Previously they gradually writing articles related to cervical cancer screening, recently received a lot of problems still consulting patien
Previously they gradually writing articles related to cervical cancer screening, recently received a lot of problems still consulting patients, referred to the HPV infection, many patients for the discovery of HPV infection, terrified, not only the spirit of tension, and spent a lot of money, so I would like to issue again for science.
HPV is a virus known as Papillomavirus (Human, HPV). HPV has more than 100 subtypes, the relationship between HPV and cervical cancer was first introduced in the 70s of last century by the German scientist Harald Zur Hausen, and has been verified. HPV is currently about according to its carcinogenicity and not divided into low-risk type and high-risk, low-risk type HPV does not lead to cervical cancer, but the high-risk type of HPV may cause cervical cancer and precancerous lesions (WeChat public account doctor Gong Xiaoming reply 015 to check the cervical cancer screening science).
The main route of HPV infection is sexual contact, but it is not the only way. HPV infection can be found in children and virgins. HPV infection is a common thing, from HPV infection in Figure 1 is probably the peak can be seen from the youth had been detected HPV infection, it can be said that everyone is HPV infection, but under normal circumstances, HPV will be the removal of the human immune system, so short infection is not a particular event, similar to you caught a cold virus infection, not even cold symptoms, your virus had been cleared from the body. The real cause of the trouble is that persistent virus infection, if the same subtype HPV virus persisted for more than 2 years, it will have the opportunity (Note: there is a chance, not necessarily, the proportion of green curve 1 represents the blue line represents the HPV infection in cervical precancerous lesions, the yellow line represents the cancer occurrence of different proportion is probably can understand this.) Lead to cervical precancerous lesions, from precancerous lesions to cancer is a long process, usually takes 10-15 years.
The current guidelines for high-risk HPV screening is not recommended in people under the age of 30, because of a transient infection would be more common, even if the screening test is positive, over a period of time will also be cleared a great possibility. In 2013, the new England Journal of medicine summed up the norms in recent years, and suggested that the recommendations for cervical screening should be as follows:
No screening under 21 years of age
21~29 years old, every 3 years for a cytological screening
30~65 years of age, every 5 years for a joint screening of HPV and cytology, or every 3 years for a cytological screening.
65 years of age, if the results of the previous normal, you can stop screening.
So it is possible to understand that HPV testing is not necessary under the age of 30.
30 years old, even found a high-risk HPV infection should not be too nervous, because although the high-risk type of virus, but it does not mean that you have cervical cancer, at this time is important for screening of cervical scraping, if cervical scraping is no problem, can not be too worried, just need to continue to follow up on good of course, if there is HPV genotyping results, if found that 16 and 18 were positive, some scholars have suggested that the direct detection and colposcopy biopsy except for cervical cancer.
From the international guidelines and research data, the current HPV virus infection, and there is no effective treatment, it is not recommended for the treatment of HPV virus carrying state. I had to communicate with a number of international counterparts, basically agree with this view. In recent years, there are many domestic hospitals to provide doctors with drugs for treatment of HPV, personally think that there is no research evidence of good support, usually to understand a therapy is effective, not to listen to manufacturers of publicity, it is important to see whether the publication in the International Journal on the related literature to support, if only the data provided by the manufacturer there is a bias, the present situation, not enough to support HPV treatment practices. Individuals even think that HPV therapy is to seize the psychological fear of cancer patients, there is a suspicion of over treatment. Do not rule out the possibility of the emergence of HPV treatment in the future, but at this stage, there is no good evidence to support.
HPV vaccine is currently there is some evidence support for preventive measures can reduce the incidence of cervical cancer, 9~26 year old women can be considered HPV vaccine, but there is still not approved, can only go to Hongkong or abroad injection. HPV vaccine is vaccinated, does not mean that the exemption of cervical cancer, is still the need for regular cervical smear examination.
Shanghai First Maternal and Infant Health-Care Hospital
Doctor Gong Xiaoming