The most dangerous strains of human papilloma are the direct cause of cervical cancer. We can live with others for years and will not cause serious symptoms. Can you get rid of HPV viruses?
Grzegorz Głąb, MD, PhD, Faculty of Health Sciences, University of Opole
What should we know about human papillomavirus (HPV)?
First of all, they are very common viruses that are transmitted through the mucus by direct contact, most often during sexual behavior. The virus spreads very easily – just touching the skin to the skin and the mucus will be transferred. 70 percent people during their lifetime have had or will come into contact with papillomaviruses.
What is the awareness of Polish women about HPV?
Unfortunately, it’s bad. Most don’t even know there is such a thing. My students did a survey which shows that only 10 percent. of the surveyed women know that viruses of this type are associated with cervical cancer.
What are the consequences of an HPV infection?
If you are unlucky and infected with viruses belonging to high-risk viruses, you risk an insidious long-term development of cervical cancer. We know that types 16, 31 and 18 are the most dangerous. These types of virus are identified by molecular testing in carriers. Cytology does not detect HPV viruses, but what they have already “damaged” in the cells, so with some delay. In colposcopy, changes are visible two or three years earlier, and the result of a molecular test is positive. If a woman finds out that a molecular test result shows types 16, 31 or 18 of the virus, she is at the highest risk.
Recently, cytology on a liquid basis is fashionable. Will she also not detect the virus?
Liquid cytology is a test that was invented in the 90s, so it is nothing new. This is a normal Pap test in which additionally whatever is washed out of the cells is tested for papillomas. The disadvantage of this test is that when you rinse the collected material, cancer cells may also be washed out and you may simply not find them.
The advantage is that what is washed out of the cells from the smear is molecularly examined for the presence of HPV viruses. However, years of experience show that whether liquid cytology or molecular testing alone is performed, the benefits are identical. In a word, cytology can be forgotten.
What about HPV tests?
The tests are now performed by the PCR method, which is very accurate. It detects 50 copies of the virus in the sample, which means it practically detects everything. On the other hand, a positive result alone does not necessarily mean that a woman is sick. This must be checked in subsequent studies, because only 2 percent. women infected with HPV will have cervical cancer. It is just like COVID-19. There are many carriers, but this does not mean that everyone who test positive for SARS-CoV-2 will end up under a respirator.
Are there any preparations available that will help get rid of HPV from the vagina and protect women from developing cervical cancer?
Yes. For those women who have viruses and are not yet sick or are only carriers, there are preparations that help to get rid of viruses from mucus. They are in the form of gels that allow the virus particles to be absorbed and neutralized. One of them additionally contains ingredients that normalize the natural defense forces. The beneficial bacteria that should be in the vagina produce, among others, proteins that “impregnate” epithelial cells and prevent viruses from settling on them and penetrating inside the cell.
These preparations can be used after the presence of a precancerous condition has been ruled out. We must make sure that the woman has no changes that require treatment. If she has changes that have not been detected, and she uses these preparations, they will not stop the disease.
The preparations are available without a prescription, but it is good if the doctor excludes, beyond all measure, cancer or pre-cancerous conditions of high intensity.
Prof. dr hab. n. med. Tomasz Paszkowski, head of the XNUMXrd Department and Clinic of Gynecology at the Medical University of Lublin
What is the relationship between human papillomavirus (HPV) and cervical cancer?
This is a well-documented, non-negotiable relationship. It is based on the fact that cervical cancer cannot develop without the so-called persistent infection with human papillomavirus, or more precisely with its highly oncogenic strains. There are many human papillomaviruses, but not all of them are carcinogenic.
However, not every woman infected with this virus is doomed to cervical cancer. Some women eliminate the virus spontaneously without any treatment. So not every occasional infection is a carcinogen.
At what age are women most at risk of HPV?
This is the age after sexual initiation as it is one of the sexually transmitted viruses. We assume that sexual activity is needed for this infection to occur. This translates into recommendations for vaccination against HPV. Ideally, they should apply to girls, as well as boys, before the sexual initiation. So that they can be protected against this infection in good time. In most countries, it is 12 years.
Do you know how long it takes from infection to cancer development?
We do not know exactly about this, but the impact of HPV infection may appear even after 10 years. A long time passes from the time the first precancerous lesions develop to the development of invasive carcinoma. This time is different for every woman.
We do know when the incidence of cervical cancer is at its peak. It is the period between 55 and 60 years of age. However, the population with the fastest growing incidence of cervical cancer in recent times is young women. We see more and more women in their thirties with invasive cervical cancer.
How can cervical cancer be prevented?
Cervical smear collection is still the main line of secondary prophylaxis. Unfortunately, its effectiveness is limited. This effectiveness depends on what percentage of the population undergoes a Pap smear test. In Poland, this percentage is embarrassingly low, despite the existence of a very well-structured cytological test program for many years. With a shamefully low percentage of women who undergo this examination, the effectiveness of secondary prevention of cervical cancer is very limited. Therefore, the only effective way to prevent cervical cancer is primary prophylaxis, i.e. HPV vaccination is best performed in the entire population.
Unfortunately, Poland is one of the fewer and fewer countries in the European Union where there are no population vaccinations, i.e. free vaccinations offered to the entire population of girls, preferably girls and boys, before sexual initiation. However, there is also optimistic news: from 1.11 this year. the bivalent HPV vaccine is partially reimbursed.
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