Preventing Cervical Cancer

Ten things to know about human papillomaviruses

1.  The human papillomavirus (HPV) is common: Human papillomaviruses are extremely common DNA viruses that only infect humans.  ‘Papilloma’ means a small wart-like growth on the skin or mucous membrane.  HPV is thought to be the most common sexually transmitted infection (STI) in the world. 

2.  There are 150+ different HPV strains: Some are harmless - such as the strains that cause warts on the hands and knees of children.  Only a small number of types cause problems by changing cells from normal to abnormal.  The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers. 

3.  Proven cancer links: HPV causes many cancers.  Most HPV infections get better on their own and don’t cause any obvious health problems.  Infection with high-risk HPV types that are not cleared by the immune system can cause cell changes in the body that can lead to cancer later in life. It is important to know that very few women and men with HPV will ever develop cancer. 

Cervical cancer is the second most common cancer in women worldwide, with about 570 000 new cases and more than 300 000 deaths each year, according to the World Health Organization (WHO). HPV accounts for about 70% of cervical cancers. HPV is also strongly associated with anal cancer and throat cancer and is now a more common risk for oral and throat cancers than tobacco use. But unlike cervical cancer, which often can be found with routine pap tests, there's no way to screen for oropharyngeal cancers.

4.  Transmission is easy: HPV lives in the surface layers of the skin and is spread through skin-to-skin contact, body fluids and intimate sexual contact, including oral sex. The virus can be transmitted by penetrative as well as non-penetrative sexual contact. Without vaccination, 80% of adults will contract this viral infection at some point in their lives. 

5.  HPV infection: Almost every person will have HPV on their skin at some point in their life, regardless of sexual practice or sexual preference, even if they only have sex with one person in their lifetime. Having HPV does not mean that a person or their partner is having sex outside the current relationship as it is impossible to know when an HPV infection occurred. HPV can lie dormant for months, or even many years, before the emergence of genital warts or cervical abnormalities. 

6.  No symptoms. No diagnosis: HPV can be diagnosed only if a person has visible warts on genital skin or if they have an abnormal cervical smear result. If a person has no symptoms, there is no test to determine if HPV is present. 

7.  No cure. No treatment: There is no cure or treatment for the HPV virus. But there are ways to treat HPV-related health problems, such as precancerous lesions and genital warts. There is no treatment for HPV that has no symptoms. The majority of HPV is naturally cleared by the body's immune system within 1 to 2 years.

8.  No complications in pregnancy: In the majority of cases, having HPV does not impact a woman’s ability to become pregnant. HPV in pregnancy has no link with miscarriage, premature labour, or other types of pregnancy complications. 

9.  Vaccinate. Vaccinate. Vaccinate: While having regular pap smears are essential for all women to make sure they don’t have cervical cancer, or if they do that it’s caught at its earliest, most treatable stage, it’s better by far to prevent getting cancer at all. The HPV vaccine guard against the most common HPVs that cause cervical cancer and warts. When properly administered, the HPV vaccine is practically 100% efficacious, making it the best vaccine in the world. 

Vaccination is most effective when given prior to HPV infection, i.e. before you start having sex. The vaccine can be given to children as young as 9 and adults up to age 26.

10.  HPV is an epidemic in South Africa: The prevalence of HPV-caused cervical cancer in South Africa is almost double the global prevalence, with 27 cancer cases in a population of 100,000 persons (the global average incidence is 15 out of 100,000). 

From the high prevalence of risk factors associated with HPV related cancers to low quality and lack of affordability for healthcare, dealing with HPV in South Africa remains a challenge, but the chance to reduce the second largest cancer-related killer of women in South Africa is within our reach. With the HPV vaccine roll-out and regular cervical screenings, we can lower the instance of genital and other HPV-related cancers in South Africa for good.

Where can I get vaccinated?

Talk to our trusted family doctors to learn more about the HPV vaccine, which is available at all Intercare Medical Centres.  

Sources and references consulted or utilised:

•    www.phasa.org.za at https://phasa.org.za/2015/02/26/implementation-hpv-vaccination-south-africa/

•    National Department of Health. 2017. Cervical Cancer Prevention and Control Policy.

•    The New Zealand HPV Project at www.hpv.org.nz

•    www.mdanderson.org at https://www.mdanderson.org/publications/focused-on-health/FOH-hpv-cancer-risks.h10-1589835.html

•    www.cansa.org.za at https://www.cansa.org.za/womens-health/

•    The Conversation at https://www.theconversation.com/africa/topics/hpv-vaccine-12345