Cervical Cancer and HPV Vaccine
Cervical Cancer and HPV; is cancer of the lower part of the uterus (cervix), called the cervix. The cervix is the part of the uterus that opens into the vagina and expands during childbirth. Cervical cancer is the most lethal cancer among women and continues to be common in developing countries. Women with cervical cancer caught early have a 5-year survival rate as high as 92% after diagnosis. The main reason for the improvement in cervical cancer outcomes is the Pap smear test, which provides early detection of precancerous cells. Cervical cancer will mostly affect women in their 30s, 40s and 50s, although about 20% are diagnosed in women over the age of 65.
Cervical cancer is caused by a long-lasting, persistent high-risk HPV infection. HPV infection is quite common; most sexually active people are infected. However, most HPV infections (Cervical Cancer and HPV) are asymptomatic and do not progress to cervical cancer. Approximately 13 HPV types have been identified as high risk and capable of causing cervical cancer. HPV 16 and 18 are the two most common high-risk HPV types associated with cervical cancer in Turkey.
It is easy to reduce the risk of cervical cancer with Pap smears and HPV testing. In a Pap test, a sample of cervical cells is taken and analyzed for abnormalities. Abnormal Pap smear results may require further testing, such as a cervical biopsy, which can reveal either precancerous changes or cancer. Most cervical cancers occur in women who have never had a Pap smear. In these cases, the pre-cancerous cells have time to progress to cancer before they are caught and treated, but the cancer is not caught because the Pap smear was not taken. HPV tests can identify if any high-risk HPV types are present, allowing further monitoring for cancer risk.
Cervical Cancer Risk Factors
The causative agent in almost all cases of cervical cancer is currently known as HPV. Most people infected with HPV do not have serious problems, but a very small percentage may develop cancer. HPV increases the chances of developing many types of cancer, such as cancer of the mouth, throat, vagina, vulva and cervix.
Women with the following characteristics are more likely to develop cervical cancer:
- Women who have been diagnosed with HPV Women who have not had the HPV vaccine
- Women who have not had regular Pap smears for precancerous lesions
- Women with abnormal Pap smear results or a history of pre-cancerous cervical cell changes
- Women with a previous history of cervical cancer
- Women with multiple sexual partners who have an increased risk of HPV infection
- Women with partners who engage in high-risk sexual activity (for example, if any partner in a couple has sex with multiple partners, both partners in the couple are at risk of HPV infection)
- Women who had their first sexual intercourse at an early age
- Women with an autoimmune condition, HIV infection or any condition that weakens the immune system. A weak immune system increases a woman’s risk of developing cervical cancer by increasing the likelihood of developing HPV infection.
- Women who smoke
Cervical Cancer and HPV Cervical Cancer and HPV
Cervical Cancer Symptoms
Cervical Cancer and HPV; In the early stages of cervical cancer, there are typically no symptoms. The earliest sign will probably be an abnormal Pap smear detected during a routine gynecological examination. Cervical cancer develops very slowly, so the symptom-free period can last for years. The stage at which abnormal cells are detected in the Pap smear is 100% curable. Advanced cervical cancer is most common in women who do not have regular Pap smears or who have abnormal Pap smear results and do not continue follow-up.
As cervical cancer develops, women will develop the following symptoms:
- Abnormal vaginal bleeding, such as bleeding between periods, bleeding after sexual intercourse or bleeding after menopause. However, abnormal vaginal bleeding can also be caused by other conditions.
- Watery, pink, pale and persistent vaginal discharge
- Longer menstrual periods with more bleeding than usual
Very advanced cases of cervical cancer that have spread to the bladder, intestines, lungs or liver will show the following symptoms
- Loss of appetite
- Weight loss
- Back pain and/or leg pain
- Bone pain and fractures
- Fatigue, exhaustion
- Urine and stool leakage from the vagina (in advanced stages)
HPV VACCINES
There are currently two HPV vaccines (Cervical Cancer and HPV) from two different companies with known efficacy. One of these is Cervarix®, a dual vaccine from GSK, and the other is Gardasil®, a quadrivalent vaccine from MSD. For both of these vaccines, girls and boys aged 11-12 years can be vaccinated before sexual intercourse, if possible; however, even if sexual intercourse is possible, girls and women aged 9-26 years can be vaccinated in three doses without HPV testing. It has also been shown to have the same effect in women up to the age of 43.
For cancer, both vaccines contain antigens against HPV 16 and 18, which are responsible for 70-80% of cervical cancers. The vaccines provide 100% protection against these two HPV types. The quadrivalent vaccine (Gardasil®) also provides 100% protection against HPV 6 and 11, which are responsible for 90% of warts. Even with the vaccine, Pap smear screening will continue, as cancer can develop with other types.
For both vaccines to be effective, three doses must be given intramuscularly (in the arm or buttock). The quadrivalent vaccine should be repeated at 2 and 6 months after the first dose. The double vaccine should be repeated at 1 and 6 months after the first dose.
It should not be started in pregnant women. If you become pregnant after the first dose, you should start from scratch after pregnancy. If there is a pregnancy after two doses, the third dose can be safely administered during breastfeeding from the 6th week after birth. There is no need to terminate the pregnancy if the vaccine was given without knowing that she was pregnant; no increase in congenital disability has been shown. It can be safely administered during breastfeeding. In the light of current knowledge, booster (repeat dose) is not necessary.
Since these vaccines do not contain live or dead virus, they cannot cause HPV (Cervical Cancer and HPV) infection, HPV-related cancer or death as side effects. Only simple side effects such as redness, pain and swelling related to the vaccination site, which are present in all vaccines, can be seen.
Except for large private health insurances, the vaccine is not reimbursed by reimbursement institutions.
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