Cervical Cancer – HPV Vaccine
Cervical Cancer one of the most common cancer affecting women ( second next to Breast cancer). It’s caused by several varients of the HPV the Human Papilloma Virus, a sexually transmitted infection (STI) of the cervix. Most types of HPV virus infections usually clear up within a few months but if the infection does not clear up or is not dealt with within twelve months, this is the time that is associated with a high risk of cervical cancer. It is however a wholly avoidable and preventable condition if people followed healthy sexual practices and/ teenage girls have the HPV vaccination.
Who is most at risk?
- The younger age group are mostly at risk from this virus. It’s a very transient virus that goes from one to the other very quickly and like most viruses, it is rapidly transmitted, as well. But it’s that persistent small proportion of women affected that might go on to develop cervical cancer.
- The risk of HPV infection takes place soon after sexual activity but it should be noted that penetrative sex is not required for the transmission of the virus. Skin to skin genital connections, penile to vulva contact, for example, is a well recognised mode of transmission.
- The virus also peaks among older women, at menopause. More couples are divorcing around this age and other experience widowhood; men in this age group have a greater disposable income and are looking for new partners, too; hence the increased risk.
- HIV infected individuals are at a higher risk of HPV infection and they can be infected by a broader range of HPV virus types. HIV indicates a reduced immune system. Therefore the more sexually active HIV person and those with multiple partners, are at a much greater risk.
- Other contributory factors to HPV infection, that are not widely known, are the Pill, having lots of children, experiencing the first sexual activity at an early age, and, cigarette smoking. Other infections like Chlamydia add to the risk because of persistent infection. The peak ages in women is those under 30 and those over 50 going through menopause. It is therefore important to look at screening and risk factors to this age group.
National cervical screening
The national screening programme has a broad base from age 25-65. It must be emphasised that this is a ‘screening’ programme, not a ‘diagnostic’ programme. It’s the abnormal cells in the smear test, that show up during screening, that may be cause for further investigation, often a referral back to the GP or clinic who can also arrange to take swabs to test for sexually transmitted infections, and other tests such as coloscopy ( direct visualisation of the Cervix).
The cervix doesn’t actually mature until the girl is probably 20-21, so taking smear tests under that age is counter-productive as you will automatically get an abnormal smear result in most cases, which can create a huge amount of anxiety. Clinics are there to educate people even if that results in many explanations.
When asked “do you know why we take the smear?” 90% will respond with “well, it’s a test for cancer” (1). The cervical screening programme is not a test for cancer. It is a test that looks at cells taken from the Cervix in an area called the transformation zone ( where cells are more likely to show malignant changes or "cell dysplasia. The smear test appointment is usually a good time for women to discuss all areas of their sexual life, if they want to, anything they are unsure about and they should be encouraged to ask questions. Women everywhere should be encouraged to attend their clinic when called forward for screening – if they feel unsure of anything, a chat with the nurse at their GP surgery can usually allay any fears or other arrangements discussed.
The HPV Vaccine
The vaccine was only introduced three or four years ago and there was a certain amount of controversy at the time as to why the Government chose one particular vaccine when another, on offer seemed, on the face of it, to do a better job. The vaccine chosen by the Government, Cervex, has more evidence to support its efficacy than other products – the choice was not about price; it was a scientific decision based on evidence available at the time and it continues to be tested.
The UK national programme for receiving the vaccine is for all girls aged 12 and 13 to get three doses over a six month period. If they miss a session, they can catch up at their GP surgery. It was decided that this age group would benefit most as they are the least sexually active. These girls are automatically placed on the screening programme as it is still very important to have screening from age 25 + to ensure the cervix remains healthy.
Even though the HPV virus is an STI, boys are eliminated from the vaccine programme because there is insufficient evidence to show the consequences. The female endocrine system, relative to boys, is quite different and giving them both the same vaccine could have quite different results and those are not yet known but are being investigated.
Current evidence shows that the vaccine is effective in reducing rarer forms of cancer and that’s a huge bonus.
About the author
Kathryn Colas is founder and author of SimplyHormones.com providing specialist advice and support for women at all stages of menopause. She is a regular speaker on radio, to women’s groups and local PCT’s. Workshops can be arranged at your place of work or women’s group or she’s happy to make a lunch time appearance. Subscription to her website is a one-off £20.
More information:
Kathryn Colas
www.simplyhormones.com
E: kathryn@simplyhormones.com
T: 01825 712858
References:
(1) Results from Gill Bower, Cancer Screening Co-ordinator, Croydon NHS Trust
Copyright YourDoc Medical Ltd 2011. All rights reserved.
