Because persistent infection increases the risk of cervical cancer, doctors recommend women get vaccinated to reduce risk and get regular check-ups before it’s too late
Of all cancers, cervical cancer is the second deadliest among working-age women in Thailand, right behind breast cancer. Every day, 25 Thai women are diagnosed with cervical cancer, bringing the number of confirmed cases to 9,158 a year. On average, 13 women die from cervical cancer every day. Even more alarming is the fact that more than 80 percent of sexually active men and women are at risk of contracting HPV at least once without developing any symptoms. Since HPV can cause cervical cancer, its infection can pose a silent threat. Over time, HPV can turn normal cells into cancer cells.
The Road to Zero HPV seminar, organized in partnership with the private and government sectors, aimed to raise public awareness of cervical cancer. Speakers included eminent medical experts such as clinical professor Dr. Vitaya Tithapan, President of the Royal Thai College of Obstetricians & Gynecologists, Professor Dr. Somsak Lolekha, President of the Royal College of Paediatricians of Thailand, and Dr. Jakkrit Ngowsiri, Deputy Secretary General of the National Health Security Office (NHSO). They were joined on stage by Ms. Somkuan Sathongkaen, a cervical cancer survivor, who shared her experience with the audience.
HPV causes cervical cancer: Don’t overlook the risks!
dr Vitaya said, “HPV, or human papillomavirus, is a virus that lives on moist body surfaces. It can thus be found in the vagina. HPV can cause various sexually transmitted diseases, including cervical cancer, vaginal cancer, vulvar cancer, anal cancer, and genital warts. Although HPV goes away on its own in most cases, in some people it remains dormant for 10 to 20 years. The affected area of skin becomes cancerous over time. Even during dormancy, carriers can also pass HPV on to their sexual partners. In addition, HPV can survive on inanimate surfaces for quite a long time. This means if you share any items with others, you can get HPV from those items.
Since HPV infections initially show no clear symptoms, active case finding is of the utmost importance. Early detection leads to timely treatments. There are two types of HPV testing in Thailand:
1. Pap smear: This test, performed by an obstetrician, involves inserting a tool into the vagina to collect samples of cells. Laboratory tests will then determine if the cells show any abnormalities.
2. HPV DNA Test: Because it focuses on DNA levels, this test has high accuracy. It also allows early detection of cancer risks.
Why is HPV important when the virus goes away on its own?
Normally, the human body can shed most of the HPV, but this can still leave a 10 percent virus residue. People tend to think that protection from HPV is not very important because they have faith in their immune systems. professor dr Somsak updated the seminar audience on the availability of HPV vaccines and stressed their importance. “Currently we have three types of HPV vaccines – the bivalent HPV vaccine, the quadrivalent HPV vaccine and the 9-valent HPV vaccine. Each has different potency characteristics. The bivalent type protects against HPV types 16 and 18 with a 70 percent effectiveness rate. The quadrivalent type protects against HPV types 16 and 18, and types 6 and 11, which account for 90 percent of genital wart cases in both men and women are responsible. Types 6 and 11 also cause potentially fatal recurrent respiratory papillomatosis in neonates who have contracted HPV from their mother. The 9-valent HPV vaccine, meanwhile, protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58. This type has a 90 percent efficacy rate against cervical cancer, genital warts and recurrent respiratory papillomatosis. HPV vaccination exposes the human body to non-infectious parts of the virus to boost the immune system against HPV,” he explained.
Doctors recommend HPV vaccines for boys and girls ages 9 and up. The best age range for vaccination is between 9 and 15 years old as it induces the strongest immunity. After completing the full vaccination schedule, protection can last for a long time without the need for a booster shot. professor dr Somsak said children under 15 only need two doses of HPV vaccine, between six and 12 months apart. Those over 15 need three doses. The first and second doses should be administered between 1 and 2 months, while the interval between the second and third doses should be six months. HPV vaccination is recommended for people of all genders. Vaccinated men are at a lower risk of developing HPV-related diseases and also of being HPV carriers.
Parents need to understand that HPV vaccination is not an indicator that they are preparing their children for sexual relationships. Instead, vaccinating their children with HPV is about disease prevention. The effectiveness rate is highest in people who have never been infected with HPV. professor dr Somsak said parents should register their children for HPV vaccination when schools schedule vaccination appointments,
Individuals over the age of 27 or who are sexually active should seek further medical advice. If they are vaccinated against HPV, they are protected from getting infected again with the old HPV types and also from getting infected with other HPV types.
Voice of Cervical Cancer Survivors
Many people wonder about the early signs and symptoms of cervical cancer, how the disease can be treated, and how long it takes to make a full recovery. The focus of the seminar was therefore Mrs. Somkuan Sathongkaen, who had survived cervical cancer. Speaking of her battle with cancer, she said: “I had cervical cancer. It took me more than a year to recover from it. Before I was diagnosed with cancer, I had never had a pelvic exam. But I noticed that I bled more heavily during menstruation. Later, my menstrual cycle became irregular and I also had severe abdominal pain during menstruation. For a while I thought these symptoms were occurring because I was getting older and approaching menopause. But as they got worse and worse, I decided to see a doctor. At that time I was diagnosed with cervical cancer. I was really shocked because it was already stage 2 cancer. I needed to calm down and think hard about treatment options and the procedures involved. Then I started concurrent chemotherapy, which lasted well over a year and cost me hundreds of thousands of baht.”
Screening & HPV Vaccination
Regarding free screenings and HPV vaccination for Thais, Dr. Jakkrit: “The NHSO recognized the danger of cervical cancer, closely monitored this threat and budgeted for the comprehensive treatment associated with it. We have promoted cervical cancer screening among Thai women aged 30-60 by offering a free screening every five years. They can assert their rights with the hospital associated with or associated with their name. In addition, we have provided HPV vaccines to more than 400,000 Pathom 5 schoolgirls across Thailand. HPV vaccination has continued for years, with a brief interruption during the COVID-19 pandemic due to vaccine shortages. We have resumed HPV vaccination for schoolchildren in 2022. Already this year, the NHSO has procured a quadrivalent HPV vaccine for all Pathom 5 students.”
“In addition, the NHSO has planned to further promote the early detection of cervical cancer by providing free HPV DNA testing kits. The kits allow women to collect samples for laboratory testing themselves. HPV DNA test kits will likely be available soon. In addition, the NHSO plans to further improve HPV prevention and care based on recommendations from an expert panel and the Department of Health. For example, the NHSO could consider giving boys HPV vaccines as well to improve health care,” he added.
Although cervical cancer is a serious disease, preventing it is not difficult. HPV vaccination for people from the age of 9 and regular check-ups every five years for women over 30 are important tools. Cervical cancer survivors, meanwhile, are advised to visit their doctor regularly for proper advice and to reduce the risk of the cancer recurring. Doctors suggest that even people who have never had cancer or been vaccinated against HPV should have regular checkups to determine their health status and, if a condition is found, receive timely treatments for continued good health.