Our expert says:
What women should know about HPV and Cervical Health.
What is cervical cancer? How common is it?
Cervical cancer is cancer that begins in the cervix, the part of the uterus or womb that opens to the vagina. Cervical cancer was once the number one or two cause of death from cancer in women. Thanks to the Pap test, the number of women in South Africa who get cervical cancer has decreased. Now a new test is available that might improve on the Pap test and help women to prevent cervical cancer. Cervical cancer can be prevented in most cases by early detection.
What is HPV? How does it lead to cervical cancer?
HPV is short for Human Papilloma Virus. An HPV infection is usually harmless and temporary: most people with HPV will never know that they are infected because the virus usually goes away on its own. There are many types of this common virus and only a few “high risk” types can lead to cervical cancer. These high-risk HPV types are spread through sexual contact. There are also “low-risk” types of HPV that can cause genital warts but do not cause cancer. If high-risk HPV types don’t go away on their own, they may progress to pre-cancer cells. If these abnormal cells are not found and treated, they may become cancer with time. However, most cell changes return to normal by themselves. It is very rare for an HPV infection to lead to cervical cancer.
Who can get cervical cancer?
Because almost all cervical cancers are caused by HPV, any woman who has had sex can get (is at risk for) cervical cancer. Some things place women at more risk than others. These include high-risk types of HPV infection, smoking, and HIV infection. The women who are most at risk are those women who are not getting Pap tests at all, or who don’t get them foe several years.
Who can get HPV?
Anyone who has ever had sex, both men and women, can get HPV infection. It is estimated that three out of every four people will get an HPV infection during their lifetime. HPV infection is spread by direct skin-to-skin contact during vaginal sex. HPV infection is more common in younger age groups, particularly in women in their late teens and 20s. Because HPV is spread mainly through sex, your chances of getting it increases with number of sex partners. Women who start having sex at a young age, who have many sex partners, and whose sex partners have or have had many other partners are at increased risk for having an HPV infection.
Will I know if I have HPV?
In most cases, infection with the HPV virus has no symptoms. However, a high-risk HPV infection may cause changes in the cervical cells. These changes will show up on your Pap test. Signs of HPV infections can appear weeks, months, or years after first infection, so it is possible to become infected without being aware of it. Only a small number of women infected with HPV develop cell changes.
Can HPV infections be treated?
There is no treatment available for the virus itself. However, there are treatments for cervical changes that HPV can cause. Your health care provider will discuss these treatment options with you, if you need them.
Is there a test for HPV?
Yes, there is and HPV test that can detect high-risk types of HPV in cervical cells. HPV tests are already used to help doctors decide which women with certain abnormal results (called “ASC-US”) on their Pap test need further testing. Now this test can also be used in routine testing of women over the age of 30 at the same time that they get their Pap test.
What is a Pap test? What is the difference between a Pap test and an HPV test?
A Pap test is the standard way to see if there are any cell changes that you should be concerned with. The Pap test looks at a sample of cells from the cervix under a microscope to see if there are any cells that are abnormal. It is a very good test for finding not only cervical cancer cells but also cells that might become cancer cells. Usually health care providers do the Pap test as part of a pelvic exam.
An HPV test checks for high-risk HPV viruses. For both the Pap test and HPV test, a small soft brush is used to collect cervical cells that are sent to a laboratory. Whether you get both tests or the Pap test alone, you will not notice a difference in your exam.
Should I be tested for HPV infection?
If you are more than 30 years old, you can get both an HPV test and a Pap test at the same time. Getting both tests together makes it more likely that any abnormal cervical cell changes will be found compared with using just one test. If both test results are negative (normal), you should not repeat either test more often than every three years. The choice of whether or not to be tested for HPV is yours, and you should discuss your decision and possible results with your health care provider. You also may want to ask about the cost of the test and whether your insurance will cover that. Remember, it will still be important to continue having health exams.
You can also choose to get a regular Pap test without an HPV test, or the new liquid-based Pap test. For finding cervical cancer or cell changes early, it is much more important to get tested at all than to get a particular kind of test.
I am under age 30 – should I get an HPV test in addition to my Pap test?
HPV is very common in women under the age of 30, and cervical cancer is very rare in this age group. In most women younger than 30 who have HPV, the virus will go away before it causes any cell changes or symptoms. Including an HPV test along with your Pap test provides no real health benefits for younger women and might lead to too many tests and unnecessary treatment.
How should I prepare for a Pap test or Pap and HPV test?
Try not to schedule an appointment for a time during your menstrual period. For 48 hours before the test: do nor douche; do not have sexual intercourse; do not use tampons, birth control foams, jellies, or other vaginal creams or vaginal medications.
If I tested positive for HPV, what does this mean for me?
Women with a normal Pap result who test positive for HPV will usually be tested for HPV again in six to 12 months. Testing positive a second time does not mean that there is great risk of cervical cancer, or even that cell changes may lead to cervical cancer, but it does mean that further tests will likely be recommended. If you have a positive HPV test result and an abnormal Pap result, your health care provider will explain what further tests you might need.
If I test positive for HPV, when did I get if?
It is usually impossible to know when a person got HPV or from whom. HPV may be found fairly soon contact, or not until many years later. Most men and women are not aware that they have the virus. Condoms do not offer complete protection from HPV. The virus is so common that having only one lifetime partner does not assure protection. For all these reasons, it is not helpful, or fair, to blame your partner.
If I have an HPV infection that goes away, can I get it again?
Most sexually active couples share the HPV until the immune response eliminates the infection. Partners who are sexually intimate only with each other do not pass the virus back and forth. In other words, when the virus is shared, being exposed to more of the same virus by your partner does not make it more difficult to get rid of the infection. When HPV infection goes away, the immune system will remember that HPV type and keep a new infection of the same HPV type from ever occurring again. However, because there are many different types of HPV, becoming immune to one HPV type does not protect you from getting another HPV type.
If I have HPV or a cell abnormality, is there anything I can do?
Yes: don’t smoke. Smoking has been shown to increase the chance the cell abnormalities might progress to more severe changes. Remember that almost everyone gets HPV at some time. Be sure to keep your follow-up doctor appointments.
Will I always have the HPV virus?
No one really knows, but probably not. HPV usually goes away within one to two years.
KEY POINTS TO REMEMBER
o Almost all women will have HPV at some point, but very few will develop cervical cancer.
o Most HPV infections are temporary and go away on their own.
o Only HPV infection that does not go away over many years can lead to cervical cancer. Cervical cancer is preventable. Early detection of abnormal cell changes is important.
o Cervical cancer is rare and almost always prevented through regular Pap tests that look for cervical cell changes that could lead to cancer.
o It can be helpful to know your HPV status if you are over age 30.This can help determine how often your health care provider will recommend that you get Pap tests.
o Don’t blame yourself or others. Your HPV status is not a reliable indicator of your sexual behaviour or that of your partner.
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