Wednesday, 28 August 2013

HPV linked to cancer

Cervical cancer is one of the most preventable cancers, but many women are still diagnosed with it because of no screening or delayed screening.

This was expressed by Obstetrician and Gynaecologist, Dr. Erroll Byer, during the annual Ermine Holmes Memorial Lecture, on the topic “A Brief Sojourn across Some Cancers of Women”, held at the St. George Secondary School in Barbados, on Sunday night.

“There is no reason in today’s world for people to be dying from cervical cancer, especially when we have available pap smears and all other inventions to detect such.”

Dr. Byer explained that cervical cancer is an abnormality of the cervix, and that the majority of cervical cancer is caused by a virus called Human papillomaviruses (HPV).

According to him, most infections with high-risk HPV do not cause cancer.

“Most high-risk HPV infections occur without any symptoms, go away within 1 to 2 years, and do not cause cancer. These transient infections may cause cytologic abnormalities, or abnormal cell changes, that go away on their own.”

However, he pointed out that some HPV infections can persist for many years, and persistent infections with high-risk HPV types can lead to more serious cytologic abnormalities or lesions that, if untreated, may progress to cancer.

Dr. Byer, who is based in New York, went on to stress that it is important to note that more than half of sexually active people are infected with one or more HPV types at some point in their lives.

He said that recent research indicates that, at any point in time, 42.5 per cent of women have genital HPV infections, whereas less than seven per cent of adults have oral HPV infections.

He also indicated that low-risk HPVs, which do not cause cancer, can cause skin warts on or around the genitals or anus.

Which cancers are caused by HPVs? Dr. Byer stated that virtually all cervical cancers are caused by HPV infections, with just two HPV types, 16 and 18, responsible for about 70 per cent of all cases.

“The incidence of HPV-associated oropharyngeal cancer has increased during the past 20 years, especially among men. It has been estimated that, by 2020, HPV will cause more oropharyngeal cancers than cervical cancers in the United States.

“Other factors may increase the risk of developing cancer following a high-risk HPV infection such as smoking; having a weakened immune system; having many children (for increased risk of cervical cancer); long-term oral contraceptive use (for increased risk of cervical cancer); poor oral hygiene (for increased risk of oropharyngeal cancer); and chronic inflammation,” he highlighted.

The most reliable way to prevent infection with either a high-risk or a low-risk HPV is to avoid any skin-to-skin oral, anal, or genital contact with another person, stated Dr. Byer.

“For those who are sexually active, a long-term, mutually monogamous relationship with an uninfected partner is the strategy most likely to prevent HPV infection. However, because of the lack of symptoms it is hard to know whether a partner who has been sexually active in the past is currently infected with HPV.

“Research has shown that correct and consistent use of condoms can reduce the transmission of HPVs between sexual partners. Areas not covered by a condom can be infected with the virus, though, some condoms are unlikely to provide complete protection against virus spread,” he pointed out.

Dr. Byer continuously urged all women present to get regular Gynaecological check-ups. He further revealed that the Food and Drug Administration (FDA) has approved two HPV vaccines: Gardasil for the prevention of cervical, anal, vulvar, and vaginal cancer, as well as precancerous lesions in these tissues and genital warts caused by HPV infection; and Cervarix for the prevention of cervical cancer and precancerous cervical lesions caused by HPV infection. (TL)

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