【Health Tips】The truth about the cervix, listen to the experts' popular science (Part 2)

Cervical cancer is a malignant tumor that endangers women's health. According to the research data on the burden of malignant tumors in China in 2022 released by the National Cancer Center, the number of cervical cancer cases in China in 2022 was 150,700, with an incidence rate of 21.81/100,000, ranking fifth in the incidence rate of female malignant tumors . Persistent infection with high-risk human papillomavirus (HPV) is the main cause of the occurrence and development of most cervical cancers.

With the popularity of cervical cancer screening, more and more women of appropriate age have received HPV testing, but problems have also arisen. The more HPV tests are conducted, the more people are HPV-positive, and misunderstandings, anxiety, panic, etc. follow. Today, let's talk about some common cognitive misunderstandings.

After many women find out that they are HPV positive, they are very confused about how they were infected with the HPV virus, and it even affects the relationship between husband and wife. In fact, this is completely unnecessary. HPV infection in women with unknown sources of infection does not mean that they or their partners have cheated. We must make a clear concept that a simple HPV positive is not a sexually transmitted disease, or even a disease. It is just a state of viral infection . In fact, there are many kinds of viruses and bacteria carried by the human body. HPV is just one of the pathogenic microorganisms that may cause disease in some people, and it happens to be transmitted through sexual contact. Genital warts caused by low-risk HPV virus infection belong to the traditional sexually transmitted diseases.

There is currently no large-scale, multi-center survey data on the HPV infection rate among Chinese men, but it is generally believed that it is not lower than that among women. The vast majority of men infected with the HPV virus also have no symptoms. Due to sampling factors, the methods for detecting HPV in men are not yet accurate and reliable. The existing method of sampling men with a sampling brush has a relatively high false negative rate. HPV virus infection has little impact on men's health. Low-risk HPV can cause genital warts, and penile cancer and anal cancer are also related to high-risk HPV, but the incidence of these malignant tumors is not high. My personal opinion is that if no abnormalities are found in the male genitals and perineum, HPV virus testing is generally not necessary.

There are no such regulatory requirements at present. There is no objection to completely suspending sexual intercourse, but there is no need to let this problem affect the relationship between the couple. If either party has genital warts, it is recommended to suspend sexual intercourse until the warts are cured. If it is just HPV positive, there is no requirement to absolutely prohibit sexual intercourse, but it is recommended to use condoms throughout the process. There is still some controversy about how much protection condoms can provide against HPV virus transmission. In theory, contact with areas not covered by condoms may also cause HPV virus transmission. Similar to respiratory viruses, the standardized use of barrier protection may not completely block the possibility of infection, but it is better than taking no measures at all.

Since most cervical cancers are caused by persistent infection with high-risk human papillomavirus, if HPV is positive, then we should start taking medication as soon as possible, right? It would be great if there were drugs to treat HPV, but unfortunately, so far, no drug has been found in the world that can effectively treat HPV. Pay attention to the adjective "definitely effective". There are many so-called drugs for treating HPV in our country, some of which are actually approved as medical devices. The complexity of obtaining approval for drugs and devices is different. Some drugs have a certain effect on HPV infection in small-scale clinical observations, but no drug has large-scale data to prove its efficacy. At present, no drug has been widely recognized by the medical community for its efficacy against HPV, and the diagnosis and treatment standards related to HPV infection at home and abroad do not recommend any specific drug. In Western countries, when women are found to be HPV positive, most of them follow the doctor's advice and let nature take its course. If the drug cannot be proven to be effective, they will not use it. For quite a number of Chinese people, the concept of drugs is that if it cannot be proven to be ineffective, they might as well try it.

The purpose of testing the HPV virus has never been to treat HPV itself. The purpose is to assess the risk of cervical lesions and detect cervical lesions at an early stage. After the HPV virus is found to be positive, the focus should be on handling it according to the standard. Check the colposcopy when it is necessary, and check it according to the standard when it is necessary. As for the HPV virus itself, 90% of positive people will naturally turn negative within two years. Before turning negative, it is recommended to maintain a healthy lifestyle as much as possible. Things that are not conducive to immunity are not recommended. Condoms should be used throughout the couple's sexual life. There is no objection to the use of drugs to treat HPV virus, but if it costs a lot of money and causes great trouble to daily life, it is unnecessary. It is true that about 10% of positive people will not turn negative for more than two years. The reason is not clear at present. It is generally believed that it has a certain relationship with the individual's immune status and genes. Even if it does not turn negative, as long as regular check-ups are carried out according to the standards and timely intervention is made at the stage of cervical lesions, serious consequences can be avoided.

In short, HPV infection is not uncommon in the population. Even if ordinary people keep themselves clean, they cannot completely avoid HPV infection. In order to detect possible cervical lesions early, it is recommended that women who have had sexual life undergo regular cervical screening. If the test is HPV positive, the focus is on follow-up examinations according to the standards. It is not important whether or not to use medication and which medication to use. In order to reduce the occurrence of cervical cancer as much as possible, it is recommended that women of appropriate age receive HPV vaccinations.

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