Human Papillomavirus (HPV) remains a widely misunderstood yet highly prevalent infection, with most individuals encountering it at some point in their lives. While a positive HPV result can cause concern, the connection between the virus and cervical cancer is more intricate than commonly perceived. Experts emphasise that understanding this nuance is crucial for effective prevention and management, particularly given the efficacy of routine screening and vaccination programmes. Miss Adeola Olaitan, a consultant gynaecological oncologist at The Wellington Hospital, provides clarity on the virus and its implications.
HPV constitutes a diverse family of viruses capable of infecting the skin and mucosal tissues, with various subtypes identified by numerical designations. Transmission primarily occurs through skin-to-skin contact in the genital area, including vaginal, anal, or oral sex, and through shared sex toys. Despite its commonality, HPV frequently presents without symptoms, and in the majority of cases, the infection is transient and harmless, clearing naturally within two years without the individual ever knowing they were infected.
A significant misconception surrounding HPV stems from the stigma associated with sexually transmitted infections. Many mistakenly believe that acquiring HPV indicates promiscuity, a notion Miss Olaitan firmly refutes. She highlights that a single sexual encounter can lead to HPV infection, underscoring that the virus’s prevalence transcends individual sexual history and is not a reflection of a person’s lifestyle.
The expansive HPV family comprises over 200 distinct types, categorised into low-risk and high-risk groups based on their potential to cause cellular changes. Approximately 14 types are classified as high-risk for cervical cancer, with HPV 16 and HPV 18 collectively responsible for about 70% of all cervical cancer cases. These specific high-risk strains can infect the cervix, and if the infection persists over time, they significantly elevate the risk of developing cervical cancer.
Detecting HPV typically relies on cervical cancer screening, as the virus often produces no discernible symptoms. This screening process is pivotal, as it identifies individuals at a greater risk of developing abnormal cells that, if left untreated, could progress to cancer. In the UK, individuals with a cervix are invited for NHS screening every five years between the ages of 25 and 64, during which a small cell sample is collected from the cervix and analysed for high-risk HPV types.
Should the initial screening reveal the presence of high-risk HPV, a reflex cytology test is performed on the same sample to check for abnormal cells. If no abnormalities are found, individuals are advised to return for an earlier follow-up screening. However, if abnormal cells are detected, a referral for a colposcopy is made to allow for a more detailed examination of the cervix, ensuring timely intervention if required.
The HPV vaccine stands as a highly effective preventive measure against the virus. It is routinely administered to children between the ages of 11 and 13, though it is licensed for use up to age 45, albeit with reduced efficacy in older recipients. Critically, the vaccine provides a stronger and more enduring immunity than natural immunity alone, making it beneficial even for those previously exposed to HPV or currently infected, particularly when received at a younger age.
While most concerning symptoms often indicate benign conditions, it remains vital for individuals to be aware of potential signs of cervical cancer. These include bleeding after sexual intercourse, irregular bleeding between periods, post-menopausal bleeding, or an unusual, persistent, and offensive vaginal discharge. Prompt medical evaluation of these symptoms is crucial to rule out any serious underlying conditions.
Ultimately, the most important message regarding HPV and cervical cancer is its preventability. Regular participation in cervical screening programmes and receiving the HPV vaccination represent the two most impactful actions individuals can take to safeguard their health. These proactive measures significantly reduce the likelihood of developing cervical cancer, empowering individuals to take control of their reproductive health.
