HPV Screening: Cervical cancer prevention before symptoms appear

     HPV Testing (Human Papillomavirus) is a crucial screening procedure to prevent cervical cancer before any symptoms appear. Cervical cancer is a frequently diagnosed cancer in women. This test helps you determine your risk of developing cancer while asymptomatic, at an early stage, or at a precancerous phase, allowing for timely treatment. Today, I would like to explain the benefits of screening and how everyone can plan their care and protection against HPV.

Because this is essential knowledge for both women and men, encompassing treatment methods, how to observe symptoms upon infection, HPV vaccination information, and safe locations to receive the vaccine.

What is HPV, and How is it Treated?

The HPV (Human Papillomavirus) family includes more than 100 strains, but only about 40 strains cause diseases in humans. Transmission occurs through direct skin-to-skin or mucosal contact, such as sexual contact involving the genitals, anus, oral cavity, or throat. Crucially, it often shows no symptoms and can take 10-20 years to develop into cancer. The primary strains commonly encountered include:

• Strains 6 and 11 cause genital warts (condyloma acuminata).
• Strains 16 and 18 cause genital and anal cancers.

Vaccines for HPV Prevention

Because infected individuals are usually asymptomatic, they can unknowingly pass the virus to others. HPV is therefore a silent threat that leads to severe diseases like cancer. Although there is currently no cure to eradicate the HPV virus itself, it can be effectively prevented through vaccination. In Thailand, 3 types of vaccines are available:

• Bivalent Vaccine (2-valent) covers strains 16 and 18.
• Quadrivalent Vaccine (4-valent) covers strains 6, 11, 16, and 18.
• Nonavalent Vaccine (9-valent) covers strains 6, 11, 16, 18, 31, 33, 45, 52, and 58.

Receiving the vaccine is an excellent way to prevent infection and minimize the risk of developing HPV-related cancers, alongside practicing safe sexual behavior.

Diseases Associated with HPV Infection

Diseases that can develop following an HPV infection: HPV is a primary cause of several types of cancers, including:

1.  Cervical Cancer

High-risk types of HPV, particularly strains 16 and 18, are the main cause of cervical cancer, found in almost all cervical cancer cases (99.7%). This virus is sexually transmitted; high-risk strains can lead to cervical cancer, while low-risk strains cause genital warts.

2.  Vaginal Cancer

Vaginal cancer is a rare type of cancer that usually originates in the cells lining the vagina. Key risk factors include:

• Sexually transmitted HPV infection
• Being 60 years of age or older
• A history of abnormal cells in the vagina or cervix
• Previous exposure to the drug Diethylstilbestrol (DES)
• Cigarette smoking and HIV infection

Since this disease is strongly linked to HPV, getting vaccinated and using protection during sexual intercourse can significantly reduce your risk.

3.  Anal Cancer

Anal cancer often presents with symptoms similar to hemorrhoids, such as abnormal bowel habits, narrowed stools, or rectal discharge/bleeding. The primary cause is an HPV infection, especially strains 16 and 18, transmitted through direct skin contact or sexual contact. Other risk factors include:

• Increasing age
• Smoking
• Weakened immune system, such as having an HIV infection
• High-risk sexual behaviors, such as having multiple sexual partners

Treatment approaches depend on the stage of the disease, its severity, and the patient's overall health.

4.  Oropharyngeal Cancer (Oral & Throat Cancer)

Oropharyngeal cancer is a serious malignancy arising from abnormal cell growth in the oral cavity and throat area, which can grow and metastasize to other parts of the body. Key symptoms include persistent oral ulcers, lumps in the mouth, changes in voice, difficulty swallowing, or feeling pain and numbness inside the mouth. Contributing risk factors include:

• Alcohol consumption
• Chronic HPV infection
• Cigarette smoking
• Betel nut chewing

5.  Genital Warts

     Genital Warts (Condyloma Acuminata) is a sexually transmitted infection caused by low-risk strains of the HPV virus, such as types 6 and 11. It results in bumpy, cauliflower-like growths or fleshy lesions around the genitals, groin, or anus, sometimes accompanied by itching, burning sensations, or unusual discharge. The virus thrives in warm, moist areas. Although manageable with treatment, the HPV virus may still persist in the body. Long-term protection can be achieved via the HPV vaccine.

What are the Symptoms of an HPV Infection?

     The infection can either present with clear signs or remain completely asymptomatic. In symptomatic cases, patients may exhibit indicators pointing to an HPV infection, ranging from abnormal vaginal bleeding to other associated symptoms.

Other Associated Symptoms

Concomitant signs can include pelvic pain, swollen lymph nodes in the groin, painful or burning urination, or other related conditions:

• Genital Warts: Appear as small flesh-colored bumps around the genitals, anus, or surrounding areas.
• Abnormal Vaginal Discharge: May have an unpleasant odor, be tinged with blood, or occur in unusual amounts.
• Genital Skin Changes: Such as persistent sores, lumps, or visible alterations in the skin texture.

Who is at Risk of Contracting HPV?

HPV is a highly contagious virus spread through sexual contact. Even individuals with a single sexual partner can still be at risk. Therefore, groups at an elevated risk of HPV infection include:

• People with active sexual lives: Particularly those who have had multiple partners.
• Teenagers & Young Adults: Individuals who become sexually active at an early age.
• Immunocompromised individuals: Such as those living with HIV or taking immunosuppressive drugs.
• History of STIs: Those with a history of infections like herpes or gonorrhea.
• Smokers: Smoking significantly weakens the body's immune defenses.

Other Contributing Risk Factors

• Pregnancy at a young age
• Having multiple childbirths (high parity)
• Inconsistent condom use during sexual encounters

How to Prevent HPV Infections

Although HPV is a silent threat to long-term health, it can be effectively prevented. The absolute best methods of prevention include:

• HPV Vaccination: Acts as a powerful shield, drastically lowering infection risks.
• Regular Health Screening: To detect HPV strains and cellular abnormalities at an early, highly manageable stage.
• Safe Practices: Adopting safe sexual health practices, such as consistent and correct condom usage.

When Should You Get the HPV Vaccine and Which Valency Should You Choose?

The HPV vaccine serves as the single best shield against cervical cancer, especially when administered at a younger age when the body's immune response yields the highest antibody levels.

• Optimal Age Window: It is recommended to initiate the HPV vaccine starting from 9 years of age for both boys and girls.
• Vaccine Types (Valency): Currently, 2-valent, 4-valent, and 9-valent options are available. The ideal choice depends on individual risk factors and goals; please consult a physician.
• Clinical Benefits: Protects against HPV-driven malignancies such as cervical, vulvar, vaginal, anal, and oropharyngeal cancers, alongside preventing genital warts.
• Recommendation: Consult with a healthcare specialist to design an optimized personal vaccination schedule.

Ensure Absolute Peace of Mind with HPV Vaccination at Ramkhamhaeng Hospital

     Ensure complete safety and peace of mind by getting your HPV vaccine at Ramkhamhaeng Hospital—a facility utilizing international medical standards, expert personnel, and fully certified vaccines capable of preventing cervical cancer by up to 90%. While mild side effects may occur, they typically resolve spontaneously within 1–2 days. For further inquiries or to schedule a health check-up, please consult our medical specialists directly at the hospital.