Will you definitely get cervical cancer if you are infected with HPV? Learning these prevention and treatment methods is the only way to be safe!

When many people hear about HPV, they immediately equate it with cancer, especially cervical cancer. If a physical examination reveals HPV infection, they will feel very panic: Does this mean that they will get cervical cancer?

Indeed, this misunderstanding and fear is understandable. According to reports, in 2018, approximately 110,000 cancer cases in China were attributable to HPV infection[1]. In addition, there are approximately 48,000 deaths from cervical cancer in my country each year, and almost 100% of cervical cancers, 88% of anal cancers, 50% of penile cancers, and 43% of vulvar cancers are related to persistent infection with high-risk HPV[2].

Seeing this string of words like "cancer", "death", and "100%", do you feel even more terrified? No, no, no, in fact, HPV infection is not as serious as everyone thinks, and sometimes it does not even require treatment. Today, Dr. Zeqiao will show you how to correctly understand first aid when infected with HPV?

01. What is HPV?

We must first know that HPV is human papilloma virus, which is a virus rather than a disease. There are more than 200 types of HPV identified so far, some of which do not cause any problems, and it may even happen that we are infected with HPV without even knowing it exists.

However, some of them are linked to cancer. HPV can be divided into high-risk and low-risk types based on whether it is carcinogenic.

According to the recommendations of the World Health Organization (WHO), my country will
HPV16/18/31/33/35/39/45/51/52/56/58/59/68 are defined as high-risk types, while HPV 26/53/66/73/82 are defined as medium-risk types. Among them, the well-known types 16 and 18 have the highest risk of inducing cancer.

(Sourced from the Internet)

02. From HPV infection to cervical cancer

Does being diagnosed with HPV infection mean that you will get cervical cancer?

This is not true. It is estimated that more than 80% of women have had at least one HPV infection in their lifetime[3]. However, more than 90% of HPV infections can be cleared naturally within 2 years, and less than 1% of patients will develop cervical precancerous lesions and cervical cancer. Therefore, if HPV infection is detected, there is no need to panic blindly, because most infections can be cleared by our immune system.

It is now clear that persistent infection with high-risk HPV is a necessary factor for the occurrence of cervical cancer and precancerous lesions. Please note that there are two key points here: one is the high-risk type, and the other is persistent infection. Low- and medium-risk HPV infections that are cleared within three or four months do not meet this necessary condition.

In addition, it takes 10 to 30 years for HPV infection to develop into cervical cancer. After persistent infection with high-risk HPV, cervical lesions of grades 1, 2, and 3 will gradually occur. The smaller the grade, the greater the probability of lesion reversal. Grade 1 lesions have a 57% chance of reversal; conversely, the higher the grade, the higher the probability of progression to invasive cervical cancer [4]. Therefore, during this long process, we can still use many treatment measures with the help of doctors to prevent the development of the disease.

03. What should I do if I am infected with HPV?

If the test results are positive for HPV16 and HPV18, the doctor will perform a further colposcopy and a cervical biopsy under the colposcopy to rule out cervical precancerous lesions and cervical cancer.

If the test result is positive for other high-risk HPV types, a thin-layer liquid-based cytology test, also known as the cervical TCT test, is required. If the TCT test is normal, a review once a year is sufficient. If the TCT result indicates some hyperplasia, a colposcopy is required. If the colposcopy shows no abnormalities, a review once a year is also recommended.

If the examination shows that it is just a positive HPV infection without cervical lesions, special treatment is generally not required, and the virus can be cleared from the body through the body's own immune system.

We only need to ensure a balanced diet, increase exercise, and avoid staying up late to improve our immunity, which is helpful for clearing the virus. If necessary, we can also use anti-HPV biological protein dressings, Nocardia rubrum cell wall skeletons, interferon or some vaginal suppositories under the guidance of a doctor to enhance local resistance and provide auxiliary treatment [5].

04. How to prevent HPV infection and cervical cancer?

● Avoid high-risk sexual behavior: avoid multiple sexual partners, clean yourself well before sex, and it is recommended to use condoms during sex.

● HPV vaccination can significantly reduce the risk of infection. Studies have shown that after vaccination of females aged 13-24, the incidence of HPV type 16/18 infection was reduced by 30-60%[6].

● Regularly conduct cervical cancer screening. Given the current age characteristics of cervical cancer incidence in my country, the recommended starting age for screening is 25-30 years old[7]. Please note that even if you have been vaccinated, you still need to undergo cervical cancer screening!

After reading Dr. Zehashi’s introduction to HPV, does your fear of HPV infection seem to be reduced a lot?

However, it is still important to note that if you experience symptoms of suspected cervical disease, such as irregular vaginal bleeding, bleeding after sexual intercourse, and abnormal leucorrhea, you should seek medical attention in a timely manner for early detection and treatment.

References

[1] de Martel C, Georges D, Bray F, Ferlay J, Clifford GM. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis. Lancet Glob Health. 2020;8(2):e180-e190. doi:10.1016/S2214-109X(19)30488-7

[2] Li Shuang, Li Mingzhu, Cong Qing, Yang Fan, Liu Hong, Li Kemin, Song Kun, Yin Rutie, Wang Xinyu, Zhang Guonan, Sui Long, Liu Jihong, Kong Beihua, Xie Xing, Wei Lihui, Martin. Chinese expert consensus on the clinical application of human papillomavirus vaccine[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2021, 22(02): 225-234. DOI: 10.13390/j.issn.1672-1861.2021.02.045.

[3] Chesson HW, Dunne EF, Hariri S, Markowitz LE. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014;41(11):660-664. doi:10.1097/OLQ.0000000000000193

[4] Chinese Preventive Medicine Association Women's Health Branch. Comprehensive Prevention and Control Guidelines for Cervical Cancer[M]. Beijing: People's Medical Publishing House, 2017.

[5] China Medical Information Query Platform. What to do if HPV16 is positive [OL]. [2022-5-11] https://www.dayi.org.cn/qa/133079

[6] Wei Lihui, Zhao Yun. Interpretation of the clinical key points of the expert consensus on immune prevention of human papillomavirus-related diseases such as cervical cancer[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2020, 21(01): 1-2. DOI: 10.13390/j.issn.1672-1861.2020.01.001.

[7] Wang Linhong, Zhao Gengli. Guidelines for comprehensive prevention and control of cervical cancer in China[J]. Chinese Journal of Maternal and Child Health Research, 2018, 29(01): 1-3.