Cervical Cancer: The Role of HPV Test and Vaccine

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Cervical cancer prevention in the era of HPV test and vaccine

Cervical cancer is the fourth most common cause of death among females worldwide. The high-risk Human Papilloma Virus (HPV) is the major cause of cancer of the cervix. Although preventable as well as curable, it is still the 2nd most common cause of death in developing nations. 1

In the United Kingdom, the incidence of cervical cancer is highest among women of the age group 30-34 years. There has been an 18% drop in cervical cancer deaths in the UK over the last decade.1 However, when it comes to cervical cancer burdens and deaths, the picture is very different in the rest of the world.

The symptoms of cervical cancer

The cervix is the part of the female genital tract. Cancer of the cervix may present with the following symptoms:

  • Vaginal bleeding
  • Postmenopausal spotting or bleeding
  • Bleeding after sexual intercourse
  • Increased vaginal discharge
  • Unexplained back pain

Does HPV cause cervical cancer?

Despite the fact that there are more than 200 types of HPV, high-risk HPV infections are most commonly associated with cervical cancer. 2,3,4

Five interesting facts about HPV infection

1. It is one of the most common sexually transmitted infections globally4,5
2. Infection can occur in the cervix, vagina, anus, penis, bladder and mouth4,6
3. More than 70% of sexually active people have been infected with HPV in their lifetime6
4. About 90% of infections resolve within 12  to 36 months7
5. HPV infection can progress to pre-cancer lesions in about 10% of cases7

The risk factors for acquiring HPV infection6,8

  • Using oral contraceptives for a long time
  • Smoking and alcohol consumption
  • Poor immune system
  • Existing sexually transmitted infection
  • Multiple pregnancies
  • Unprotected sexual intercourse and multiple sexual partners

Barrier’s to the cervical cancer screening program6

When to attend cervical cancer screening?

American Cancer Society Screening in 2020 advised the screening for cervical cancer between the age group of 25 to 65. Co-testing (PAP smear and HPV test) is the most preferred method.4,10

There is a remarkable reduction in the rate of cervical cancer with a single HPV test when compared to a cervical PAP smear.9

The HPV vaccine: What one should know 4,6,11

Cervical cancer is one of the very few preventable cancer and therefore HPV vaccination has become a global priority

·        The most commonly used vaccine is Gardasil and Cervarix
·        HPV jab is  given to girls between the age group of 9 to 12 years
·        When given at pre-puberty age, it can reduce cervical cancer in 90% of cases
·        Has also been started for boys to prevent genital cancer in some countries

Take home message

Cervical cancer prevention requires a collaborative effort by various stakeholders. Despite campaigns and awareness programmes worldwide, there is a lack of participation, especially among women in low socioeconomic countries. Therefore, there is a need to make cervical cancer screening programmes more women-friendly.

Several studies confirm the effectiveness of HPV vaccination when immunized before the age of puberty. Hence, it is necessary to convey a similar message to parents and carers regarding the benefits of the HPV vaccine along with the potential side effects of the HPV jab.


  1. Cancer Research UK (2021) Cervical cancer statistics. Cancer Research UK. http://www.cancerresearchuk.org
  2. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
  3. Human papillomavirus (HPV): the green book, chapter 18a. Public Health England, 2019
  4. Rosalik K, Tarney C and Han J. Human Papilloma Virus Vaccination. Viruses. 2021, 13, 109
  5. GLOBOCAN 2012 database. Cervical Cancer: Estimated Incidence, Mortality and Prevalence Worldwide in 2012. International Agency for Research on Cancer; Accessed July 15, 2018
  6. Okunade KS. Human papillomavirus and cervical cancer. J Obstet Gynaecol. 2020 Jul;40(5):602-608
  7. Rositch AF, Koshiol J, Hudgens MG, Razzaghi H, Backes DM, Pimenta JM, et al. Patterns of persistent genital human papillomavirus infection among women worldwide: a literature review and meta-analysis. Int J Cancer. 2013 Sep 15;133(6):1271-85
  8. Quinlan JD. Human Papillomavirus: Screening, Testing, and Prevention. Am Fam Physician. 2021 Aug 1;104(2):152-159
  9. Sankaranarayanan R, Nene BM, Shastri SS, et al. HPV screening for cervical cancer in rural India. N Engl J Med 2009; 360: 1385–94
  10. Wentzensen N, Schiffman M, Palmer T, Arbyn M. Triage of HPV positive women in cervical cancer screening. J Clin Virol. 2016 Mar;76 Suppl 1(Suppl 1):S49-S55
  11. Tsikouras P, Zervoudis S, Manav B, Tomara E, Iatrakis G, Romanidis C, et al. Cervical cancer: screening, diagnosis and staging. J BUON. 2016 Mar-Apr;21(2):320-5

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