Friday, 20 April 2018

HPV Infection as the Cause of Cervical Cancer

Approximately 99.7% of cervical cancer cases (cervix) are caused by the infection of Human Papilloma Virus (HPV). This becomes a serious disease for women. The prevalence and death rate of this type of cancer is the highest in Indonesia. Unfortunately, HPV infection is generally asymptomatic and it can be identified when the severity has spread (invasive stadium) and the possibility of recovery has dropped to minuscule. Actually, we can prevent the severity if the HPV infection is identified early.

There are 2 (two) types of HPV, namely high-risk and low-risk. Infection by the low-risk HPV may cause slight temporary changes on the cervix, but will not lead to the risk of cancer. However, such infection may sometimes also result in genital warts. On the other hand, the infection by the high-risk HPV, particularly the persistent one, may cause transformation of cervical cells. which will eventually develop into cervical cancer if left unattended. The transformation of the high-risk HPV to cervical cancer needs 10-20 years.

The risk-groups of the persistent HPV' s infection are women above the age of 30, having immunodeficiency disorders (such as HIV and Lupus Erythematosus), and smoking. Most people, both women or men, who are sexually active can be infected by HPV. For women, the risk of HPV infection can increase, if:

  • Married/already having sexual intercourse

During the puberty, the cervix is immature and the cervical cell is highly active, thus, easy to be penetrated and altered by the HPV.

  • Having multiple sexual partners

Keep in mind that men can also be infected by HPV and potentially transmit it to their partners or anyone who has sex with him. Having sex with different partners can increase the risk of HPV infection.

HPV infection can occur within the body for a long time without being noticed, because commonly it does not show any symptoms. Someone can be infected by HPV after a sexual intercourse and recover by himself/herself without experiencing any health problems. However, it is important to have a screening on the diseases that may be caused by HPV, such as cervical cancer.

Nowadays, the HPV-DNA test has been available, i.e. the molecular test using hybrid capture II method, which has been approved by the Food and Drug Administration (FDA) to detect the presence of high-risk DNA HPV on test sample taken from the cervix. **) There are 13 types of high-risk HPV that can be detected, namely 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. The Food and Drug Administration (FDA) has approved the use of the HPV-DNA test along with Pap Smear as a primary screening of cervical cancer, particularly on women above 30 years old. The HPV-DNA test is also recommended when Pap smear result is not definitive or is confusing, to determine if colposcopy test is necessary.

Although today the vaccine to prevent high-risk HPV is available, such vaccine can only be used for 2 (two) types, namely 16 and 18, which means, it cannot provide a complete protection against cervical cancer. Therefore, cervical cancer screening is still important for vaccinated women.

High-risk HPV infection is not similar to cancer, but it can cause cellular changes and cancer if the infection persists.