With the continuous development of the economy, the awareness of the significance of healthy sexual and reproductive behaviour has dramatically deepened, among which the cervical health conditions have been taken into serious consideration. As technology keeps advancing, the detection of cervical precancer and cancer becomes easier. This passage will be covering the cause, transmission, and the prevention of cervical cancer, while offering tips on vaccination.
Several factors have been discovered to be contributing to cervical cancer. Mainly triggered by the infection of human papillomavirus or HPV for short, cervical cancer can also result from the joint effect of microbes such as herpes simplex virus (HSV), Trichomonas vaginalis, and Chlamydia trachomatis. On top of this, malnutrition, poor hygienic conditions, and smoking exposure have been discovered to be the contributing factors to the disease.[1]
Categorised as the first class of carcinogen by International Agency for Research on Cancer (IARC), HPV and HSV can either bind their DNA with the DNA of the cell, or create episome floating in the cell nucleus, both of which express certain proteins, taking part in the cytoregulation process, thus increasing the risk of carcinogenesis.[2] Around 80% of people will be infected with different strains of HPV in their lifetime, while 70% of cervical cancer is triggered by HPV 16 and HPV 18.[3]
There are also diverse explanations as to the routes of transmission of HPV. According to textbooks, HPV is transmitted through sexual behaviours, mother-infant contact, and skin contact. However, the CDC of the US suggests that there is no firm evidence suggesting that HPV can be transmitted through hard surfaces like the toilet seat or the doorknob, nor is it contagious in bathtubs.[4] Therefore, there is no need to concern about using public toilets or taking a bath. In general, HPV has relevantly low infectivity, which leads to our next topic: prevention.
Having known the basic causes of cervical cancer, the HPV, and its transmission, it is crucial to keep in mind that cervical cancer is preventable. Sexual healthiness ranks first when it comes to prevention. It is advisable not to have high-risk sexual behaviours and using condoms can also decrease the risk of infection. Besides that, it is of great significance to have regular screening. TCT and HPV tests are performed when doing the screening. TCT helps to identify cancer cells and pathogenetic microbes while HPV tests can detect HPV if it exists. Vaginal microscopy can be of assistance if needed. For females in their 20s, a TCT should be taken every 3 years while for those aged between 30 to 65, an additional HPV test should be taken every 5 years. For those aged above 65, it is not necessary to take these if no risk factors were reported. Apart from that, personal hygiene and habits should be taken into account, and quitting smoking is also highly suggested.
Lastly, vaccination proves to be an effective way of preventing cervical cancer. There are currently 3 types of HPV vaccines: the 9-valent, quadrivalent, and bivalent vaccine, covering different numbers of strains of HPV. It is recommended to get vaccinated at the age of 9 to 12 for the highest immune rate, but vaccination can also be done between the age of 9 and 45.[4] It is suggested that one should be vaccinated before having the first sexual intercourse for best prevention. Regardless of the price, the 9-valent vaccine has the prevention rate of 92% cervical cancers as well as other related STDs. However, there are also downsides of vaccinations. Let alone allergic reactions, the lasting time proves to be around just one decade, and there is still a risk of getting infected by other strains of HPV that can lead to cancer. Above all, it is taking regular screening that matters in the long run.
Through the research, several conclusions can be made.
1. Cervical cancer is mainly caused by the infection of HPV, accompanied by other environmental factors.
2. HPV is transmitted mainly through sexual contact, which indicates the significance of safe sexual behaviours.
3. Cervical cancer is preventable if regular screening and early treatment are taken.
4. HPV can be effectively prevented through vaccination.
In the world where the level of sex permissiveness is getting higher, the awareness on the importance of healthy sexual behaviours should keep up as well. Thanks to the advancement of medicine and technology, vaccination and medical screening make it possible for us to fight against HPV infection and make an early diagnosis. With the joint effort of the entire society, we are able to rid human from HPV, thus lowering the risk of cervical diseases, resulting in better health conditions.
References
- https://dxy.com/disease/3230/detail
- Hu Jiachang, Li Fang. Research progress of integration of high-risk HPV DNA with host genes and carcinogenesis[J]. Progress in Obstetrics and Gynecology,2015,24(5):384-386.(in Chinese)
- https://zhuanlan.zhihu.com/p/112397074
- https://www.cdc.gov/hpv/hcp/schedules-recommendations.html