Cervical cancer is a term that describes an uncontrollable growth of cells in the outer layer of the cervix. HPV cervical cancer is a type of cervical cancer caused by the human papillomavirus (HPV) (Hirschmann, 2010). Cervical cancer is among the top most common types of cancer that are causes a lot of deaths all over the world. Having several sexual male partners, engaging in sexual activities at a young age, and having a weak immune system are some of the risk factors for HPV cervical cancer. HPV is sexually transmitted and can be prevented by using a vaccine for young girls, regular screening tests, and avoiding the risk factors. According to World Health Organization, about 510,000 new cases of cervical cancer are diagnosed yearly. HPV testing is a standard screening method in most countries for diagnosing the disease. This paper describes the epidemiology, history, causes, signs/symptoms, transmission, treatment, and prevention of HPV cervical cancer.
Epidemiology
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According to Centers for Disease Control and Prevention Report, cervical cancer is the fourth most common cancer in women worldwide. In 2012, there were 530000 new cases of cervical cancer, which represents 7.5% of female deaths due to cancer. Some estimates show that around 270,000 deaths occur yearly as a result of cervical cancer; of which 85% are in the developing countries. Developed countries have put in place various programs that give women access to screening services. Regular screening identifies pre-cancerous lesions at early stages, thereby giving a chance for successful treatment. The testing and early treatment are significant for preventing the disease. According to Del Mistro (2015), up to 80% of cervical cancer cases are prevented in the developed countries. However, the case is very different for the developing countries. Access to adequate screening services is usually quite limited, making it hard to identify the disease. In most cases, individuals identify the disease once it has progressed to advanced levels. Besides, there is no sufficient equipment for treatment of late-stage cancer, leading to increased death rate in developing countries (Louvanto, Isidean, & Franco, 2014).
Previously, cervical cancer was the primary cause of cancer deaths among women in the United States. However, the number of cases of cervical cancer and deaths due to it has drastically decreased over the last four decades. The reduction in the occurrence has been as a result of increased awareness and regular Pap tests among women. Early Pap tests discover cervical pre-cancer before it develops to a cancer, making it much more easily manageable. Del Mistro (2015) asserts that there are about 1200 new cases of HPV cervical cancer diagnosed yearly in the U.S. Majority of women infected by the disease are African American and Hispanic who do not have access to screening services. According to a study carried out in 2012, of 12042 women who were diagnosed with cervical cancer in the U.S., 4074 women died from it (“CDC – HPV-Associated Cancers Statistics,” n.d.). This clearly indicates that despite the efforts made by the U.S. government to control the disease, it still remains a threat.
As mentioned earlier, almost 70% of the total cases of HPV cervical cancer are reported in countries with lower levels of development. According to WHO, in sub-Saharan Africa, for 100,000 women tested, 40 new cases of cervical cancer are discovered, and 23 women die as a result of the disease. These are much higher than 7 and 3 per 100,000 women respectively in North America. The drastic difference is a result of different development levels in the two regions as manifested in lack of cervical cancer awareness in Africa, poor screening procedures, and inadequate treatment facilities among others (“WHO | Human papillomavirus (HPV) and cervical cancer,” n.d.).
Ranjbar (2015) argues that individuals who engage in sexual intercourse at an early age are at higher risk of developing HPV cervical cancer. Having multiple sexual partners also puts an individual at a higher risk of developing the disease. Smoking is another causative agent of HPV cervical cancer. Women who smoke are at a higher risk of developing the disease. Moreover, women with a weak immune system such as HIV-infected individuals are more likely to develop the disease as their immune system is weak and thus cannot address the HPV before it leads to cervical cancer. Such individuals are encouraged to maintain a nutritious diet as well as manage their sexual habits and lifestyle (Schiffman & Wentzensen, 2013).
History
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Human Papillomavirus is among the most common sexually transmitted diseases among both sexes. In the United States, it is perceived to be the common sexually transmitted viral disease. Worldwide, it causes around 260,000 deaths annually, of which 80% are from the developing countries. A German virologist Harald zur Hausen first linked HPV infections to cervical cancer in the early 1980s. According to Hausen’s studies, HPV has a higher association with cervical squamous cell carcinoma than that of smoking and lung cancer. In 1996 the World Health Association in collaboration with other organizations discovered that HPV was a causative agent of cervical cancer. Currently, we have more than 90 HPV genotypes of which 15 can cause cervical cancer. HPV 18 and 16 are the most common types of the virus and are responsible for approximately 70% of the total cases of cervical cancer worldwide (Hirschmann, 2010).
Causes
The primary cause of HPV cervical cancer is the human papillomavirus (HPV). There are several types of HPV, ranging from low-risk to high-risk. The high-risk HPV types are usually the ones that cause cervical cancer development. In Europe and the USA, HPV type 16 accounts for approximately half of the cervical cancer cases while type 18, 31, and 45, account for the other half (Hirschmann, 2010). Having many sexual male partners, early sexual intercourse, and weak immune system are risk factors for HPV cervical cancer
Symptoms
Most of the HPV infections do not usually cause diseases or have symptoms but instead resolve spontaneously. However, if an individual is persistently infected with various types of HPV, they may develop precancerous lesions. If these lesions are not cured, after an extended period it may lead to a cervical cancer . Typically the symptoms of cancer tend to appear once the disease has already reached an advanced level. Therefore, women with HPV cervical cancer are likely not to have symptoms until the disease becomes invasive. Irregular bleeding is one of the most common sign of cervical cancer. Bleeding may occur between menstrual periods or after a sexual intercourse. Other symptoms include experiencing vaginal discharge that contains an unpleasant odor, vaginal discharge mixed with blood, pain during intercourse, pain during urinating, and swelling of legs. All these experiences are potential signs of HPV cervical cancer or other severe health complication (“WHO | Human papillomavirus (HPV) and cervical cancer,” n.d.).
Transmission
Any sexually active woman is at risk of being infected with HPV that may lead to cervical cancer. Many individuals are likely to develop HPV shortly after becoming sexually active. HPV is a sexually transmitted disease; although penetrative sex not an exclusive way of transmission. Skin-to-skin genital contact is the primary mode of transmission of HPV (Hirschmann, 2010).
Treatment
Currently, there is no established treatment for HPV infections, although the cancers resulting from the infections can be treated. The common approaches to curing the precancerous changes in the cervix include loop electrosurgical excision conization, cryosurgery, surgical conization, and laser vaporization. Treatment of HPV cervical cancer highly depends on its stage and type of HPV. Therefore, physicians usually determine the stage of the disease as well as type of HPV that caused it before determining the type of treatment. Sometimes, HPV cervical cancer is treated like any other type of cancer, whereby patients are subjected to radiotherapy and chemotherapy (Hirschmann, 2010).
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Prevention
There is a variety of ways to prevent development of HPV cervical cancer. Frequent screening for cervical cancer significantly reduces the number of deaths due to the disease. Cervical cancer screening entails testing for both pre-cancer and cancer in healthy women who do not display any signs of it. Screening aids in indentifying pre-cancerous lesions that are easily treated, thereby avoiding cancer. HPV vaccination is another approach to preventing cervical cancer. Currently, there are two vaccines that protect individuals against particular types of HPV (Schiffman & Wentzensen, 2013). However, they should be administered to young girls. According to WHO, primary HPV cervical cancer prevention begins with vaccination of girls aged 9-13 years before becoming sexually active. Vaccination happens to be one of the best means of prevention. Moreover, community education, palliative care, and social mobilization are also cervical cancer preventive measures (Kricker, Burns, Goumas, & Armstrong, 2013).
Conclusion
HPV cervical cancer is a threat to any society, although it is much more prominent in the developing countries. Governments in collaboration with the appropriate organizations should come up with programs that would prevent and control the spread of the disease. Early identification of the virus is easily treated as opposed to the state when virus has matured and already caused cervical cancer. Moreover, prevention measures should be well laid in such a way that the possibility of disease transmission is minimized. The high death rates from HPV cervical cancer in developing countries imply that is not enough equipment and personnel to deal with the disease. Therefore, there is a need for developing countries to improve their equipment and deploy more efforts in fighting the disease.