HPV and cervical cancer
Cervical cancer remains a major killer of women, with 80% of cases occurring in developing countries, including 130,000 in China, accounting for 28.2% of all new cases of cervical cancer worldwide.
The prevention and treatment of cervical cancer is indeed a major issue in safeguarding women’s health and an important responsibility of obstetricians and gynecologists. It is noteworthy that the occurrence of early cervical cancer, especially the trend towards younger age, is very obvious. This is clearly related to the human papilloma virus (Haman Papilloma Virus HPV) infection.
HPV is the only fully identifiable oncogenic virus in human carcinogenesis. Current research confirms that prevention of HPV infection prevents cervical cancer, and that absence of HPV infection prevents cervical cancer.
There are multiple subtypes of HPV.
The common low-risk types are: 6, 11, 42, 43, 44, etc.
Common high-risk types are: 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 68, etc.
HPV infection is divided into high-risk and low-risk types of infection: transient, delayed, and persistent.
The high-risk persistent infection is the most important. Only high-risk persistent HPV infection can result in national high-grade CIN.
Cervical lesion screening.
HPV testing (assay-HC2) has a high sensitivity (88%-100%) and negative predictive value (NPV, almost 100%).
HPV testing in combination with cytology (TCT LCT) is the most accurate test available for clinical use.
HPV negative, cytology negative – routine screening at 3-5 years.
HPV positive, cytology negative – colposcopy and repeat HPV screening at one year.
HPV negative, positive cytology; HPV positive, positive cytology – colposcopy.
Colposcopy positive area for biopsy histopathology
Proper understanding and treatment of HPV infection:
The absence of HPV infection prevents cervical cancer, but it does not follow that the presence of HPV infection necessarily results in cervical cancer. HPV infection is more common, especially in sexually active women before the age of 30. Most HPV infections can be cleared, so these infections are transient and do not cause cervical cancer. Only a small number of persistent high-risk HPV infections lead to cervical precancerous lesions cervical cancer.
The time from HPV infection causing cervical precancerous lesions (CIN1, 2, 3) to cervical invasive cancer is usually 8-10 years. High-risk HPV infection is the cause of cervical cancer, while low-risk HPV infection rarely causes cervical cancer. A positive HPV test only indicates an infection, not a disease, let alone a cancer, and the risk of getting cancer is only 2%. Without HPV infection, especially without high-risk HPV infection, cervical cancer is not possible. To deal with HPV infection, the current method is to treat the cervical lesions caused by HPV, which is the treatment of HPV infection and an important measure to prevent cancer. It is inappropriate to take HPV infection screening and treatment lightly and to be overly afraid of HPV infection.
In conclusion, the occurrence of early cervical cancer, especially the trend of young age, is very obvious, and it is very important to pay attention to the prevention and treatment of cervical cancer by cancer screening (i.e. HPV TCT or LCT).
Prevention of HPV infection can prevent cervical cancer, and without HPV infection, cervical cancer is not possible.
Only a few persistent high-risk HPV infections can cause cervical cancer HPV vaccine is the most effective prevention and treatment.