Today, HPV infection is one of the most common and prominent sexually transmitted diseases (predominantly sexually transmitted infections), infecting the majority of the sexually active population of the planet. The peak of HPV infection occurs at the age of 18-25 and decreases after 30, when the frequency of dysplasia and cervical cancer increases significantly, peaking at 45.
The clinic performs diagnostics of human papillomavirus infection, as well as procedures for the prevention of infection with sexually transmitted infections after casual sexual intercourse.
At least 50% of the sexually active adult population is infected with one or more types of HPV and, in most cases, genital HPV infection in them is unrecognized, subclinical, or asymptomatic. Genital HPV infection is highly contagious and is acquired during the first sexual contacts; infection with a single sexual contact occurs in about 60% of cases.
Risk factors for human papillomavirus infection
Recent studies have established that HPV is a necessary but insufficient factor in cervical cancer. Risk cofactors for the development of the disease can be:
- disturbances of cellular and humoral immunity
- unfavorable socio-economic condition;
- sexual behavior;
- concomitant sexually transmitted diseases (herpes, chlamydia, trichomoniasis, gonorrhea, syphilis, etc. );
- hypo and avitaminosis;
- young age;
- to smoke;
- pregnancy;
- vaginal dysbiosis.
The virus is also sometimes transmitted from mother to child both in utero and during childbirth. In addition, pregnancy is a provoking factor for the manifestation and growth of neoplasms, as well as for their transition to cancer. This is due to a decrease in immune defenses and changes in hormone levels.
Most often, we are dealing with a situation in which a patient is diagnosed with a high oncogenic risk human papillomavirus (HPV). As a rule, doctors immediately report that there is a risk of developing cervical cancer. Often rather aggressive treatment is immediately prescribed, a biopsy is performed, however, in general, it is not clearly explained what actually happens and what the future prognosis is. So, if you have a high oncogenic risk of human papillomavirus (HPV) detected by PCR, this doesn't mean at all that you need to panic. There is nothing serious about this find, it is just an excuse to undergo an appropriate examination.
Cervical screening, aimed at identifying potentially cancerous human papillomavirus infection and associated lesions of the cervix, continues to be a necessary component of health care and every woman should remember the need to "overcome" it.
How often should you screen and when to start?
It is important to note that the greatest number of cervical injuries, including severe ones, occur at an early reproductive age. Therefore, it is more advisable to start screening for cervical pathology as soon as possible after the start of sexual activity. Cervical cytology screening should be performed from the age of 18 or the age of sexual debut. Only thanks to this approach, the number of women in whom the disease is detected late is reduced.
What should be done to prevent cervical cancer from developing?
- Once a year, it is imperative to undergo an examination by a gynecologist with a mandatory examination of the cervix - colposcopy.
- A simple examination of the cervix is not enough - some tests must be performed. That is, to answer two questions: do you have human papillomavirus and whether there are changes in the cells of the cervix that can potentially lead to the development of cervical cancer.
Most often, in ordinary clinics and laboratories, a simple cytological smear and a smear by PCR are performed to determine the virus (that is, an analysis that simply answers the question: is there this virus or not). These analyzes have several disadvantages that can significantly affect their accuracy.
Disadvantages of conventional cytology and PCR smear:
A smear from the cervix is taken with a flat brush and the material is "smeared" on the glass. In which:
- the doctor may not collect cells from the entire surface of the cervix;
- when applied to glass, a smear is obtained with an unevenly applied material (somewhere thicker, somewhere thinner), which does not allow a cytologist to fully examine it and correctly evaluate all the cells obtained;
- the glass with the smear applied can "clog", which also affects the quality of the evaluation of the cells obtained.
As a result, a PCR smear will show whether human papillomavirus is present or not. It cannot be used to judge the amount of this virus and this is important.
Therefore, at the moment, the most accurate diagnostic method isliquid cytology method.
The essence of the method is that the material is taken from the cervix using a special brush, which, thanks to its design, allows you to capture cells from the entire surface of the cervix and the cervical canal. After that, the brush is dipped in a special container with a solution. This solution "preserves" the cellular material collected by the doctor, prevents cell damage, allows to overcome bacterial "contamination" and allows the collected cells to be transported to the laboratory in optimal conditions.
For both the physician and his patients, the advantages of using the liquid are its resistance to temperature fluctuations, the ability to store cellular material for several years, and the ability to conduct additional or necessary tests for the full range ofgenital infections, including genetic testing. for human papillomavirus. . .
A more important analysis can be made from the resulting solution with the cells: the determination of a specific protein. The determination of this protein allows to clarify the situation when identifying the altered cells of the cervix, which have indirect signs of transformation. Detection of this protein indicates that the cell is severely damaged and that there is a high probability of its malignant transformation. The absence of this protein indicates that the defect in the cells is not dangerous and the probability of malignant transformation is minimal.
All studies can be performed from a vial with liquid cytological material; the patient does not require additional visits to the doctor, which means that the implementation of simultaneous or sequential cytology and genetic detection of the virus and, therefore, the complete screening of cervical lesions in this case is facilitated as much as possible.
Using a liquid method to collect material to examine women for infectious cervical pathology is the most logical and economically feasible approach. But the most important thing is that this new technology makes it possible to increase the effectiveness of cervical screening and not to "lose" those women whose lesions on the cervix have already acquired the status of "precancerous".
In the course of the study of the new research technique, a comparative analysis of the traditional technique and liquid cytology was carried out. As a result of the analysis of more than 100 traditional cervical smears, "suspicious" or so-called "atypical" cervical cells were found in only one in five women, and as a result of a new liquid cytological study - in every second woman.
Such a triple test allows you to analyze the cells of the cervix as accurately as possible and decide what to do next.
Such a test is important not only for women who have already had changes in the cervix or diagnosed with the presence of oncogenic types of human papillomavirus. This test should be done prophylactically once a year, in which case you can be sure that you don't miss any possible changes in the cervix.