HPV is the cause 99% of the more than 1,400 cases of cervical cancer diagnosed each day and is the fourth most common cancer among women worldwide. Most women who are sexually active are very likely to have contracted HPV (Human Papilloma Virus) at some point in their life. Globally, the figure is approximately 80%. Most HPV infections produce no symptoms and are cleared by the body’s natural immune system within two years. Conversely, in some women the HPV virus stays in the body and may lead to cervical cancer.
Symptoms of Cervical Cancer
Often there are NO SYMPTOMS of HPV infection or pre-cancerous lesions. When symptoms do occur, it is usually when the cancer is relatively advanced and difficult to treat. Symptoms of cervical cancer according to The World Health Organisation includes the following:
- Irregular, intermenstrual (between periods) or abnormal vaginal bleeding after sexual intercourse;
- Back, leg or pelvic pain;
- Fatigue, weight loss, loss of appetite;
- Vaginal discomfort or odourous discharge
- A single swollen leg
Halting HPV from causing cervical cancer is now the mainstay of cervical cancer death prevention. However, a cervical cancer awareness survey last year that covered 300 women in Hong Kong produced the startling result that, even though there was a good level of awareness of cervical cancer (83%) and of HPV (65%), only 38% of women were aware of the link between the two. There are over 100 types of HPV. Specifically, HPV16 and HPV18, cause approximately 70% of cervical cancer cases.
“Cervical cancer prevention has made great advances since I started practicing over 30 years ago. It has gone from being a misunderstood, unpreventable, largely undetectable and commonly fatal cancer to one of the most preventable and treatable. This success has come largely from understanding the role of HPV – in both the causation of pre-cancerous and cancerous changes in the cervix,” says Dr. Lucy Lord.
Screening is the key to prevention and regular Pap smears have been shown conclusively to reduce the risk of cervical cancer. The Pap smear, which only takes a few minutes, looks for changes in the cells of the cervix and is recommended every 1-3 years. However, a single Pap smear may miss up to 50% of cervical cancers, with a reduction in rates for those who get regular smears. A high-risk HPV test is different. It looks for the 14 high-risk HPV types that can cause cervical cancer and can detect the risk of pre-cancer even before changes appear in the cells of the cervix. Some tests identify HPV 16 and 18 individually. Women with HPV 16 or HPV 18 are 35 times more likely to develop cervical pre-cancer than those without HPV.
Gold Standard of Detection
Co-testing produces even better results by combining a Pap smear with testing for the HPV virus, which can make a single smear much more accurate. According to Dr. Lord, a normal Pap smear with a negative HPV test will give a patient reassurance that they don’t have cervical cancer or pre-cancerous changes with over 99% accuracy. She goes on to say, “It is important for women to have cervical cancer screening regularly, including the high-risk HPV test. Every woman should learn what their results mean so they can be informed when discussing the next steps with her doctor.”
This message is dedicated to Debbie Alvarez; Healthy Living Asia contributor who passed away from cervical cancer. For more on Debbie’s journey through life and her continued impact on those she knew, please read more here.