Cervical cancer is one of the gynecological malignancies, second only to breast cancer in incidence, and is a major killer of women’s health. Cervical cancer is a lesion caused by a group of human papillomavirus (HPV for short) infections. The HPV family is very large, with more than 130 subtypes, including high-risk and low-risk types, and only more than 30 high-risk HPV types are associated with cervical infection and lesions. High-risk HPV subtypes About 90% of cervical intraepithelial neoplasia (CIN) and more than 99% of cervical cancer tissues are found to be infected with high-risk HPV types, of which about 70% are associated with HPV types 16 and 18. In addition, subtypes 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82 are also closely associated with the development of cervical cancer and are also high-risk HPV types. Low-risk HPV subtypes are mainly composed of HPV6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, 108, etc. and can cause Ectopic warts-like lesions on the perianal skin of the genital tract and lower vagina, flat warts-like lesions, and low-grade cervical intraepithelial neoplasia. What is a woman’s lifetime chance of contracting HPV? The prevalence of HPV infection in women with normal cytology has been reported to be 10.2% to 40.0%. The probability of being infected with HPV is particularly high in sexually active women, with a rate of HPV infection of about 50% to 80%, but only 5% to 10% of women will develop persistent infection, and cervical precancerous lesions may occur when the infection persists for more than 14 months or more. Will cervical cancer occur after HPV infection? No. Low-risk types are not, but high-risk types are possible. This HPV virus is like a cold virus, it is easy to get infected when the resistance is poor. After increasing the immunity, 80% of HPV infections will be cleared naturally within 8 to 12 months. Therefore, for transient HPV infection, treatment is usually not needed, but of course it depends on the result of cervical cytology, if the TCT is normal, it will be rechecked after one year. If it is still positive after one year, it is a persistent HPV infection and further testing and treatment should be considered. As a reminder, persistent, high-risk HPV infection is a prerequisite for the development of cervical precancer and cervical cancer. With such a close relationship between HPV and cervical cancer, prevention is especially important. The launch of HPV vaccine has brought a boon to women, and HPV vaccination has become the first line of defense against cervical cancer. Difference between bivalent, quadrivalent and nine-valent HPV vaccines 1. Bivalent HPV vaccine Targeting HPV16 and HPV18, as mentioned above, more than 70% of cervical cancer is related to HPV16 and 18. It is suitable for women aged 9 to 25 years old and requires a total of three doses, in the 0th, 1st and 6th months. 2. Quadrivalent HPV vaccine On the basis of the bivalent vaccine, i.e. in addition to HPV 16 and 18, two low-risk subtypes of HPV 6 and 11 are also included. These two low-risk types of HPV can cause ectopic warts-like lesions on the perianal skin of the genital tract and the lower part of the vagina, flat warts-like lesions and low-grade cervical intraepithelial neoplasia. In addition to reducing the risk of cervical cancer, the vaccination also prevents sexually transmitted diseases common to both men and women. It is suitable for women aged 20 to 45 years old and requires a total of three doses at the age of 0, 2 and 6 months. 3.Nine-valent HPV vaccine On top of the quadrivalent vaccine, five HPV subtypes, 31, 33, 45, 52 and 58, which belong to the high-risk group, have been added, and these five subtypes also account for a relatively high proportion of cervical cancer patients. Therefore, the nine-valent HPV vaccine can benefit women more. The applicable population is women aged 16 to 26 years old, and a total of three doses are required, in the 0th, 2nd and 6th months. The HPV vaccine is currently a Class II vaccine in China, and the vaccination unit should inform the vaccinees scientifically and provide vaccination to those who are willing to receive it based on the principle of “informed consent and voluntary self-payment”. Do I need to be tested for HPV before vaccination? According to domestic and international health organizations, HPV DNA testing is not required prior to HPV vaccination. It is not necessary especially for young non-sexual women. If it is a routine medical checkup, it is better to get tested. Can HPV vaccine be given to those who are HPV positive or have abnormal cervical cytology? According to foreign health organizations, HPV vaccination is available regardless of whether the vaccine recipient has HPV infection status, abnormal cervical TCT results, existing HPV-related precancerous lesions or external genital warts. It is important to note that HPV vaccination does not have any therapeutic effect on the subtypes of HPV infection and associated lesions that already exist. This means that the vaccine is only preventive and has no curative effect. For HPV infection or resulting cervical lesions that are cured, HPV vaccination can reduce the recurrence of the disease. Does the vaccine mean that I won’t get cervical cancer? Answer: No! HPV vaccine is only for the HPV subtypes it covers, but there are many HPV subtypes related to the development of cervical cancer. It is known that more than 90% of cervical cancer is caused by HPV infection, and some cervical cancer may be caused by other factors. The bivalent and quadrivalent vaccines currently available in China can prevent and control 84.5% of cervical cancer risk, while the nine-valent vaccine can prevent 92.1% of cervical cancer. Do I still need to be screened for cervical cancer after HPV vaccination? Yes. HPV vaccination is not a substitute for routine cervical cancer screening, nor is it a substitute for other measures to prevent HPV infection and sexually transmitted diseases. Finally, we remind you that the HPV vaccine should be applied to prevent cervical cancer by choosing the right type of vaccine for you according to your age.