, you can get the quadrivalent and 9-valent vaccines.
In recent years, "HPV vaccination with daughter" has become popular in many first-tier cities. Is it true that the sooner you get the HPV vaccine, the better?
On November 11, 2022, a nurse from the Obstetrics and Gynecology Hospital of Fudan University demonstrated the 9-valent HPV vaccine. Photo by Liu Ying
Widespread HPV vaccination during adolescence is key to prevention and control. From 2022, the National Medical Products Administration will approve the 9-valent HPV vaccine as a suitable age of 9~45 years old, which is the same as that of European and American countries, and with the advent of domestic HPV vaccines, the price is also more affordable.
But the HPV vaccine is not a panacea. There are hundreds of subtypes of HPV, and even the 9-valent vaccine, which currently covers the most widespread types of HPV, can only prevent 9 types of HPV. There are still many HPVs that have a certain ability to cause disease without corresponding vaccines.
"Double Ribbon" in action,
There is still a long way to go in cancer screening
Young sexually active women have the highest rate of HPV infection in the cervix, and the peak age of infection is 20~25 years old. In view of the characteristics of the current age of onset of cervical cancer in mainland China, the recommended starting age for screening is 25~30 years old. The interval between screenings should not exceed 1 year and may be once a year. If HPV infection is detected by screening, there is currently no specific treatment drug, and it is mainly advocated to improve immunity through a healthy lifestyle, while cleaning oneself, paying attention to personal hygiene, using contraception, etc., to avoid mutual and repeated infection with sexual partners.
While promoting HPV vaccination, popularizing the knowledge of cervical cancer prevention and healthy life education are still in a position that cannot be ignored in the primary prevention of cervical cancer. Promoting a healthy lifestyle (quitting smoking, exercising, eating a sensible diet), establishing a healthy sexual outlook (delaying the first sexual intercourse, having a regular sexual partner, etc.), encouraging instrumental contraceptive protection, and avoiding damage to the cervix from multiple unwanted pregnancies are all important preventive measures.
On November 11, 2022, a woman received the 9-valent HPV vaccine at the Obstetrics and Gynecology Hospital of Fudan University. Photo by Liu Ying
For parents, positive psychological and physical health education for their children is more important, and good sex education can benefit children for life.
In recent years, the incidence of cervical cancer in mainland China has continued to rise, with an average annual growth rate of 8.7%, and the incidence of cervical cancer is second only to breast cancer among female reproductive system tumors, and the prevention and treatment situation is not optimistic. Since the beginning of the 21st century, the mainland government has made efforts to promote screening activities for two cancers (breast cancer and cervical cancer). The Programme for the Development of Chinese Women (2011-2020) proposes to increase the screening rate of cervical cancer among women to 80%. However, due to various practical constraints, the screening rate of cervical cancer in mainland China is generally low, even in the eastern urban agglomerations with better screening conditions, only 31.3%, and there is still a long way to go in screening promotion. (The authors, Wang Chen, are attending physicians in the Department of Gynecology and Obstetrics and Gynecology of Beijing Obstetrics and Gynecology Hospital, Capital Medical University; and Kong Weimin is chief physician of the Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University)
Author: Wang Chen, Kong Weimin / Editor: Zhang Xi
*This article is the content of the 4th issue of "Half Moon Talks" in 2024