Human Papillomavirus (HPV)
Human papillomavirus or HPV is a small DNA virus that infects the deepest layer of the skin or genital surfaces (epithelium). There are over 100 types of HPV, of which about 40 infect the genital area. The virus is ubiquitous and HPV infections are very common. The majority of all HPV infections resolve on their own and cause no clinical problems. Approximately 70% clear within a year and 90% within two years.
However, persistent infection with some HPV types can cause cervical cancer, genital warts, other rarer anogenital cancers and cancers of the head and neck
HPVs are classified as either:
- 'high-risk' or oncogenic types which can cause cervical cancer and the early changes in the cervix associated with cervical cancer, or
- 'low-risk' types, which lead to the development of benign genital warts.
Cervical cancer
Infection by a high-risk type of HPV is necessary for the development of cervical cancer. Over 99% of cervical cancers are caused by HPV infection. Persistent infection with a high-risk HPV type can cause abnormalities of the cervix, which, if left undetected and untreated, can progress to cervical cancer. The time span between being infected by a high-risk HPV and the development of cervical cancer is, in most cases, many years.
While infection by genital HPV is most common among young adults (aged 18-28), cases of cervical cancer peak in women in their late 30s. Two high-risk types, HPV 16 and HPV 18, are responsible for over 70% of all cervical cancers in Europe. Other high-risk HPVs that cause cervical cancer include HPV types 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 66.
Other cancers
Among the other cancers that can be caused by HPV less than half of the total cases are attributed to HPV infection, as these cancers are either much rarer than cervical cancer or can also be caused by other factors (Parkin 2006).
National Human Papilloma Virus (HPV) Immunisation Programme
In October 2007, a new immunisation programme against HPV was introduced in Scotland. The HPV immunisation programme aims to help protect girls against developing cervical cancer later in life. The vaccine protects against the two High Risk HPV types HPV-16 and HPV-18 that cause over 70% of cases of cervical cancer.
The Scottish HPV immunisation programme started in September 2008, and vaccination is now routinely offered to all girls during their second year of secondary school (aged 12 to 13). At the start of the programme, all 13 to 17-year-old girls in Scotland were also offered HPV vaccine through a time-limited catch-up campaign. This finished on the 31 August 2011.
Cervical Cancer Screening Programme
Cervical screening aims to detect and treat abnormal changes in a woman's cervix (the neck of the womb) which, if left untreated, may develop into invasive cervical cancer. The test is designed to pick up any changes so that they can be simply and effectively monitored or treated. Cervical screening saves around 5,000 lives in the UK every year and prevents 8 out of 10 cervical cancers from developing.
The Scottish Cervical Screening Programme has been in place since 1989. All eligible women in Scotland between the ages of 20 and 60 are routinely invited for a cervical smear test every three years.
Women who have been vaccinated with HPV vaccine, will still need to attend for cervical screening when they reach screening age for the best protection against cervical cancer.
Further Information
Information about the immunisation programme and vaccine uptake statistics
Information about the cervical screening programme, screening uptake and cervical cancer statistics
References
- Parkin DM, Bray F. 2006 Vaccine. Chapter 2: The burden of HPV-related cancers. Aug 31;24 Suppl 3:S3/11-25. Review.
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