About Vaccination Against and the Prevention of Cervical Cancer
Recently we have seen a push to raise the awareness of the importance of early detection and the prevention of cancer of the cervix. Women have heard about a vaccine against cervical cancer, and are asking if it is possible to have immunity to cancer, how cancer can be caused by a virus, and what they should do about it. There are answers to these questions!
Human Papilloma Virus, or HPV for short, is a common virus. More than one hundred different species of this virus have been identified, numbered, and their effects on different parts of the body catalogued. For example, HPV 1, 2, and 4 cause warts on the hands and on the legs, and HPV 6 and 11 can cause genital warts. About 30 species of HPV are transmitted via sexual contact and affect the sex organs, one of which is cancer of the cervix.
Most women and men are exposed to the virus during their lives and the majority will not be aware of it, for the simple reason that majority of the infections pass without symptoms and only a few of the people that are exposed will develop a phenomenon or significant disease.
Transmission of the virus
The virus is transmitted via sexual contact, anal/oral contact, or enough contact with the skin of the hand or fingers, even in relations without penetration.
Risk from the virus is greater, the earlier a person begins to have sex. The highest risk is between the ages of 15 to 19, but the risk of getting the virus continues throughout life
Multiple partners raise the risk of exposure to HPV, as does the sexual behavior of the mate. Truly in our sex partners we meet all of their partners, too, and are exposed to everything to which they have been exposed. The most dangerous mates are the widowers of women who died of cancer of the cervix. Men who are not circumcised also raise the risk of exposure.
Smoking also is a risk factor for the virus, and to the development of cancer of the cervix. Just another reason of many to stop smoking!
It is interesting to note that nuns are not a group at risk for HPV; and the absence of any sexual contact indicates a method to prevent infections. Also when the two partners have never had other mates is a deterrent, but it must be remembered that the virus can be transmitted even without penetration.
Using a condom is not a guaranteed deterrent to transmission of the virus, since HPV can be conveyed on the condom’s surface, passed to the skin, and can infect the genitals that way. However, using a condom with care can significantly reduce the risk of infection, and certainly is vital to the prevention of other sexually transmitted diseases.
So what kind of an infection is this? A sexually transmitted disease? Or something else? We must emphasize that most people exposed to this virus will not be adversely affected. And when there is an infection, the issues raised depend on which of the species of the virus is present.
Species 6 and 11 for example, cause genital and anal warts, called in medical terms Kondiloma Akominta, without much significance to the cervix. This is not a particularly dangerous disease and it doesn't have significant health implications, but clearly it is disagreeable and unpleasant condition.
There has been a significant rise in the diagnosis of genital warts throughout the world and also in Israel. It is possible to transmit Kondilomas in all stages of life, but it seems that genital warts are especially increasing in the young.
This disease is treatable, but surely it is more worthwhile to prevent it in the first place.
Species such as 16 and 18 can cause pre-malignant changes in the cervix and cancer of the cervix. These species do not relate to genital warts.
These species cause malignant changes to the DNA of the cells around the cervix and reduce the immune factors that could fight the cancerous growth. This occurs in most cases.
Cancer of the cervix to a certain degree is considered a sexually transmitted disease. However, it is a disease that develops at a slow pace, and it is possible to diagnose it in the stage before it becomes cancerous. Annual Pap tests detect the virus in its early stages. Most of the women that develop cancer of the cervix do not have routine Pap tests.
Again, cancer of the cervix is treatable, but it is always preferable to prevent it.
What is the vaccine against HPV?
The vaccination in use for girls from ages 9-26 is called Gardasil, successfully blocks the development of HPV species 6 and 11 (causing genital warts) and 16 and 18 (causing cervical cancer.)
Studies conducted in recent years have confirmed 100% efficiency both in prevention of cancer of the cervix and in prevention of genital warts. It is important to emphasize that the immunity works only for prevention and not for treatment of women that already have been diagnosed with cancer of the cervix. Vaccination is highly recommended for young women before they become sexually active.
The vaccine is given in three injections: On the first day, again after two months, and the last after six months. Generally there are no severe side effects to the vaccine, although moderate aching around the injection site or low fever can be expected in some people.
The vaccine is available for use in Israel, but has not yet entered the program of the standard vaccinations for the state of Israel. In order to receive an vaccination, approach your doctor and request an order to receive the vaccine. Testing by doctors and more information about the vaccine is possible in the women’s clinic at Hadassah Medical Center.
The vaccination does not remove the necessity to get annual Pap tests, and it also does not prevent other sexually transmitted diseases, so if there is a risk, condoms should be used.
It is only smart to vaccinate against HPV and prevent the diseases it causes!
This tip provided by Dr. Sagit Arbel-Alon
Gynecologist Department in Hadassa Ein Kerem