First Published in Billy Termite Blogspot
Image credit: Snap_it: pixabay.com through Creative Commons CC0
By Rebecca B. Singson, M.D., FPOGS
 

Cervical cancer is the most common cancer in the female reproductive tract and the second most common cancer in women second to breast cancer. In 2005 alone, our National cancer Institute statistics reveals that there are 7,225 new cases of cervical cancer in the Philippines. Sadly, two-thirds of these cases are diagnosed when they are beyond the operative stage, such that 32.3 percent of them die in one year. The irony is that it is completely preventable, or at let diagnosable before it becomes life threatening.

Over a century ago, it was observed that women who developed cervical cancer were those with husbands who traveled frequently, or who had penile cancer, or whose wife had died of cervical cancer, or those who fleeted from one sexual partner to another. It was not until the past two decades that research has shown that one of the main causes of the cervical cancer is a virus called the Human Papillomavirus.

“It is a virus acquired through sexual contact and infects the lining cells of the genitalia and can be detected in 5-40 percent of women of reproductive age.”World experts on the Human Papillomavirus from 18 countries gathered recently to organize the Asia Oceania Genital Infection & Neoplasia (AOGIN), a research organization on genital infection: to share their latest research on the virus and to discuss global initiatives on cervical cancer prevention. It was revealed that there are 70 distinct site-specific types of this virus (meaning they will grow on one part of the body and not another). Of these, about 35 types are found in the anus and the genital areas, causing warts and cervical cancer, the most notorious being types 16 and 18. It is a virus acquired through sexual contact and infects the lining cells of the genitalia and can be detected in 5-40 percent of women of reproductive age. It has been found that infections are relatively short-lived lasting usually 8-10 months. This indicates that our bodies are indeed are capable of clearing the virus which is why in women over 30 years old, the prevalence drops down to 5-10 percent. It is in this group of women with persistent infections who are not able to clear the virus from their bodies that cancer in the cervix now has a chance to progress.

Because of the advances in our knowledge linking the human Papillomavirus to the causation of cervical cancer, it became necessary to develop the HPV test that would indicate if a woman is positive for the high risk strains of the virus that would increase her risk for cervical cancer.

The HPV DNA test using the Hybrid Capture II System, developed by a company called Digene, recently came out with a commercially available test which has a sensitivity of 90 percent and negative predictive value of over 90 percent. Available in major hospitals, the test entails taking cervical swabs, much like a Pap smear, using the brush from the Digene Cervical Sampler, Pap smear collected with a broom collection device and rinsed in the ThinPrep System PreservCyt solution may also be used to provide the same specimen for HPV testing. You can in fact ask your gynecologist to perform the test when you get your next pap smear.

It is important to understand the risk factors that increase your chances of acquiring the virus as well the co-existing factors that mediate progression to cancer.

“they evaluated cervical cancer risk in relation to sexual behavior, histories of specific venereal diseases, and hygiene practices, it was noted that early age at first sexual intercourse and increasing number of sexual partners were associated with significantly increased risk for cervical cancer.”In a case-control study of women with invasive cervical cancer in four Latin American countries where they evaluated cervical cancer risk in relation to sexual behavior, histories of specific venereal diseases, and hygiene practices, it was noted that early age at first sexual intercourse and increasing number of sexual partners were associated with significantly increased risk for cervical cancer. Risk increased over twofold among women reporting first intercourse at 14 to 15 years of age, compared to those who started after 20 years old. Having an uncircumcised male partner, cigarette smoking, an impaired immune system (such as AIDS patients), and poor nutrition (diet low on fruits and vegetables, and deficient in Vitamin A, C and folic acid) all increase one’s risk for cervical cancer.

“Risk increased over twofold among women reporting first intercourse at 14 to 15 years of age, compared to those who started after 20 years old.”It is vital for us to educate our youth that it is prudent for men as well as women to delay having sex as late as possible. This is because the earlier age you engage in sexual intercourse, the higher the chances for having multiple sexual partners which will increase the chances of acquiring the carcinogenic HPV.

“Promiscuity can be potentially lethal if one acquires the HPV virus or worse, AIDS, so sex should be limited to a significant other or to one destined to be a life partner. It was also found choosing a circumcised male partner can also decrease one’s risk for cervical cancer..”Men should realize that although the virus does not cause much harm to them in general other than having occasional causing unsightly penile warts, they can transmit the virus to their unsuspecting partners.

Promiscuity can be potentially lethal if one acquires the HPV virus or worse, AIDS, so sex should be limited to a significant other or to one destined to be a life partner. It was also found choosing a circumcised male partner can also decrease one’s risk for cervical cancer.

The HPV test may be recommended to all women over 30 years and above together with a pap smear. If both tests run up a negative, and the last three Pap smears were normal, you can even defer your next Pap smear test for three years. If your tests turns up positive, you may either opt for a repeat testing in one year or go for a colposcopy of the cervix to check for possible precancerous changes.

(Dr. Rebecca B. Singson is a Fellow of both Obstetrics and Gynecologic Society and Philippine Society of Cervical Pathology and Colposcopy and may be emailed at obmd@surfshop.net.hp)