HPV – the Human Papilloma Virus and Cervical Cancer

HPV is the abbreviation used for human papilloma virus.  HPV causes the disease known as Genital Warts but it also causes cervical cancer.  It is one of the most common sexually transmitted diseases in the world today.There are many different types of HPV and not all types cause the wart like lesions to appear in the genital area.  In fact most people who have this sexually transmitted disease do not know they have it.Statistics suggest that up to 50% of sexually active adults will aquire HPV in their lifetime.  A robust  immune system will most likely be able to take care of the initial HPV infection so you may never even know that you had it.  If you were infected with the type of HPV that causes Genital Warts you may see the wart like lesions around the genital area, including on the shaft of the penis and the anal area.  Women with Genital Warts may not see any lesions at all if they are confined to the vagina. The strains of HPV that cause genital warts are classed as low risk viruses whereas the strains that cause cervical cancer are classed as a “high risk”.   The link between cervical cancer and sexual activity was first suspected when the observation was made (1841) that nuns were never diagnosed wtih cervical cancer. At the same time it was noted that cervical cancer was more common in women who were prostitutes.  A link between pappilloma viruses and cancer was found in research on rabbits but it was not until the human papilloma virus was identified that the link to HPV and cervical cancer was made.  This occurred in the late 1970’s.

Both the Canadian and American Cancer Society lists other risk factor for cervical cancer as long term exposure to female hormones such as those found in birth control pills, smoking, HIV infection, exposure to certain hormones such as diethylstilbestrol (DES), and genetic factors.

Cervical Cancer

The cervix is the opening of the uterus.  When infected with the high risk human papilloma virus strains these cells can become cancerous.  Women over 30 are at more risk to develop cervical cancer suggesting that it takes some time for the cancerous changes to occur after the HPV infection.  Not all women who are infected with the human papilloma virus will go on to develop cervical cancer.In the United States cervical cancer is more prevalent among the Hispanic and Black populations who also have a higher mortality from the disease.   In Canada higher rates of cervical cancer are seen among the older (ages 40-59), immigrant, aboriginal, and lower socio-economic populations. In both countries it is thought that rates are higher among these populations because of lack of screening, which results in detection at a much later stage of the disease.The number of deaths from cervical cancer in the last 50 years has decreased dramatically because of the ability to diagnose the disease early with the Pap test. This test bears the name of its originator George Papanikolaou.  It is a simple test that requires a sample of cells from the cervix.  The tissue is sent to a laboratory for examination under a microspope.  Cancerous changes can be detected very early this way and early diagnosis improves success rates for treatment.Treatment When diagnosed early enough cervical cancer can be treated by removing the cancerous cells.  This may range from removal of cells confined to the cervix to a complete hysterectomy depending on how advanced the cancer is and whether or not it has spread to lymphatic tissue.Prevention

You can lower your risk of developing cervical cancer by limiting the number of sexual contacts and knowing your partner’s HPV status.  If you are sexually active and not in a monogamous relationship you should use a barrier method of protection with every sexual encounter and undergo regular screening as part of your routine health examination. It is recommended that sexually active women should have a gynecological exam with a Pap smear every three years to age 69.HPV vaccine

Vaccines have recently come on the market that provide protection from two strains of high risk HPV. Health officials are recommending all young women be vaccinated before they beome sexually active.  The vaccine is provided free of charge to girls in most provinces in Canada.  Many states in the US are attempting to pass legislation requiring the vaccine but  to date only 3 have been successful in getting legislation passed.