Sex and ‘CIN’ — 10 things every woman should know about HPV
WITH all the information available, it is easy to feel overwhelmed. This article provides 10 simple facts about the role of the human papillomavirus (HPV) in cervical cancer, prevention through vaccination, and will finally answer the question, ‘What on earth is CIN?’
1. Cervical cancer is, for the most part, sexually transmitted through the HPV. HPV is a virus that is spread by skin-to-skin contact, including sexual intercourse, oral sex, anal sex, or any other contact involving the genital area such as hand to genital contact. Condoms do not provide complete protection from HPV infection because condoms do not cover all exposed genital skin.
2. To date over 200 sub-types of HPV have been identified, of which 30 to 40 affect the genital region of males and females. HPV not only gives rise to cancer of the cervix, it causes cancer of the penis and anus as well as head and neck cancers. The majority of women and men become infected with HPV for the first time between ages 15 and 25 years.
3. HPV also causes genital warts. Warts are fleshy lesions which are skin coloured and may be smooth and flat or raised. They are usually located on the labia or entrance to the vagina or anus. Most women with warts do not have any symptoms, but they may have burning or tenderness in the genital region.
4. HPV infects the cervix and leads to a series of pre-cancerous changes called cervical intra-epithelial neoplasia or CIN. If not cleared by the body or medical intervention, CIN can progress to cervical cancer. Most people who are infected with HPV have no signs or symptoms and clear the infection within two years. In 10 to 20 per cent of women; however, the infection persists. In this situation, there is a greater chance of developing cervical pre-cancer and then cancer.
5. Pap smears can detect CIN before it progresses to cancer. It takes roughly 20 years for HPV infection to cause cervical cancer. Therefore, regular testing is important in detecting cervical abnormalities early, before cancer develops.
6. A HPV test can be done along with a Pap test or as a separate test. Like a Pap test, the HPV test is done during a pelvic exam, using a small brush to collect a sample from the cervix. Women who are under age 30 are not usually tested for HPV because many women in this age group have temporary infections which will go away without treatment. Doing the HPV test with along with the Pap smear allows you to increase your screening intervals.
7. HPV vaccines boost our bodies’ natural defense against HPV, to prevent CIN and cervical cancer. Vaccines are available to protect against HPV. They are given over a period of six months. Persons ages nine to 14 will need two doses while persons 15 years and over will need three doses. The vaccines are safe and effective and have been shown to reduce the risk of cancer and CIN.
8. HPV vaccines should ideally be given before females and males become sexually active. The vaccines offer the greatest protection from HPV if given before becoming sexually active. However, if you are sexually active or had an HPV infection as evidenced by an abnormal Pap smear or CIN, you may still benefit from HPV vaccination. Some studies show that the vaccine may prevent repeat infections.
9. Persons who have received their HPV vaccine still need to do Pap smears. The vaccine does not treat pre-existing infections and there are some HPV which may not be prevented by the vaccine, which can cause cervical cancer.
10. Cervical cancer is largely a preventable disease. Speak to your doctor today. Get screened, get vaccinated and prevent cervical cancer.
Dr Natalie Medley is a consultant obstetrician and gynaecologist at the Mona Institute of Medical Sciences, UHWI. She can be contacted at (876) 977-1512, (876) 618- 6048 or nmedsingh@gmail.com.
