There are several methods for screening cervical abnormal cell changes. While the conventional Pap smear is the most common method, new molecular technique, namely HPV DNA Genotyping test is the most advance technique and gaining popularity as it can identify the specific genotype of the virus.
Q. What's the difference between a Pap test and a HPV test?
A Pap smear test is a cytological screening technique used to detect cervical cancer or any cell changes that may lead to cervical cancer whereas HPV DNA is a different technique which can detect HPV virus before abnormal cells develop and assess one’s risk of developing cervical cancer. In cases of ASCUS (minor changes), HPV DNA can help to differentiate between those that are at risk of cancer from those that may be caused by bacterial infection.
Q. Any check up is required prior to vaccination?
Check up serves the purpose of screening / early detection of infection and cell changes. Hence it is not a “must” step prior to vaccination. However, initial check up for someone who had been sexually active can provide re-assurance that there is no pre-exiting abnormality or treatment can be implemented at an early stage.
Q. What are the effective screening methods for HPV?
For female, a pap smear test is the most common and affordable way for checking normality of cervical cells whilst the latest HPV DNA screening technique will make it more conclusive on detecting various “risk type” in case if abnormal cervical cell is found.
Even HPV vaccination is of high female coverage, there is only modest reduction of HPV-related diseases in men.
Male vaccination can further reduce the incidence of HPV diseases in female population.
Q. I am a male, so do I need vaccination?
Male are not at risk of cervical cancer but have a chance of getting genital warts and other genital diseases, such as penile and anal cancer. Males who are HPV carriers can transmit the virus to their partners (male/female). The carrier can also pass the virus onto the next generation at birth and through normal skin contact. In some countries such Australia, Canada and some States in US, have started national or state-wide vaccination program for boys to be vaccinated against HPV.
Q. Will I still be infected by HPV even if I do not have any sexual contact?
Yes. HPV is a common virus that can be found on skin and it can be spread through skin contact or even through environmental contact.
Q. Is HPV a genetic disease?
No, HPV is not a genetic disease yet it is an infection that can be passed from parents onto child. Vaccination can provide protection to parents so that the chance of passing HPV onto the child can be effectively minimized.
Q. How long will HPV infections develop into cervical cancer /genital warts once detected in human body?
It usually takes 7-10 years of persistent HPV infections for abnormal cells to develop into cervical cancer. However, it may take only 3-6 months for genital warts to develop.
Preventive Care to Reduce Risks
In 2006, about 12,000 women were diagnosed with cervical cancer and 3,976 women died of the disease. Widespread vaccination has the potential to reduce cervical cancer deaths around the world by as much as two-thirds.
There are 2 HPV vaccines available. They protect against different HPV types and choosing which one will depends on individual’s risk exposure, past history, current infection state etc. We recommend people should consult specialist before receiving the vaccine.
Q. When will protection take effect after I get vaccinated? Will it start after my first injection?
Antibodies will have significant increase from 2 weeks after your 2nd injection but full and prolonged protection will only take place after the 3rd injection. It generally takes 6 months to complete the course of injection. However, if someone had already carry HPV or if his/her partner already has HPV, a shorter schedule over 4 months is recommended to obtain protection in a shorter period of time. Usually the second shot is given after 1 month and final shot in 4 months.
Q. If I am already infected by HPV, can I have the vaccination now?
Yes. Many people have misconcept about HPV vaccine, even among health professionals. HPV can be a recurring infection. People may catch one type and clear it by their own immune system but they can catch the same type or a different type in the future. The vaccination protects against future infections and therefore it is still recommended for those who are infected as it will help protecting against other genotypes infection as well as reduce the chance of developing into the end point diseases such as genital warts, cervical and rectal cancer.
Q. How long will the protection last after having vaccination and how effective is it?
Research studies show that protection will last for at least 10 years and reduce risk of cervical cancer by 70% and genital warts by 90%.
Q. Will any booster or another course of vaccination required when one’s immunity against HPV subsides?
Both research studies and FDA (Food and Drug Administration) have not yet indicated that a booster is required.
Q. When HPV infection is found, does it mean one has cheated?
Not necessarily. HPV can remain in the human’s body for a long time or even a lifetime, showing no sign of its presence. The latency period of the virus therefore makes it hard to back track to a specific partner. Hence, an HPV diagnosis only means the person contracted an HPV infection at a point during his or her life.
Research from our centre and other sources had confirmed that HPV can be found on environmental surfaces for a short period of time (in terms of hours). Also in about 50% of people with HPV in their genital areas, carry HPV on their hands. Therefore in high people travel areas, such as hand rails on MTR, lift buttons, etc, HPV can be found. Therefore, HPV can be transmitted through non-sexual contacts.
Q. Does an abnormal Pap smear mean a woman is at high risk of cervical cancer?
A. An abnormal Pap smear can be due to various factors such as local irritation, infection of a low-risk HPV type, or even a mistake in the preparation of the cell sample. Therefore, an abnormal pap smear cannot be concluded to cancer immediately.
Q. If I have genital warts, does it mean it will recur for the rest of my life?
A. Most people’s immune system will increase against the infected virus, making recurrences less often and may eradicate them entirely in couple of years. However, the virus may remain in the person’s cells in a latent state without producing any symptoms.
Q. Older women do not need to do Pap smears?
A. No. In fact, older women have a high chance of developing cervical cancer due to higher frequency and longer duration of sexual contact. Thus, it is recommended for older women to have regular pap smears.
Q. Will genital warts be no longer contagious after receiving treatment?
A. Removing warts cannot guarantee that the risk of transmission is entirely removed as the area surrounding visible warts may also contain HPV.
Q. If a woman has an abnormal Pap smear, should her male partner also do an HPV test?
A. Yes. If a woman has found to be infected by HPV, there is a good chance of transmitting the infection to her partner through skin contact. Therefore, an HPV test for her male partner is highly recommended.
Q. Can latex condoms provide protection against contracting HPV?
A. No, as HPV is transmitted through skin contact, condoms do not cover up the whole genital area for both males and females during sexual activity and therefore, leaving the uncovered area vulnerable to HPV infection.
Q. If I am over 46 years old and would like to take the vaccination now, will the vaccination still be effective?
A. Since HPV vaccination protects against future infections, it is better to be given at a younger age. However, it is still effective even if given after 46 years old. The recommended age group for vaccination is based on the age group used by research studies submitted for authority registration approval. Anyone seeks for vaccination should consult the doctor.
Q. Will there be any age limit for a Pap smear ?
A. A Pap smear check up is not necessarily age related but more depend on whether the first sexual contact has taken place and the check up time should be advised by doctor. Various countries may have different guidelines on the frequency of performing Pap smear. However, the following may serve as a reference:
Pap smear check up is needed 3 years after the first sexual contact, and will need to repeat after 12 months. If no specific cervical cell changes is found after these 2 checkups, then once in every 2-3 years would be appropriate.
If a combined Pap-HPV DNA test is used and the result is normal/negative, screening can be done once every 2-3 years. (The Pap-HPV DNA test is recommended by FDA for women over age 30).
However, if high-risk HPV genotype is found, an annual check up is recommended.
Regular check up should continue until or beyond 70 years old.
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