Shock, despair, confusion, surprise, anxiety, worry, guilt – the mixture of emotions some people experience after receiving the results of their cervical screening when it states that Human Papillomavirus (HPV) has been detected.
For some, it’s the first they’ve ever heard of the virus and for others it is a cause of relationship breakdown and fidelity questions. The lack of awareness, myths, misconceptions, taboo and stigma surrounding HPV, cervical screening and cervical cancer, I believe, all play a role in this.
A recent survey by YouGov for the Eve Appeal, the UK’s leading gynaecological cancer charity, found that only 15% of the people had a good understanding about cervical screening. This is a disappointing stat but also potentially explains why the numbers of people attending their screening appointments has continued to drop in recent years. In the UK, currently, only 1 in 3 attend. Why would you go for an assessment that is quite intimate and embarrassing (for many) if you do not understand its significance or the basis behind it?
What is cervical cancer and what is its connection with HPV?
Cervical cancer occurs in the cervix also known as the neck of the womb, the part that connects the vagina to the womb. It is the fourth most common cancer occurring in people with vaginas worldwide. It affects anyone with a cervix at any age but its incidence rates in the UK are highest amongst women aged between 30-34.
Cervical cancer is strongly associated with the virus, HPV. According to cancer research UK, HPV causes 99.8% of cervical cancer. It does this by causing changes to the cells of the cervix, which overtime can develop into cancer. There are over a hundred different strains of HPV including those that cause warts on the hands, face, feet, genitals etc. 13 of these strains are considered ‘high-risk’ as they are linked with cancer – of the anus, vagina, vulva, penis, mouth, throat and, as mentioned earlier, cervix. HPV is quite common and most people will have it at some point in their lifetime – around 80%! The good news is that our immune system is very good at getting rid of it – 90% of people will have cleared the virus within 2 years.
HPV is a sexually transmitted infection and this is likely where a lot of the taboo and stigma around it stems from – its link to sex. So many people assume that contracting it must mean that an individual has had multiple sexual partners or partook in high-risk sexual behaviours when in reality, it can be picked up from the very first sexual encounter, regardless of gender or sexual orientation and it does not have to involve penetrative sex. HPV can be transmitted through oral, vaginal or anal sex, sharing sex toys, fingering and so on. HPV does not often cause any symptoms so an infected person is usually completely unaware that they have it thereby facilitating its spread. Additionally, HPV can lay dormant/inactive in the body for a long time without being detected or causing any problems and then becoming active many years later. This is why it can be difficult to know at what point the virus was contracted and from whom.
Having said all of that, there are ways in which we can reduce our risks of being infected with HPV. This includes partaking in the HPV vaccination programme, which has been found to be 90% effective and its protection lasts at least 10 years. The vaccine is most effective when given before any sexually activity has begun. For this reason the vaccine is offered to both boys and girls aged 12-13 at schools in the UK. Not smoking, practicing safe sex, and building our immune systems can all help to reduce our risks too.
Awareness around HPV, its close link to cancer, how easily transmitted it is and the fact that it is preventable is paramount. A recent YouGov survey found that only 5% of people had a good understanding about HPV. This desperately needs to improve – knowledge is truly power and in this case lifesaving. Conversations surrounding HPV should be more open and free of judgement. They are crucial – especially as preventing HPV in turn helps to prevent cervical cancer.
How does cervical screening work and why is it important?
Cervical screening also known as smear test/pap smear is a test to check the health of the cervix. In the UK, women and people with a cervix between the ages of 25-64 are invited every 3-5 years depending on how old they are, where they live and their previous results. The test involves inserting a speculum which is a tool used to open up the vagina to clearly visualise the cervix and then using a brush to collect a sample of cervical cells which is then sent to a lab to be examined.
In England, Scotland and Wales, HPV primary screening is used where they test for high risk HPV first and if present cell changes are then assessed for. If these are found, the patient is referred for further assessments involving colposcopy -where the cervix is examined more extensively using a microscope and then treated accordingly. In this way, preventing cervical cancer from occurring at all.
Cervical screening literally saves thousands of lives a year. It prevents 70% of cervical cancer deaths and in the UK, it is free, as part of the national cancer screening programme. Anyone with a cervix is encouraged to attend their cervical screening appointment when eligible, whether they are lesbian, married, trans men or have only had one sexual partner their whole lives and regardless of how long it’s been since their last sexual encounter. Even individuals who have not had sex before can also partake, if they wish. This is your friendly reminder; please book your appointment when you’re due/invited. It could save your life!
If there is anything I would like you to remember after reading this, it is:
- Get your HPV vaccine and encourage others to if eligible
- Attend your cervical screening appointments when invited
- Please don’t smoke
- Raise awareness about what you have learnt in this article by sharing the knowledge with family and friends. Knowledge is truly power.