HPV Cervical Cancer
Understanding the Risks and Taking Control of Your Health
Many of us may still remember that the famous singer, Anita Mui, died of cervical cancer on December 30, 2003 at the age or 40 and that her elder sister also died of cervical cancer 3 years earlier at the age of 40. Cervical cancer is a significant health concern affecting women worldwide. While it is a highly preventable and treatable disease, it remains a leading cause of cancer-related deaths among women in many developing countries. By increasing awareness, understanding the risks, and promoting regular screenings, we can take proactive steps to protect ourselves and our loved ones from this potentially devastating illness.
What is cervical cancer?
Cervical cancer refers to the abnormal growth of cells in the cervix, the lower part of the uterus that connects to the vagina. Most cervical cancers are caused by persistent infections with certain types of the human papillomavirus (HPV). HPV is a sexually transmitted infection that is extremely common and can be contacted by both men and women.
How common is cervical cancer?
Cervical cancer is the fourth common cancer in women globally with an estimated 604,000 new cases and 342,000 deaths in 2020. In Hong Kong, 167 persons died of cervical cancer in 2022.
What would increase the risk of cervical cancer?
- Lack of HPV vaccination: HPV infection is the primary risk factor for cervical cancer and women who have not received HPV vaccination are at much higher risk in developing cervical cancer.
- Lack of regular screening: Regular Pap smears and HPV tests are essential for early detection and treatment of cervical abnormalities before they progress to cancer. Women who do not undergo regular screenings are at a higher risk.
- Weakened immune system: Individuals with a weakened immune system are more susceptible to HPV infections and the development of cervical cancer.
- Early sexual activity and multiple sexual partners: Engaging in sexual activity at an early age and having multiple sexual partners increases the risk of HPV infection.
- Smoking: Cancer-causing harmful substances from cigarettes may cause DNA damage in cervical cells. Also, smoking weakens the immune system and makes it more difficult for the body to fight off HPV infections, thereby increasing the risk of cervical cancer.
How to detect cervical cancer?
In its early stages, cervical cancer often does not cause noticeable symptoms. However, as the disease progresses, symptoms may include abnormal vaginal bleeding (between periods, after intercourse, or after menopause), pelvic pain, and unusual vaginal discharge.
Regular screenings play a vital role in early detection. Pap smears, also known as Pap tests, involve collecting cells from the cervix to check for abnormalities. HPV genotyping tests that screen for high-risk types of HPV including HPV 16 and HPV 18, may be used alone or in conjunction with Pap smears for cervical cancer screening.
How to prevent cervical cancer?
Preventing cervical cancer involves a combination of lifestyle choices and medical interventions. Here are some key steps:
- HPV vaccination: Vaccination is most effective when administered before becoming sexually active. According to the WHO, the primary target for HPV vaccination is girls aged 9-14 years. Secondary target population includes females aged 15 or above, boys and older males. In Hong Kong, starting from the 2019/20 school year, eligible female primary school students are provided with HPV vaccine under the Hong Kong Childhood Immunisation Programme. School Immunisation Teams of the Department of Health visit schools to provide the first dose of 9-valent HPV vaccine to Primary Five female students and the second dose to the girls when they reach Primary Six in the following school year free of charge. It is estimated that this vaccine, which covers major genotypes including HPV 16, 18, 31, 33, 45, 52 and 58, accounting for cervical cancer cases in Hong Kong, could potentially offer protection against around 90 per cent of cervical cancer in Hong Kong.
- Regular screenings: Pap smears and HPV tests can detect early cellular changes, allowing for timely treatment and prevention of cervical cancer. According to the Department of Health of Hong Kong, Women aged 25 to 64 who ever had sexual experience should have regular cervical screening as shown below:
A) Women aged 25 to 29 who ever had sexual experience should have screening by cytology every 3 years after two consecutive normal annual screenings.
B) Women aged 30 to 64 who ever had sexual experience should have screening by:
(i) cytology every 3 years after two consecutive normal annual screenings; or
(ii) HPV testing every 5 years; or
(iii) co-testing (cytology and HPV testing) every 5 years.
C) Women aged 65 or above who ever had sexual experience:
(i) may discontinue screening if routine screenings within 10 years are normal.
(ii) should be screened if they have never had cervical screening.
- Safe sexual practices: Consistent and correct use of condoms can reduce the risk of HPV transmission.
- Healthy lifestyle: Maintaining a healthy lifestyle, including not smoking, eating a balanced diet, and exercising regularly, can help support a strong immune system and reduce the risk of cervical cancer.
How to treat cervical cancer?
Treatment options for cervical cancer depend on the stage of the disease and may include surgery, radiation therapy, chemotherapy and immunotherapy. Early detection and treatment significantly increase the chances of a positive outcome.
Conclusion
Cervical cancer is a preventable and curable disease when diagnosed early. By understanding the risk factors, promoting vaccination, and prioritizing regular screenings, we can take control of our health and reduce the burden of cervical cancer. It is important to spread awareness and encourage women of all ages to prioritize their well-being by staying informed and proactive in protecting themselves against this potentially life-threatening condition. Remember, early detection saves lives!
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