What is all the fuss about HPV and Cervical Cancer? by Clare Knapp

Cervical Cancer is the third most common cancer in women word wide and the most common cancer in women in South Africa. It is one of the top killers of women along with breast cancer. It mostly affects women under 45 years old, who often have young families.

Human Papilloma Virus (HPV) is the virus that causes cervical cancer. The cells of the cervix (neck of the womb or uterus) are unstable and are very susceptible to this virus.

There are about 100 kinds of HPV with only about 15 causing cervical cancer. The most common subtypes are 16 and 18 which account for 70-80% of cervical cancer.

The other subtypes can cause warts, vaginal, penile and anal cancers.

HPV is very easily transmitted, not only through sexual contact but also through skin to skin contact. The viruses that cause cervical cancer are only sexually transmitted. It is a very tough virus and difficult to destroy.

Since there are no signs of HPV infection in men and women, many people don’t know they are infected and can pass it on to a partner.

For most women the virus goes away on its own, with the body’s own immune system eliminating it,  but for a few it can lead to cancer.  This may take many years after the initial infection. If the body is immune-compromised it can take a much shorter time to progress.

The only way to pick up an HPV infection is on a pap smear or a biopsy of an abnormal cervix.

This is why doctors recommend regular cervical smears (or pap smeers –named after Dr Papanicolaou who developed the test) and check-ups. If the cancer is caught early, it is very easy to treat and the cure rate is excellent. We are now also recommending an HPV test at age 30. If it is negative and the Pap smear is normal, routine cervical screening only needs to happen every 3 years.

There are now 2 vaccines that protect against HPV infection, thus decreasing the risk of cervical cancer dramatically. Both are “Virus Like Particle” (VLP) vaccines which means they are very safe and don’t cause an active infection or cancer. They are like the “empty shell” of a virus and induce a protective immunity. They are designed to prevent infection of HPV and not treat it (although further studies are looking at this).

It is preferable to vaccinate before there is a chance of any sexual contact and for this reason it is recommended that girls at age 9 be vaccinated. In fact the South African government from 2014 is going to vaccinate girls at this age.  It is also recommended that boys be vaccinated to stop the spread of HPV.

Any female can be vaccinated against HPV from age 9. There is no upper limit although cervical cancer is less common over the age of 65yrs.

Both vaccines are given over a six month period and require 3 small injections into the upper arm. The cost of the Gardasil vaccine which covers both cervical cancer and genital warts is R1155 per vaccine and the cost of the Cervirix which only covers cervical cancer is R667 per vaccine.

These vaccines are not inexpensive but they have the potential to dramatically reduce the risk of cervical cancer. We do believe this is a very small price to pay to prevent the emotional stress and costs associated with an abnormal Pap smear or treatment of cervical cancer.