What is HPV?
Human papillomavirus (HPV) is the most common viral infection of the reproductive tract. HPV can be spread through vaginal, anal and oral sex. Most sexually active women and men will be infected and some may be repeatedly infected. There are many types of HPV and some do not cause any complications but some can lead to certain types of cancer and genital warts. The two most common types that cause cervical cancer in women are HPV types 16 and 18.
There are more than 100 types of HPV and currently, it is known that 14 of those types are cancer-causing. Some HPV types can progress into cervical cancer which impacts many women in Indonesia. Vaccination and regular pap smear testing is encouraged to prevent this.
HPV Further Complications
Usually HPV infections are asymptomatic or present with no symptoms, and 90% of the infections clear within 2 years. However, some will show symptoms after it has progressed to genital warts or some types of cancer.
Genital Warts
Genital Warts are bumps that may appear around your genital area. Common warts that are associated with HPV are common warts, plantar or flat warts. Some warts can resolve without treatment however, other warts require medication or in some cases require surgical interventions.
Cancer
HPV can lead to different types of cancer, the most common being cervical cancer however, HPV can also be responsible for anal, vaginal, vulvar, penile or oropharyngeal cancers.
Not all HPV types cause cancer however, 99% of cervical cancer is caused by HPV. It will take years for HPV to develop to cervical cancer however, symptoms of cervical cancer will only show at its advanced stages. Keeping this in mind, screening HPV infection earlier will allow for early intervention and prevent HPV from progressing to cancer.
Causes and Risk Factors
HPV infection can be transferred through skin-to-skin contact. HPV can be passed on through sexual intercourse or other forms of contact of the genitals. This means that HPV can be transmitted through vaginal, oral or anal sex.
Some risk factors include:
- Multiple sexual partners
- Having sex with someone with multiple sexual partners
- Weakened immune system (e.g. HIV)
Testing
Pap smear test
Pap smear test is a screening test for cervical cancer in women. It involves collecting a sample from your cervix ― between your vagina and uterus. A HPV test is done at the same time during this pap smear test.
Pap smear tests are very accurate and have been seen to reduce cervical cancer rates as it catches HPV infection early. HPV can progress to cervical cancer and therefore treating it before it progresses reduces rates of cervical cancer and mortality.
It is performed by your doctor or gynaecologist and would take only a few minutes. You will lie down with knees bent and your doctor will insert a speculum into your vagina that will allow your doctor to easily see your cervix. Your doctor will then collect samples of your cervix by scraping with a soft brush.
Many women might feel uncomfortable to come in for the pap smear however, it is very quick and can potentially save your life.
If cells were normal, you won’t need any further testing or treatment until your next pap smear and pelvic exam. Abnormal pap smear does not directly indicate that you have cancer, it indicates that there are abnormal cells on your cervix. Some of those cells can be precancerous however, do consult with your doctor about the next steps to take after an abnormal pap smear. Your doctor might perform a colposcopy to examine the tissues of the cervix further.
Guidelines vary for every country however, it is recommended that you do screen regularly. If you have certain risk factors, doctors may encourage more frequent pap smear testing. Pap smear is done regularly because it takes years for HPV to progress to precancerous cells, cancer or genital warts to be detected.
Treatment Options
Most HPV can clear on it’s own however some HPV can progress into genital warts or some types of cancer. We discussed above, in particular cervical cancer in women.
If you have genital warts as a result of an HPV infection, doctors might prescribe cream that you can use at home. Sometimes people also choose to surgically remove the warts.
For warts and also abnormal cancerous cell findings through a pap smear can lead to health professionals to remove them. There are different types of treatment such as cryotherapy, conization, laser therapy or loop electrosurgical excision procedure (LEEP); all aim to remove these abnormal cells. Other cancer treatments include radiotherapy, chemotherapy or palliative care.
Prevention
Practice safe sex
To prevent HPV infection, it is best to practice safe sex. Condoms are effective at reducing the risk of catching or spreading STDs, during vaginal, anal or oral sex.
It is also important not to have sex when there are visible genital warts.
Getting the HPV Vaccine
HPV vaccine is available that will protect you for the two most common types that cause HPV-related cancers, five other HPV types associated with cervical cancer and two types that cause genital warts. All girls and boys can and should get the HPV vaccine as more people are protected, lesser chances of spreading.
Routine pap smear test
Pap smear test is a screening test for cervical cancer in women. Pap smear tests are very accurate and have been seen to reduce cervical cancer rates as it catches HPV infection early. HPV can progress to cervical cancer and therefore treating it before it progresses reduces rates of cervical cancer and mortality.
