Guest Author - Dr. Denise Howard
Cervical cancer is a malignancy of the cervix that is known to result from sexual exposure to a virus called Human Papilloma Virus (HPV). Once the cells of the cervix are infected it is possible for the body to fight the infection however this doesn’t occur in all women. In some cases the cervix may undergo precancerous changes and eventually develop cancer. This process can take years providing an opportunity for early detection of changes and the prevention of cancer.
Cervical cancer is the 3rd most common cancer in women worldwide and the 2nd most common cancer in women age 15-45. Cervical cancer is caused by HPV infection; its presence has been found in 97-100% of cervical cancer cases. Women who develop cervical cancer are known to have specific factors. Over 60% of them have never received a pap smear or have been inadequately screened. Those who develop cervical cancer have persistent infection with the high-risk HPV types, are heavy smokers or are immunosuppressed. Cervical cancer screening when done correctly is effective.
Thirty-five of the over 100 HPV types are known to infect the genital tract. The types are categorized as being high risk due to their strong association with cervical and other genital cancers. HPV types 16, 18, 45 and 31 causes 65% of the cases of high-grade precancerous lesions. Types 16 and 18 have been implicated in 70-80% of the cases of cervical cancer and 10 other types with the rest of cervical cancers. Types 6 and 11 are generally associated with low-grade lesions but causes 80-90% of the cases of genital warts.
Over 20 million adults in the U.S. are infected with the Human Papilloma Virus. It is estimated that the acquisition rate for sexually active adults is 6.2 million per year. Seventy-five to 80% of all sexually active adults will become infected at some point in their life. Women, especially younger women are more likely to be infected and it is estimated that 60% of them will become infected within 3 years of becoming sexually active.
The vast majority of HPV infections resolve spontaneously, the majority within 8 months but some may take up to 30 months. Of women with high-risk HPV types, 15-30% will develop high-grade lesions within 4 years and the rate of progression to invasive cancer is 1.44% during a 2-year period.
Precancerous changes are described as dysplasia and are categorized as low or high-grade lesions. The low-grade lesions are typically due to an acute HPV infection and usually regress. The high-grade lesions are associated with persistent HPV infection and thus are at greater risk of developing into cancer. This progression can take from 3-12 years and occurs in more than 30% of the severe dysplasia cases.
Cervical cancer is one of the most preventable cancers. The availability of screening cytology (pap smear), ability of early detection and treatment of precancerous changes and recent vaccination means that no woman should, (especially in developed countries) should die from this cancer. The possibility of eradication of this cancer is within our grasp. Every woman and girl should be given the opportunity to take advantage of screening test and preventative methods.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!