Everything you need to know about HPV but were too afraid to ask

Did you know that cervical cancer is the top gynaecological cancer in the world and the tenth most common cancer among women in Singapore? What many people don’t know is that 99% of cervical cancer is caused by the human papillomavirus (HPV) which is easily prevented by getting vaccinated.

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When we talk about preventable cancers, the conversation often centers around lung cancer. While doctors tell us that smoking makes people 8x more likely to get lung cancer, very few doctors are telling their female patients that women who test positive for HPV at 16 or 18 years are 35x more likely to have pre-cervical cancer. There has been a lot more discussion recently around the issue because of the relatively new HPV vaccine.

Even fewer doctors in Singapore tell their patients about HPV, its link to cervical cancer and how it can easily be prevented.

There are many misconceptions about HPV due to a lack of education on the matter and misinformation available online.

What is HPV?

HPV or the Human Papillomavirus is a virus that is transmitted through through sex or other intimate physical contact. The virus is often asymptomatic but can manifest as warts, or in the worst cases, cervical cancer.

HPV is very common; four in five women will contract it at some point before the age of 50 and most people (men and women) will contract the virus during their lifetime1.

There are over 100 strains of HPV, the majority of which your body will fight off without you even noticing. However, there are fourteen strains of HPV that have a high-risk for cervical cancer, specifically types 16 and 18 are the worst culprits, leading to 70% of cervical cancers. 

The good news is that there is a vaccine for HPV that brings your chances of getting it and therefore cervical cancer to nearly 0%.



Misconceptions about HPV

One of the biggest misconceptions about HPV is that it is linked to HIV, however there is no relation between the two viruses are completely unrelated. This leads to another myth that only women who are promiscuous can get HPV but this is simply not true.

Even women who only ever have one sexual partner are at risk of getting HPV.

Another myth is that getting an annual PAP smear is a sufficient method to protect against HPV or cervical cancer. While the PAP smear has worked well in the past, the method was invented in the 1940s and is no longer the best test on the market.

One of the very dangerous misconceptions is that the high risk strains of HPV are more aggressive and difficult for your immune system to fight. However, this is not the case. Your immune system reacts to all strains of HPV in the same way. This becomes a concern when there is a chronic infection of high-risk strains which increase women's risk of cervical cancer.

HPV Vaccine

Young women today need to speak to their parents and doctors about getting the HPV vaccination. Different vaccinations prevent different strains of HPV but all vaccinations protect against strains 16 and 18.

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The ideal age for young women to receive the vaccination is around 14 years old, however, it definitely falls into the category of better late than never and all women who are still sexually active should approach their doctor for more information.


HPV Testing

Even for women who have had the vaccination, it is important to maintain a regular schedule of HPV testing. Whereas the PAP smear provides a snapshot at the time of the procedure, the HPV test looks forward and can show your level of risk for the next 3-5 years.

It should be noted that the HPV test is not recommended for women under 30 because the results for HPV are likely to return positive, but at this stage, it is not yet problematic.

At the moment, only a few hospitals and clinics in Singapore offer this test as a standard procedure, however, you should speak to your doctor for more information and recommendations for where you can have the test performed.

Ultimately, cervical cancer is one of the most preventable types of cancer and combining the HPV vaccination with HPV tests every few years are the first steps in prevention.

 

References
1 www.cdc.gov/std/hpv/stdfact-hpv.htm