Cervical Screening, HPV and HPV vaccine.

Two months to my 25th birthday, I received a mail in my post inviting me for a cervical screening. I had been to my GP a couple of days before that due to a suspected urinary tract infection and even as a health care practitioner, my first thought was, "Is this invite as a result of something serious that showed up during my routine examination"?.

Undoubtedly, there are a lot of women out there who do not know what cervical screening is, the importance and when it should even be done. As cervical cancer is the 12th most common cancer in the UK as opposed to being the 14th most common a couple of years back, it is paramount to avoid or at least detect it early and that is one of the importance of cervical screening. This blog post will therefore answer few of the common questions I have received from women about cervical screening and its the importance.

Question 1: What is the Cervix?

Answer: The cervix is a cylinder-shaped neck of the tissue found in the lower part of the womb and it connects the vagina and the uterus. It is a separate anatomical structure and has a thick layer of fibromuscular tissues. As a result of the closeness of the cervix to both the outside environment and the internal reproductive organs, a problem with the cervix could be detrimental to a woman's health, fertility and well-being.

Question 2: What is Cervical Screening?

Answer: Cervical screening otherwise called a smear test or a pap smear is a slightly invasive but painless procedure which focuses on detecting cancer, precancerous cells or other abnormalities in the the cervix. Although, it is not a test for cancer, it is however a preventative measure to cancer as early detection of abnormal cells (either benign or malignant) is absolutely helpful.

Question 3: Who should have a cervical screening done?

Answer: All women including transgender females.

Question 4: When Should I ideally have cervical screening done?

Answer: It is advised that women from the age of 25 to the age of 64 who are (or not) sexually active should have cervical screening done. The first smear test should ideally be done at the age of 25 and if the results are normal, should have their smear test done every 3 years afterwards until they are 64 years old or no more sexually active. If however, there are some abnormal changes in your cervical cells, further investigations will be done at the discretion of your primary health practitioner. Even if you are past the age of 25 now and still haven't had your first smear test done, I'd strongly advise you do this ASAP.

Question 5: What is HPV and what is HPV vaccine?

Answer: HPV is Human Papilloma Virus, a group of viral infections that cause abnormal skin or mucous membranes growth such as warts and could also cause cancer in the throat (head and neck cancer), cervix, anus, vagina, vulva and even most recently in the male penis. In MOST not all men, it causes no trouble, but not so in women. The easiest way of transmission is through sexual intercourse. On the other hand, HPV vaccines are vaccines which protect you from HPV and could protect you from up to 18 HPV strains out of the 100 strains of HPV of which 14 are cancer causing strains.

Question 6: Can I still get vaccinated even though I am or not sexually active?

Answer: Yes, either way, you can and should get vaccinated because chances are you have not been exposed to all strains of Human Papilloma Virus, so getting the vaccine will further protect you. Cancer is a dreadful disease and should be prevented at all cost and if not, reduce your risk factors.

Question 7: What age can I get the HPV vaccine?

Answer: Ideally, you should get it by age 9 to age 15 but you can still get it until age 45.

Question 8: How many doses will I have to take?

Answer: For those between 9 and 15 years and not sexually active, it would be 2 doses.

- First injection at the point of contact and second injection 6 to 12 months after the first booster. For those above 15 years up to 45 years and/or sexually active, you'd have 3 boosters.

- First one at the point of contact, second one 2 months after the first booster and third one 6 months after the second one.

Question 9: Can boys be vaccinated as well?

Answer: Yes they can. It's now recommended from age 11 for boys to be vaccinated as a study in 2008 shows there was a significant drop in the rate of HPV infections in women when men were vaccinated as well. The age limit is what I am yet to find out.

Question 10: How much does these vaccines cost?

Answer: This is not definitive but an estimate after finding out information from a few hospitals in Nigeria. In Nigeria, two boosters cost about #30,000 (each at the rate of #15000) and 3 boosters is #45000. In the UK, it is free up to age 25, and afterwards you'd pay about £470 for 3 boosters.

Question 11: It's way too expensive though, is it that important?

Answer: Considering the statistics of women being diagnosed with cervical cancer is about eight (8) every day in the UK and cervical cancer is 99.8% preventable with HPV vaccine and cervical screening, I'd say it is important. Cancer drugs, brachytherapy and other management of cervical cancer as well as the psychological effects are quite expensive even more than the vaccines, and as Anne Schaef said, "Good health is not something we can buy. However, it can be an extremely valuable savings account".

Question 12: You mentioned men are the primary carriers of HPV and primarily transmit it during sex, I am a lesbian, do I still need it?

Answer: I would say yes, viruses are very intelligent beings, and unfortunately, there are different strains of HPV that could cause other types of cancer (such as throat cancer) or even worse, STIs such as warts which can still be contracted via oral sex.

Question 13: Is there a blood test for HPV?

Answer: No, there is none yet but HPV is usually tested for when you have your pap smear examination done which is one of the reasons it is ULTIMATELY IMPORTANT you get your cervical screening done! For males, there is currently no way of diagnosing HPV unless you have warts. So ladies do yourself a favour, get your pap smear/cervical examination booked ASAP! Until the next blog post where I would tell you how the appointment went with my GP and what to expect if/when you decide to do yours (if you haven't), keep safe, wash your hands and stay six feet from others.

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