【Health Tips】The truth about the cervix, listen to the experts' popular science (Part 1)

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, the incidence rate was 21.81/100,000, the number of deaths was 55,700, and the mortality rate was 8.06/100,000, ranking fifth in the incidence of malignant tumors in women . Persistent infection with high-risk human papillomavirus (HPV virus) is the main cause of the occurrence and development of most cervical cancers. March 4, 2024 is the 7th " International HPV Awareness Day ". This year's theme is " Let the world worry less (One Less Worry) ", which aims to call on the public to pay attention to and understand HPV and its harm, and eliminate diseases such as cervical cancer caused by HPV as soon as possible.

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.

Myth 1: I got married right after graduation and only had one sexual partner, so the chance of infection is 0

Current research results show that the main transmission route of HPV is sexual contact. But this does not mean that maintaining "clean" sexual contact will not cause HPV infection and cervical lesions. HPV virus can survive for several days after leaving the human body and has a certain tolerance to some disinfectants such as alcohol . Indirect contact with the genital perineum area can theoretically cause infection.

Statistics show that the HPV infection rate among Chinese women is about 15%. In clinical work, we come into contact with many women infected with HPV, and it is hard to explain how HPV is transmitted. Although HPV can be avoided as much as possible through abstinence, condoms, vaccines and other methods, many people still cannot avoid it completely, and the reason is not clear. The conclusion based on statistical data and mathematical models shows that 80% of women will be infected with HPV at least once in their lives . Therefore, HPV is not far away from ordinary people like us who keep ourselves clean.

Myth 2: Cervical cancer sounds scary, but it has nothing to do with ordinary people like us.

First of all, the incidence of cervical cancer is not low. Isn't it worth paying attention to that it ranks fifth in the incidence of female malignant tumors? The vast majority of patients with cervical lesions and early cervical cancer have no symptoms, and doctors cannot diagnose them by naked eye examination of the cervix. Cervical screening is almost the only way to detect cervical lesions and cervical cancer in the early stage.

In recent years, with the popularization of cervical screening and other factors, the incidence of cervical cancer has shown a trend of younger people. As the result of the 2008 Nobel Prize in Medicine, it is now clear that the vast majority of cervical cancers are caused by persistent infection with high-risk human papillomavirus . If high-risk HPV virus is detected in cervical exfoliated cells, it indicates the risk of cervical lesions. In certain cases, vaginal examination and cervical biopsy should be further performed according to the regulations to confirm the presence of cervical lesions.

Similar to cervical lesions, the vast majority of people do not have any symptoms of HPV infection in the female lower reproductive tract. In fact, statistics show that the HPV infection positive rate among Chinese women is about 15%. This data is enough for "us ordinary people" to pay attention to. As the first person responsible for their own health, "ordinary people" who do not have any symptoms should also perform cervical screening regularly according to regulations.

Myth 3: After getting the HPV vaccine, you don’t need cervical screening

There are currently three types of HPV virus vaccines, namely bivalent, quadrivalent and nonavalent. They cover different numbers of HPV subtypes and have different levels of protection against cervical cancer. Bivalent and quadrivalent vaccines can prevent about 70% of cervical cancer . Two domestic vaccines of the former are already on the market, which are more cost-effective. The latter provides additional protection against genital warts caused by two low-risk HPV viruses, HPV6 and 11. The nine-valent vaccine can prevent about 90% of cervical cancer, but the appointment cycle is currently long and it is difficult to get a shot. No matter which vaccine is used, it is impossible to completely prevent the occurrence of cervical cancer. After all, there are still some high-risk HPV viruses that are not covered by the current HPV vaccine, and some cervical cancers are not related to HPV. According to regulations, even if you have been vaccinated with the HPV vaccine, you should still do regular cervical screening. The frequency and content of the screening are the same as those of those who have not been vaccinated.

Many female friends are confused about which HPV vaccine to choose. In fact, each vaccine has its own characteristics. My personal opinion is to get vaccinated as early as possible at the appropriate age . Whichever vaccine can be obtained early, get it. The earlier the vaccine is, the earlier the protection. No matter which vaccine is taken, the subsequent regular cervical screening should not be ignored. Similar to some respiratory virus vaccines, although HPV vaccination may not completely prevent HPV virus infection, its protective effect on high-grade cervical lesions and cervical cancer caused by high-risk HPV virus infection has been verified for many years in many countries/ethnic groups. The effect is definite, and the chance of serious side effects is extremely low.

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.