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HPV and Cervical Cancer

HPV & Cervical Cancer: The Facts

Cervical cancer is one of the most prevalent cancers in women worldwide and one of the highest causes of women's cancer-related deaths1—more than 500,000 new cases of cervical cancer are diagnosed annually.2 Furthermore, cervical cancer disproportionately affects women who don’t yet have access to screening; more than 80% of newly diagnosed cases and nearly 85% of deaths are in low and middle income countries.1 Yet, cervical cancer is nearly 100% preventable, with proper vaccination, screening, and treatment.

The link between cervical cancer and human papillomavirus (HPV) has become clear over the past few decades. It is well-known that persistent infection with specific types of HPV account for nearly all cases of cervical cancer.2 Because cervical cancer rarely causes overt symptoms in its early stages—when treatment is most effective—it is important to screen for high-risk HPV infections that are at the greatest risk of progressing to cervical precancer and cancer. Identifying women at risk, before disease develops, is an important part of prevention. With today's technologies, no woman should die from cervical cancer.

42% of women ages 14-59 in the U.S. are likely to be infected with HPV at any time3
Worldwide, 8 out of 10 women will have an HPV infection by age 504
500,000 new cases of cervical cancer are diagnosed annually worldwide2
Cervical cancer leads to approximately 311,000 deaths worldwide each year2

HPV: A Link to Cervical Cancer

HPV is a common sexually transmitted infection, and most women will not know that they or their partners have it. HPV is most often spread through sexual intercourse. It can also be transmitted via non penetrative sexual activity.5

HPV is a small, double-stranded DNA virus that affects epithelial cells such as skin and mucous membranes. There are more than 150 HPV genotypes, about 30 of which are sexually transmitted. Most HPV strains are harmless; however, a handful of high-risk types cause infections that can develop into cervical cancer.

There are 14 high-risk HPV types that are detected in over 99% of cervical cancers.2,3 Two HPV types, HPV 16 and HPV 18, are associated with 70% of all cervical cancers.3 HPV 16 causes approximately 55% to 60% of cervical cancer cases, and HPV 18 accounts for 10% to 15%.2 Globally, genotypes HPV 16 and HPV 18 are more oncogenic and likely to progress to high grade cervical disease than all other high-risk HPV genotypes combined.6

The Progression to Cervical Cancer

While most HPV infections resolve on their own, some infections with high-risk HPV types can progress to low-grade cervical intraepithelial neoplasia (CIN1) within a few years of infection. Some persistent HPV infections can progress directly to high-grade CIN2, in which moderately abnormal cells are found within the cervical epithelium, or CIN3—the immediate precursor for cervical cancer—in which abnormal cells are found throughout all layers of the cervical epithelium.  It is important to note that it is possible for lesions to resolve and the infection to clear at all stages of CIN, although higher-grade CIN cases are less likely to regress.3 If left untreated, CIN2 or CIN3 can progress to cervical cancer years or decades after the initial infection.6

Early treatment at the precancer stage is critical because in this stage, high-grade lesions and cervical cancers confined to the cervix can be completely excised, and the cure rate reaches as high as 98%.7 If cervical cancer is detected and treated before it has spread, the 5-year survival rate is approximately 90%.8

 

References

  1. Human papillomavirus (HPV) and cervical cancer 24 January 2019. https://www.who.int/en/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer (accessed 29April2020)
  2. Cancer Today, International Agency for Research in Cancer (IARC) GLOBOCAN 2018 Registry: https://gco.iarc.fr/today/data/factsheets/cancers/23-Cervix-uteri-fact-sheet.pdf (accessed 29April2020)
  3. Hariri S, Unger ER, Sternberg M, et al. Prevalence of genital human papillomavirus among females in the United States, the National Health and Nutrition Examination Survey, 2003–2006. J Infect Dis. 2011; 204(4):566-73. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21791659  Accessed 19May2020..
  4. Chesson HW, et al. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014;41(11):660-4
  5. Centers for Disease Control and Prevention. Human papillomavirus: Epidemiology and prevention of vaccine-preventable diseases. Available at: https://www.cdc.gov/vaccines/pubs/pinkbook/hpv.html Accessed 19May 2020.
  6. Khan MJ, Castle PE, Lorincz AT, et al. The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst. 2005;97(14):1072-1079.
  7. Burd E. Human papillomavirus and cervical cancer. Clin Microbiol Rev. 2003; 16(1):1-17. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC145302/  Accessed 19May 2020
  8. National Cancer Institute. SEER stat fact sheets: cervix uteri. Available at: http://seer.cancer.gov/statfacts/html/cervix.html. Accessed 19May 2020.