When it comes to the issue of HPV infection, there are many patients who are alarmed and not only mentally stressed but also spend a lot of money for this purpose because of the discovery of HPV infection. The following is a scientific overview of this issue. HPV is a virus called Human Papillomavirus (HPV).
There are more than 100 subtypes of HPV, and the relationship between HPV and cervical cancer was first suggested by the German scientist Harald zur Hausen in the 1970s.
HPV is probably classified into low-risk and high-risk types according to its carcinogenicity. low-risk HPV will not cause cervical cancer, but high-risk HPV may cause cervical precancer and cervical cancer (reply to Dr. Gong Xiaoming on WeChat public account 015 for cervical cancer screening). The main way of HPV infection is through sexual contact, but it is not the only way, children and virgins are found to have HPV infection present. HPV infection is in fact a common thing, from the peak of HPV infection in Figure 1 is probably can be seen from adolescence has been detected HPV infection, so it can be said that everyone is the host of HPV infection, but under normal circumstances, HPV will be cleared by the human immune system, so a brief infection is not a special event, similar to you have a cold virus infection, even without the symptoms of the cold, you have a short-lived infection. Without even having cold symptoms, your virus has been cleared from your body. What really causes trouble are those viral infections that persist. If the same subtype of HPV virus persists for more than 2 years, then there is a chance (note: there is a chance, not a certainty. The green curve in Figure 1 represents the percentage of HPV infection, the blue curve represents cervical precancer, and the yellow curve represents the occurrence of cancer, and the different percentages probably make this point clear.) The progression from precancerous lesions to cancer in the cervix is also a long process, usually taking 10-15 years. The current guidelines for screening for high-risk HPV are not recommended for people under 30 years of age, because transient infection will be more common, and even if the screening is positive, there is a high probability that it will be cleared after a period of time. 2013 New England Journal of Medicine summarized the norms in recent years and probably proposed the recommendations for screening the cervix roughly as follows: Under 21 years of age do not need to be screened Between 21 and 29 years of age Between the ages of 21 and 29, screening with cytology every 3 years Between the ages of 30 and 65, combined HPV and cytology screening every 5 years, or cytology screening every 3 years Over the age of 65, screening can be stopped if previous results are normal. So it is probably understandable that HPV testing is not necessary under the age of 30. Above 30 years old, even if you are found to have high-risk HPV infection, there is no need to be too nervous because although it is a high-risk virus, it does not mean that you have cervical cancer, and the important thing at this time is screening cervical smear. Some scholars recommend direct colposcopy and biopsy to exclude cervical cancer. From international guidelines and research data, there is no effective treatment for HPV infection and therefore treatment for HPV carrier status is not recommended. Previously, I have talked to several international colleagues and basically agree with this one view. In recent years, there are many hospitals in China to provide doctors with drugs for HPV treatment, personally I think there is no good research evidence to support, usually I want to understand whether a therapy is effective, not to listen to the manufacturer’s propaganda, it is important to look at the literature published in international journals on the relevant, if only the data provided by the manufacturer, is biased, in the current situation, is not enough to support the practice of HPV therapy. Personally, I even think that such HPV therapy is seizing on the patient’s fear of cancer and is suspected of over-treatment. The possibility of future HPV therapies cannot be ruled out, but at this stage, there is no good evidence to support it. HPV vaccine is a preventive measure that has evidence to support that it can reduce the incidence of cervical cancer, and women aged 9 to 26 can consider HPV vaccination, but it is still not approved in China and can only be injected in Hong Kong.