Sunday, August 24, 2008

The truth about HPV

The truth about HPV

New campaign to spread the word about the virus


Have you been aware of the following facts?

Cervical cancer is the most common cancer found in Thai women. On an average, seven women die from the disease every day. About 6,000 new cases of cervical cancer are diagnosed in Thailand each year. This disease is caused by the Human Papilloma Virus (HPV). Eight out of 10 women are infected with HPV by the age of 50. HPV occurs most commonly among young adults between the ages of 18 and 28.

Getting to know HPV

The National Cancer Institute recently launched a TV campaign to raise awareness on the disease. HPV can be sexually transmitted and most women who are infected are unaware of the fact.

Dr Thiravud Khuhaprema, institute director, says that Thai people do not know much about cervical cancer. A recent survey found only 20 per cent of women know about the disease.

The doctor says that though the cancer itself is not contagious, it is HPV that is the cause of worry. According to Dr Thiravud, there are about 200 subtypes of Human Papilloma Virus, 40 of which are sexually transmitted. Of the 40 subtypes, about two - Types 16 and 18 - are major causes of cervical cancer.

"HPV is an sexually transmitted disease. That means men and women who have many sexual partners or are sexually active are at high risk of infection," says Dr Thiravud.

A man contracting HPV may have a cancer in his sexual organ or anus, or he can be a carrier of the virus, and spread it, without knowing it.

Even a condom cannot be 100 per cent protection

Dr Wisit Supakarapongkul, president of the Thai Society for Colposcopy and Cervical Pathology, says HPV is easily spread via skin-to-skin contact. A person can easily contract the virus from their partner even if it is not on his or her sexual organ, so wearing a condom does not mean 100 per cent protection against this disease.

"Even when you use a toilet, if someone with HPV touches it, then you can be infected," says the doctor.

However, he urges people not to panic. Most often, the body's immune system clears the infection.

Infection of high risk HPV

The following are factors that cause an HPV infection to easily develop into cervical cancer.:

- Multiple sexual partners

- Having sex at a young ages will put you at risk as the cervical tissue are delicate and prone to an infection.

- HIV/Aids

- Smoking. Nicotine also weakens the cervical cells.

- Long-term use of the contraceptive pill (longer than 10 years)Incubation period

From the day you are infected with HPV, it normally takes 10 years or more for the cancer to develop. As people mostly get infected with HPV between the ages of 18 and 28, they suffer from cancer at the age of 35 and above.

Treatments during the incubation or precancerous period produce effective results.

Screening method for HPV

- Conventional pap smear. A pap smear is a test to look for cervical or vaginal cells that are cancerous or could be potentially pre-cancerous. The sample of cells is smeared on glass slide. The test allows the infection to be treated promptly at an early stage.

- Liquid-based pap, a testing method in which the sample of cells is preserved in liquid rather than smeared on a microscope slide, also providing reliable results.

- HPV test-typing. This new method is done by collecting the cervical tissue for HPV DNA test, to determine if the patient is infected with high-risk strain of HPV that increases a chance for the cancer to develop.

Precancer treatments

Dr Wisit says an HPV infection is treatable when it is detected at an early or precancerous stage. But after it develops into cancer, the treatment will be much more difficult and prolonged.

The following are a list of some precancer treatments:

- Cold Knife Conization (CKC) is a procedure to remove a small cone-shaped sample of tissue from the cervix and examine under a microscope for cancer. The biopsy serves as a treatment if all of the diseased tissue is removed.

- Surgery or laser treatment, to cut off or use an intense light to destroy the infected cells. The new cells will regenerate afterwards.

- Cryotherapy. The method involves freezing and destroying the abnormal cells with liquid nitrogen. The procedure generally takes five to 15 minutes. It can be painful, both during and after the procedure.

- Loop Electrosurgical Excision Procedure. The abnormal cells are removed with an electrical current. The method is painless and the patient is discharged right after the treatment.

The best prevention:

HPV vaccine

The best way to prevent HPV infection is to get vaccinated. A research has confirmed safety of the vaccine, with small side effects, such as low fever or swelling in the area of injection.

The vaccine will have better effect in young girls than adults. The efficacy of the vaccine is proved to last for at least five years.

Advice for cervical cancer prevention

- Make sure you have safe sex, and avoid early sexual intercourse.

- Get a pap smear test every year, after you cross the age of 30, or two years after you start having sex.

- Getting an HPV vaccine can reduce the risk of cervical cancer by 70 per cent.

Is it necessary to have a HPV screening test before vaccination?

Those below the age of 26 can get the vaccine without having an HPV test.

However, women who have had sexual experiences are recommended to undergo a pap smear or other HPV screening test first. Any abnormalities found must be treated before getting the vaccine.

Dose and cost

Dr Wisit says the appropriate time to get an HPV vaccine is between nine and 26 years old. The sooner you get the vaccine, the better the prevention.

The vaccine has three doses, all given over the six-month period. The services are available in general private hospitals. Cost is about 4,000 baht per dose, or 12,000 baht for the three-dose package.

Is the vaccine helpful for women with sexual experience?

The vaccine promises highest efficacy for those who never contract the virus, or have never had sex. However, for those who are sexually active, the vaccine is still beneficial as it helps prevent the infection of other HPV subtypes.

Consult the doctor before getting a vaccine.

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