How does HPV relate to cervical cancer?

In this informative guide, revered consultant gynaecologist and cancer surgeon Dr Natalia Povolotskaya expertly explains how human papillomavirus (HPV) infection relates to the development of cervical cancer and also discusses the most common symptoms and risk factors association with the condition.

How common is cervical cancer?

Cervical cancer is the cancer of the neck of the womb. It is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer mortality in women. Persistent infection with oncogenic human papillomavirus (HPV) is prerequisite in most cervical cancers. However, in recent years HPV‐independent cervical cancers, especially adenocarcinoma have been recognised.

How does human papillomavirus (HPV) relate to cervical cancer?

Between ninety and ninety-nine per cent of cervical cancers are HPV related. However, ninety per cent of HPV infections resolve spontaneously within two years and only about ten per cent of all HPV infections become persistent, which puts the woman at risk of developing precancerous cervical lesions. The time interval between HPV infection and development of precancerous lesions is between one and ten years, and progression to invasive carcinoma is usually from seven to ten years.

What are the key risk factors associated with cervical cancer?

The main risk factors associate with cervical cancer are:

• Persistent human papillomavirus (HPV) infection
• Not taking part in cervical screening programme
• Untreated high-grade cervical intraepithelial neoplasia (CIN)
• Tobacco usage
• Immunodeficiency state

If you have abnormal smear test results, you will need to have colposcopic assessment of your cervix. A colposcope is a microscope that stays outside your body, but allows a clinician to undertake an assessment and take a biopsy.

What are the symptoms of cervical cancer?

Cervical cancer doesn’t always cause symptoms however some patients may experience:

• Unscheduled vaginal bleeding
• Heavy menstrual bleeding
• Contact vaginal bleeding, i.e. after sexual intercourse
• Vaginal discharge which is watery or malodorous
• Pain during sexual intercourse
• Bleeding after menopause
• Unexplained, persistent pelvic and/or back pain
• Urinary symptoms

How is cervical cancer treated?

The treatment depends on the stage of cervical cancer. In the very early stages, when cancer can be seen only under microscope, undergoing a LLETZ procedure may be enough to remove the disease while allowing the patient to preserve their fertility.

If fertility preservation is no longer required, a minimal access hysterectomy can be performed. In relatively small (but visible to a human eye) organ-confined tumours, a radical hysterectomy is an option. For tumours that are of higher stage, chemoradiotherapy is the treatment of choice. MRI and CT scans, along with PET-CT scanning (positron emission tomography–computed tomography) are used to stage cervical cancer prior to making a decision on the correct treatment for the patient.

If you would like to schedule a consultation with Dr Povolotskaya, you can do so by visiting her Top Doctors profile.