Breaking the Silence on HPV and Cervical Cancer
Getting to know this crafty virus and what it means when you are told you have an HPV (human papillomavirus) infection.
By Izabella Kaczmarek
Having HPV, abnormal Pap tests or having cancerous cervical cells isn’t something that comes up regularly when friends are chatting about their recent or past sexual experiences. People usually shy away from mentioning a diagnosis even among friends, which makes sense. By talking about it you have to think about it and all those negative emotions of feeling dirty or ashamed that you have pushed down start creeping back up again.
First, I’ll mention that you shouldn’t feel dirty or ashamed and anyone — whether a friend or a lover —who makes you feel that way is not worth your time. Secondly, the more we talk about it the more we realize that HPV/Pap-related diagnoses are more common than we think, and by sharing experiences we realize that many people share the same. Having more information can help navigate from diagnosis to treatment to your daily life with less worrying about the “What ifs” and more support by knowing the facts.
So here is some of the basic information everyone should know about HPV and its association to cervical cancer:
1. HPV is one of the most common sexually transmitted infections.
Approximately 75-80 percent of people in their lifetime will have an HPV infection. This doesn’t mean that 80 percent of the current population is walking around with HPV but that as an individual who is sexually active in the span of their whole lifetime has an approximately 80 percent chance of potentially having some type of HPV infection (more about different HPV types below).
The reason that HPV is so common is that it can be transmitted through genital to genital touching so even if you are using any form of protection (condoms or dental dams) during the most intimate times there is still a chance of potentially transmitting HPV.
2. There are over 100 strains of HPV — some are designated as high risk (HR) and others as low risk (LR).
Most of them will just chill and not do anything until your body naturally gets rid of it — it’s a virus so you have the tools to fight it! Sometimes though, your body doesn’t fight the virus off and it doesn’t go away causing a persistent infection. When HR or LR strains of HPV become persistent it can cause some unwelcomed effects. About 40 known LR strains of HPV can cause genital warts while about 14 HR strains can potentially lead to different cancers with cervical cancer being one of them.
Just keep in mind that with these HR HPV persistent infections it still takes many years for cancer to develop, between 10–15 years most of the time. Also, these HR HPV strains which are persistent can also at a point in time be naturally removed by your body with no unwelcomed effects. We can’t really say why some HR HPV strains sometimes stay longer in the body and cause issues, while in others it eventually goes away. Hopefully with more research in this area we will be able to learn more about this crafty virus!
3. The difference between a Pap test and an HPV test.
Just in case there is some confusion, the Pap test and HPV test are two completely different testing methods. For the Pap test, also known as cytology, a healthcare professional will collect your cells from the cervix and send it to a lab to be observed under a microscope by a Cytologist for abnormalities. The HPV test is when a DNA sample is collected from inside the vagina canal close to the cervix. The sample is also sent to the lab and processed for presence of HR HPV strain using a molecular diagnostic machine.
4. Being High Risk (HR) HPV positive or having an abnormal Pap test doesn’t mean you have cervical cancer.
Being HR HPV positive only means that you are at a higher risk of potentially getting cervical cancer. If you only had an HPV test, doctors will recommend you do a Pap test. Depending on your Pap test result these are the following recommendations (please note that these vary between provinces and states):
Negative Pap Test (but HR HPV Positive): Usually recommended to get another Pap test either after 6 months or a year. This all depends on age and level of abnormalities found.
Positive Pap Test (and HR HPV Positive): Depending on the age of a person, recommendations will either be to wait 6 months for another Pap test or have a colposcopy. A colposcopy is where a doctor examines your cervix, vagina and vulva for signs of disease.
HPV tests are not recommended for women under the age of 30 years. This is because it’s more common for these women to have some type of HPV infection that usually clears with no issues. So, if you’re 30 years of age or younger and just received an abnormal Pap test and were also asked to come back in six months to do another Pap test — don’t panic! Pap tests have a sensitivity of just over 50 percent, which means that there is only a 50 percent chance that the test correctly identified abnormalities. Due to the low sensitivity, it is recommended to do this test once more to see if it comes back positive again before taking the next steps such as a colposcopy or biopsy (a sample of tissue is collected and sent to lab for further testing).
It’s okay to be concerned though, those feelings are valid! Don’t be afraid to ask your doctor for further clarification about your test results, the testing method itself, treatment, or more in-depth pathology of HPV. If you have a HR HPV strain and are following your doctor’s screening recommendations to monitor your cervix regularly, then you are doing everything in your power to ensure you catch and treat anything before it is too late.
Izabella is responsible for education and community coordination at Eve Medical, a social venture that is extending women’s health screening beyond the clinic into the privacy and comfort of women’s homes. Motivated by the 500,000 cases of cervical cancer that occur worldwide each year, Eve Medical developed and launched Canada’s first Eve Kit, the do-it-yourself at-home HPV screening service. On the side, Izabella is completing her Master of Public Health at the University of Waterloo with particular interests in addressing inequalities within the Canadian health system.
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