“Cervical Cancer” A Deadly Threat Near You and Your Loved Ones!
3rd most common cancer in Thai women
According to 2020 statistics, cervical cancer is the 3rd most common cancer in Thai women, with an more than 9,000 new diagnosed cases and more than 5,000 deaths per year. Meaning that every day in Thailand, around 13 women die from cervical cancer.
Caused by HPV infection
Almost 100% of cervical cancer is caused by infection with HPV (Human Papillomavirus).
More than 85% of the population (both men and women) had been infected with HPV once in their lifetime!
According to statistics, more than 660,000,000 people worldwide are infected with HPV each year, which means that every hour, 75,000 people get infected.
Everyone has a chance of contracting HPV because
It can spread through skin-to-skin contact including kissing, any route of sexual intercourses ex. vaginal, anal, and oral. Sharing personal objects or devices with infected individuals can also be a cause of transmission.
Condom cannot provide 100% efficacy against HPV tramsmission. That’s why you do not need to have multiple sex partners to get HPV. You can get HPV from the first time you have sex!
HPV can cause many disease in both men and women.
There are more than 100 strains of HPV, of which can be categorized into two main types:
- Low-risk HPV types, especially HPV type 6 and 11, cause genital warts.
- High-risk HPV types, especially HPV type 16 and 18, infected cells have high risk of developing into the cancer cells.
HPV is the cause of the diseases and cancers as follows:
90%
of genital warts
70%
of head and neck cancer
90%
of anal cancer
70%
of vulvar cancer
75%
of vaginal cancer
60%
of penile cancer
Cervical cancer is often asymptomatic.
HPV can live in the body for up to 10-30 years without any symptoms. Also, cervical cancer is often asymptomatic in early stage. It may cause abnormal vaginal bleeding, especially after sexual intercourse and abnormal vaginal discharge.
In late stages, it may cause symptoms caused by compression of the tumor, such as lower abdominal pain, swollen legs, etc.
How can we prevent HPV infection and cervical cancer?
The best prevention against HPV infection is HPV vaccination, which can provide up to 90-97% efficacy against HPV-related diseases and cancer (depending on the type of vaccine). It can be used for both men and women. Cervical cancer screening is required in women.
Cervical cancer screening test
Currently, there are 3 tests for cervical cancer screening.
*The ATHENA study, which compared Pap and HPV DNA tests in more than 47,000 women, found that this method was more sensitive in detecting precancerous lesions.
The World Health Organization (WHO) currently recommends HPV testing (HPV DNA test) as the primary screening test for cervical cancer prevention for both women in general and women living with HIV. The American Cancer Society also recommends HPV testing (HPV DNA test) as the primary method of cervical cancer screening in women aged 25-65.
How to do the cervical cancer screening?
Usually, cervical cancer screening can be done in a clinic or hospital. This is most often done during an internal examination.
The patient must lie on her back with the feet up in stirrups. The doctor then inserts an instrument called speculum into the vagina to expand the vaginal canal so the cervix can be seen and allows the doctor to collect cell samples around the cervical area.
Pap test (Pap smear) must be repeated every 2 years. HPV DNA test, which is more sensitive, can be repeated every 5 years.
People at risk of cervical cancer need to be extra careful!
- People who have never screened for cervical cancer
- People who have never been vaccinated against HPV
- People who have multiple sexual partners
- People with immunocompromised, such as people with HIV Smoking
- People with history of sexually transmitted diseases
- People who have many children
- People who use oral contraceptives for a long time
If you are at risk, you should be screened for cervical cancer regularly or get frequent testing for HPV before your cells become cancerous.
Prevent it by start testing today!
In 2021, the World Health Organization (WHO) has announced new guidelines for cervical cancer prevention which recommends collecting samples for examination that can be collected by healthcare provider or yourself.
Research has found that self-sample collection for cervical cancer screening is as accurate for finding HPV (HPV DNA) as sample collection by healthcare provider during a pelvic examination.
HPV Vaccination
In Thailand, there are two types of HPV vaccines, 4-valent HPV vaccine and 9-valent HPV vaccine. It was found that the 9-valent HPV vaccine can prevent 97% of HPV-related diseases and cancers.
- International Agency for Research on Cancer (World Health Organization) [Internet]. Thailand fact sheets (Globocan2020). [updated 2022 Mar 28; cited 2022 May 28]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/764-thailand-fact-sheets.pdf
- Centers for Disease Control and Prevention (CDC). Human papillomavirus. In: Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington DC: Public Health Foundation; 2015:175–186.
- Centers of Disease control and Prevention (CDC) [Internet]. Genital HPV infection – Basic fact sheet. [updated 2022 Apr 12; cited 2022 Jun 20]. Available from https://www.cdc.gov/std/hpv/stdfact-hpv.htm
- Matthews KJ, Carter JS. Cervical cancer [Internet]. Medscape; 2022 [cited 2022 May 28]. Available from https://emedicine.medscape.com/article/253513-overview
- Wright TC, Stoler MH, Behrens CM, Sharma A, Zhang G, Wright TL. Primary cervical cancer screening with human papillomavirus: end of study results from the ATHENA study using HPV as the first-line screening test. Gynecol Oncol. 2015;136(2):189-97.
- World Health Organization (WHO). WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. Geneva: World Health Organization; 2021.
- National Cancer Institute [Internet]. HPV and cancer. [updated 2021 Oct 25; cited 2022 May 28]. Available from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
- American Cancer Society [Internet]. HPV and HPV testing. [updated 2020 Jul 30; cited 2022 Jun 28]. Available from https://www.cancer.org/healthy/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html
- Royal Thai College of Obstetricians and Gynecologists. RTCOG Clinical practice guideline cervical cancer screening. Clinical practice guidelines. 2021;3:289-299
- Polman NJ, Ebisch RMF, Heideman DAM, Melchers WJG, Bekkers RLM, Molijn AC, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncology. 2019 Feb;20(2):229-238.
- Centers of Disease control and Prevention (CDC) [Internet]. Reasons to get HPV vaccine. [updated 2021 Nov 10; cited 2022 Jun 20]. Available from https://www.cdc.gov/hpv/parents/vaccine/six-reasons.html
- Huh WK, Joura EA, Giuliano AR, Iversen OE, de Andrade RP, Ault KA, et al. Final efficacy, immunogenicity, and safety analyses of a nine-valent human papillomavirus vaccine in women aged 16-26 years: a randomized, double-blind trial. Lancet. 2017;390(10108):2143-59.
