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HPV and Cervical Cancer

Human papillomavirus (HPV) is regarded as the most common cause of sexually transmitted diseases. The primary mode of transmission for this virus is through skin-to-skin contact, but there is a possible risk of becoming infected with HPV even without encountering any sexual activity. There is no logical reason behind this except, as the virus can spread easily,  prolonged contact with infected skin, such as holding hands, may cause transmission of the virus.

More than 90% of people infected with HPV clear eventually after a period of 2 years. However; in some instances, the virus tends to stick around for longer periods, contributing to adverse outcomes such as cancers of the cervix, vagina, vulva, and penis. The most common cervical cancer is squamous cell carcinoma, accounting for 70% of cases.

The diagnosis of HPV & cervical cancer is, however; determined by histopathological examination while the treatment is based on the stage of the disease, tumor size, and metastasis of the disease. Enrolling in clinical research trials dedicated to HPV screening might help better manage the condition.

About HPV and Cervical Cancer

Cervical cancer is the fourth most frequently diagnosed form of cancer in women, mostly found in those residing in low and middle-income countries. Nearly all cases of cervical cancer are attributed to HPV 16 and 18 ( the most common viral infection of the reproductive tract). In some cases, women infected with HIV are 6 times more likely at risk of developing cervical cancer. About eight out of 10 women might have had HPV at some point in time by the age of 50. The rate of progression of cervical cancer is typically slower, taking about 15 -20 years to show visible symptoms in immunocompetent individuals. Therefore early intervention plays a vital role in preventing the progression of cervical cancer.

The privilege of living in high-income countries proves beneficial, as the women’s health programs are in place providing girls with HPV vaccinations and catering to other women to get them screened regularly and treated adequately. The role of screening is such that it allows early identification of the pre-cancerous lesions at stages where they can easily be treated. While the sad reality of low-and middle-income countries is that women’s health is neglected because of their limited access to preventative measures and lack of awareness. As a result, cervical cancer is often not identified until it has further advanced and the outlook of symptoms develops.

In addition, inaccessibility to potential options for treating cancerous lesions (for example, cancer surgery, radiotherapy, and chemotherapy) results in a higher mortality rate from cervical cancer in these countries.

Signs & Symptoms of HPV & Cervical Cancer

Some types of HPV( HPV 6 and 11) are associated with the formation of warts while others such as HPV-16 and HPV-18, do not cause wart formation but can lead to certain cancers. The most common symptoms associated with HPV 6 and 11 are:

  • Warts(cauliflower-like lesions), but not everyone who has HPV has them. They may be raised, flat, or shaped like a cauliflower, and of different sizes. The areas where warts typically show up are on your genital areas
  • Earache
  • Hoarseness of voice because of the prolonged sore throat
  • Odynophagia (Pain and difficulty while swallowing)
  • Abrupt weight loss.
  • Lymph node swelling

HPV and its association with Oro-pharyngeal cancer

Other than cervical cancer, HPV has other trademarks of clinical presentation such as sore throat. The infection can linger in some individuals causing Oropharyngeal cancer(back of the throat and base of tongue).

What are early-stage cervical cancer symptoms?

Cancer is a silent form of the disease, which is why cancer of the cervix silently brews with no visibility of symptoms in its early stages. In case of the presence of symptoms the most commonly experienced one is unusual vaginal bleeding occurring after sex, in between periods, or after menopause. Other symptoms indicative of cervical cancer are:

  • Postmenopausal spotting or bleeding
  • Increased vaginal discharge with a sometimes foul odor

As cancer advances, more severe symptoms may appear including:

  • Persistent back, leg, or pelvic pain
  • loss of appetite and weight loss
  • Vaginal discomfort
  • Swelling of either or both the legs

Other causes of Cervical Cancer

Besides HPV some other factors that influence the onset of cervical cancer are:

  • Smoking habits and being chronically immunocompromised increase your risk of developing cervical cancer.
  • Not having routine cervical cancer screening tests (Pap tests).
  • HIV and AIDS.

High-risk and Low-risk individuals likely to get cervical cancer

The susceptibility to developing high-risk HPV infection escalates in individuals who are sexually agile long before they turn 18 years and those with multiple sex partners.

Although anyone with a cervix can get cervical cancer an exception to this is women who have had a total hysterectomy(surgery done to remove the womb and cervix). Women,trans-men, and non-binary people at high risk of getting cervical cancer include:

  • Those under 45 years – young people are more prone to getting cervical cancer
  • Immuno-compromised individuals, i.e have HIV or AIDS
  • Active birth cycle( given birth multiple times or early birth <18 years)
  • Hormonal medicine diethylstilbestrol (DES)
  • History of vaginal, vulval, kidney, or bladder cancer

Individuals less likely to get cervical cancer are:

  • Regular cervical screening of women aged between 25-64 years
  • HPV vaccination for children between 12-13 years as a preventive measure against genital warts
  • Condom users
  • Eating a healthy and balanced diet
  • Former smokers

How does HPV cause cervical cancer?

A long-lasting infection if not discovered and timely removed puts the women at high risk of developing cancer. For instance, when the person’s immune system is not capable enough of resisting and eradicating HPV infection, an HPV infection caused by an oncogenic type can remain for a longer period and eventually transform healthy cells into cancerous cells.

Myths and Facts About HPV & Cervical Cancer

Myths about HPV & cervical cancer:

  • Every individual who has ever been infected with HPV will probably develop cancer
  • Pap tests are enough to identify any signs of cancer
  • HPV infection brings along warning signs prior to the actual onset of viral infection
  • Screening and pap tests are the only measures to avoid HPV cancer
  • HPV-vaccinated individuals no longer need pap or HPV tests

Facts about HPV & cervical cancer:

  • Every woman who has ever had sex is at risk of getting infected
  • Pap tests alone are not enough to protect from cervical cancer
  • HPV is prevalent while cervical cancer is not soo common
  • HPV has no incubative symptoms
  • The risks of developing cervical cancer can be minimized by integrating lifestyle changes such as: quitting smoking, exercising, not involving in early sexual activities, and avoiding sexual contact with multiple partners
  • Pap tests are equally important for HPV-vaccinated individuals as they are for non-vaccinated individuals

Outlook
HPV & cervical cancer is curable if detected early and treated effectively. The two most cost-effective ways to avoid cervical cancer are; Primary prevention (HPV vaccine), and secondary prevention (screening and treatment of precancerous lesions). Other preventive measures such as tertiary prevention (detection and treatment of invasive cervical cancer), and palliative care are all parts of comprehensive cervical cancer control. Palliative care is a crucial component of cancer management to alleviate unnecessary pain and suffering brought on by the disease. Multiple Clinical Research in Michigan, near you, are conducting clinical trials to help eradicate this debilitating cancer.

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