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Understanding the Cancer-Causing Virus, HPV

 
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Cancer related image Photo: Getty Images

There are three viruses known to cause cancer, one of them is HPV or Human Papillomavirus. While this virus has been in the news lately, it has actually been around for several hundred years.

HPV is typically referred to as an STI (sexually transmitted infection) because it is transferred, for the most part, during sexual activities. I say activities because it does not require actual intercourse to spread the virus but merely skin-to-skin contact predominantly with mucous membranes such as occur in the vagina, mouth and anus.

HPV has an incubation period of approximately three months after which, symptoms may appear. However, this is often called the symptomless disease because, more often than not, it produces no symptoms at all. The body’s immune system can then suppress the virus and it can remain dormant in the body for weeks, months and even years. Because of this, it can return again later in life for a multitude of reasons not fully understood.

Some of these may include a decrease in the person’s immune system or an increase in viral load, the amount of the virus the body is exposed to. Reducing the viral load is one reasons why wearing condoms, even if in a monogamous relationship, remains important.

The human papillomavirus has what are referred to as high and low risk strains. A strain refers to the same virus with a slight difference. There are more than 150 strains of HPV documented to date. Some of these low risk strains cause such things as the warts found the hands and plantar warts on the feet. Other low risk strains cause genital warts.

High risk strains of HPV, thirteen of which are regularly tested for, can, if persistent, result in dysplasia or a changing within the normal cells. Dysplasia can occur in varying degrees basically low, intermediate and high risk for causing cancer.

Dr. Ralph Richart, M.D., and pathologist at Columbia Presbyterian Medical Center in New York City developed the term intraepithelial neoplasia (IN) meaning an abnormal change within the epithelial layers of the skin. The letter symbolizing the part of the body affected comes before such as CIN for cervical intraepithelial neoplasia and so on. This is further broken down into CIN1, CIN2 and CIN3/CIS (carcinoma in situ).

Up to sixty percent of CIN2 lesions can regress themselves however, there are still forty percent which may not. The current recommendations by the ASCCP (American Society of Colposcopy and Cervical Pathology) still calls for treatment of CIN2 lesions or greater in order to reduce the number of potential cancers.

The majority of CIN3 lesions, if untreated, will go on to result in cancer. The numbers utilized basically explain the degree of tissue which is affected with abnormal cells. Simply put, CIN1 affects one-third, CIN2 two-thirds and so on.

While there is no cure for HPV, there is treatment for the various conditions it can cause if caught early. There is also a vaccine which protects against two low risk(those that cause ninety percent of genital warts) and two high risk strains of HPV (those that cause ninety-nine percent of cervical cancers and over eighty percent of anal cancers).

Routine screening via Pap smear and also anal Pap by a colorectal surgeon or other physician can result in early detection of these strains allowing the patient to receive the more scrupulous follow-up that he or she requires.

Ask your physician about the HPV vaccine, as well as the anal pap, which has been slow to gain acceptance amongst the medical community as a whole. Patient advocacy can help to chance this going forward, and when it comes to cancer, the majority of types diagnosed early maintain a much better prognosis.

Resources:

http://www.thecmafoundation.org/projects/HPV/ProviderResources_CME.aspx
http://dceg.cancer.gov/about/staff-bios/kreimer-aimee
http://www.cdc.gov/std/hpv/HPVWebcast.pdf
http://www.sciencedirect.com/science/article/pii/S1043148905000126
http://www.iuhpe.org/uploaded/Activities/Scientific_Affairs/CDC/CCPP%20Training%20Module%20-%20Epi%20and%20Natural%20History%20of%20CaCx.pdf
http://www.iuhpe.org/uploaded/Activities/Scientific_Affairs/CDC/CCPP%20Training%20Module%20-%20Epi%20and%20Natural%20History%20of%20CaCx.pdf
http://www.traveldoctoronline.net/epidemiology-of-human-papillomavirus-infection-in-men--cancers-other-than-cervical-and-benign-conditions-MTg4NDc1NTQ=.htm
Histology, classification and natural history of cervical intraepithelial neoplasia (CIN) www.cme.hu/dlObject.php?aid=523&/...pdf Chap 42 page 7.

Reviewed July 25, 2011
by Michele Blacksberg R.N.
Edited by Shannon Koehle

Add a Comment4 Comments

Thank you for pointing this out. It is the high risk strains togther which cause 99.9% of cervical cancers, HPV16 and 18 which are covered by Gardasil are responsible for 70% of the 99.9%. That should have been worded differently to clarify it for the reader.

July 29, 2011 - 3:31pm
EmpowHER Guest
Anonymous

I'm concerned that you may have some facts wrong. Forgive me if I'm mistaken, but I believe that Gardasil protects against 2 high risk strains of HPV that cause up to 70 percent of cervical cancer, not 99 percent. In fact, at least one study found that even prior to the introduction of Gardasil, one of those strains had lost ground to others and the two highest risk were causing 66 percent of cervical cancers in that area.

I believe that Cervarix protects against a couple more strains but not against genital warts.

LOL about comment to dating site ad.

July 29, 2011 - 9:27am
EmpowHER Guest
Anonymous

I have HPV and I am an engineer who works for the largest STD dating and support site STDslove. com. I have to tell you a secret, you can choose not to believe me. But the truth is that this site has more than 1,880,000 members and about 80% members are good looking in my estimation.

Unfortunately, STD rates soar worldwide and most people with STDs don't even know that they have them. The government should grant more money for STD education to lower the rates of STD transmission.

July 27, 2011 - 12:31am
(reply to Anonymous)

Anonymous - You are absolutely right, the government has failed miserably in educating the public about HPV. The only real "education" people have received is from the pharmaceutical companies who make the tests or the vaccines who of course have conflicts of interest. Unfortunately most peole think that HPV only affects the cervix because of Merck's campaign portraying it as a way to prevent cervical cancer. As a result, few are aware of how far HPV can reach and that if affects many other areas as well.

The medical community also needs to educate their members because much erroneosu information is passed on by poorly educated doctors and nurses as well. The ASCCP has a wonderful CME program on HPV but not well advertised so few aside from their direct members are aware of it. The more the medical community understands about this virus the better the care they can provide to their patients.

When it comes to STD dating sites, I have heard many individualas mentino that if they already have an STI and are well aware from the nature of the site alone that the members will have an STi as well that the last thing they want is a second STI. I can understand this especially as somone who has dealt with multiple cancers from HPV. One STI is enough for me personally but others may be willing to venture into relationships yet again.

July 27, 2011 - 5:00am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.