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National Cervical Cancer Coalition


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PostPosted: Wed Jan 26, 2011 9:22 pm 

Joined: Fri Jan 21, 2011 11:42 am
Posts: 11
Location: United States
The purpose of my post is in an effort to help those who are experiencing anxiety from a HPV / CIN diagnosis.
My wife was diagnosed with CIN 2, about two years ago, she decided to “wait and watch”; thankfully since then she has had 3 negative / clear paps and tested negative for HPV. Originally I was over come with anxiety about her health and it really affected my well being. This forum was so helpful to get great information on HPV and really put the risk of cancer from HPV into perspective.

I wanted to try to give back by sharing the information I compiled that might help those with high anxiety to really not be as stressed about HPV leading to cancer as I originally was. Don’t get me wrong I am in no way saying ignore any HPV / CIN diagnosis but rather try to lower anyone’s high anxiety over it. Personally the way I looked at it was if we are doing what the doctors says and following up with our appointments there is really no reason in this day in age should a CIN / HPV lead to cervical cancer.

About 55 million Pap tests are performed each year in the United States. Of these, approximately 3.5 million (6 percent) are abnormal and require medical follow-up.

Keep in mind only about 12,000 women a year are diagnosed with cervical cancer. Of that 12,000; 50% have never had a pap before in there life and about another 10-15% have not had a pap within the past 5 years. So if you had an abnormal pap and worried about getting cancer keep in mind only 0.003% will progress to cancer form an abnormal pap.

It normally takes about 10-15 years for cervical dysplasia to progress to cancer if it does. So if you go for annual PAPS and go to any required follow up testing you will be able to treat cin before it ever turns to cancer. This is not something that normally progresses so quickly you can not treat it.

Also there is no need to get overly stressed like I did over my wife and doctor electing to “watching” of your dysplasia if your doctor recommends this instead of surgery.

Progression rates I have seen reported from reliable sources are as follows;
-less than 1% of cin 1 cases will lead to cancer if left untreated
-about 5% of cin 2 cases will lead to cancer if left untreated
-about 12-15% of cin 3 cases if left untreated will lead to cancer.


These statistics mean that if you had even cin 3 and never did anything about (not recommended) you still have a very good chance of never developing cancer from it. Fredo is correct from my research cancer form HPV is extremely rare.

Clearance Rates of HPV

"Studies have shown that 70% of new HPV infections clear within one year, as many as 91% clear within two years. The median duration of new infections is typically eight months. HPV-16 is more likely to persist than other HPV types; however most HPV-16 infections become undetecable within two years. The gradual development of an effective immune response is thought to be the likely mechanism for HPV DNA clearance."
Source: CDC 2004 Report to Congress on Prevention of HPV

"The average duration of HPV infection was eight months. Repeated HPV DNA testing showed that seventy percent of the women cleared their HPV infections within one year through the natural immune process, and only nine percent continued to be infected after two years. Another study conducted in Sweden supported these findings, with a five-year clearance rate of 92 percent"

"Most people (up to 90%) who test positive for HPV with very sensitive tests for HPV (polymerase chain reaction [PCR] and Hybrid Capture® II) will become HPV negative on the same tests within 6-24 months from first testing positive. This is due to an effective immune response to HPV."
Source: Human Papillomavirus and Cervical Cancer Quick Reference For Clinicians - http://www.arhp.org

"In almost all cases, the immune system will keep the HPV virus (including the cancer-related HPV types) under control or get rid of it completely."
Source: HPV Resource Center - http://www.ashastd.org

Cervical Dysplasia, even severe, should be considered pre-cancerous but not cancer. It is important to realize dysplasia is limited to the "skin" of the cervix, and has not invaded into the underlying tissue. Without treatment however, severe cervical dysplasia is much more likely than CIN 1 dysplasia to develop into cervical cancer. This is a long, slow, process taking 10-20 years for severe dysplasia to progress to invasive cancer. It is extremely uncommon for dysplasia to progress to cancer if it is properly treated and you have regular follow up exams.


Go for annual PAPS, do what your doctor tells you, and relax; if you do this you should not get worried about HPV, that’s IF you do that.

I hope this help lower someone’s anxiety over HPV.


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PostPosted: Wed Feb 02, 2011 8:25 pm 

Joined: Mon Jan 31, 2011 3:16 am
Posts: 2
Location: rp
Thank you. I can't tell you how many terrible stories and facts I have read online. I have had so much anxiety about HPV that it really started affecting my daily life. This has really given me clarity and reassurance, so thank you.


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PostPosted: Sun Feb 06, 2011 1:45 pm 

Joined: Fri Jan 21, 2011 11:42 am
Posts: 11
Location: United States
your welcome; i am very happy to help. this board was such a blessing when i found it and wanted to give back what i could. it is so hard to find factual information all in one place that also puts hpv into perspective.

i did my best to put the most helpful information i gathered first and i will be adding to this post later with a summary of some more info i found helpful.

in the mean time i would recommend taking the following supplements morning and night to help support your body fight the virus;

multi vitamin
vitamin c
beta-carotene
vitamin e
b 12 complex
folic acid

I hope this helps as well and I will add more when I have time to summarize the info I gathered.


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PostPosted: Mon Feb 07, 2011 8:19 am 

Joined: Thu Jul 29, 2010 9:24 am
Posts: 31
Location: Asia
Hi, thanks for your encouraging post. I'm wondering, if ANYONE can simply take multi-vitamins. I suffer from Severe Fallots Tetralogy (it's a heart condition) and I'm not sure if I am allowed to consume any sort of multi-vitamins.


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PostPosted: Wed Feb 09, 2011 7:32 pm 

Joined: Fri Jan 21, 2011 11:42 am
Posts: 11
Location: United States
grief,

that i am not sure but you can call you doctor; should be a simple answer.

from my research i also wanted to prodive some common questions and answers some women with hpv might have. it is so hard to find soild info all in one place; i hope this thread can help calm some of their inital anxiety and get answers to there question instead of spending weeks on end STRESSING out searching the internet:

I have had an abnormal pap, and had cryosurgery (or another treatment) does this mean I'm cured? Yes, for most people. Recent studies show that in women who had cryosurgery or a LEEP procedure for an abnormal pap only 8-10% of women had detectable HPV DNA two years after their procedures.

I've had an abnormal pap (ASCUS, LGSIL, etc) and a biopsy showed CIN I (or CIN 2) am I going to get cervical cancer? NO, not as long as you get the proper surveillance (follow up pap smears after whichever treatment is indicated). These are PRE-CANCEROUS changes that can, rarely, lead to cervical cancer only if left untreated for many years.



I just found out I have HPV, will anyone ever want to be intimate with me again and do I have to wear condoms for the rest of my life? Please remember you are not alone and HPV is very very common. In some studies on college students 70-80% of those tested have the presence of HPV DNA when screened. There is no question frequent use of condoms decrease the risk of transmission of all types of HPV (those that cause genital warts and those that cause abnormal cervical Pap smears). So, I advise my patients to use condoms with all sexual partners and if/when you become serious with the one person who may be your lifetime partner you can think about switching to another method.


I am a teenager who had an abnormal pap followed by a biopsy which was abnormal and was told to do nothing other than follow- up Pap smears, is this ok? In adolescents the rate of regression is high and the rate of progression to cervical cancer is low so follow up of abnormal pap smears is different. After colposcopy and biopsy if CIN 1,2 or 3 is confirmed a reasonable approach is to repeat the pap in 6-12 months and if abnormalities persist after 24 months additional therapy is recommended. The reason for this is that procedures done on the cervix at a young age (like a LEEP) can lead to incompetent cervix and cause problems during pregnancy


1How do I get tested for HPV? For women, testing for the HPV types that cause cervical cancer (HPV 16 and 18) can easily be done on your Pap smear specimen. For genital warts (caused by the strain of HPV not tested for on Pap smear) your doctor can look at the lesions and if there are warts present he/she can put a dilute solution of acetic acid which turns the warts white in appearance and aids in the diagnosis. If you are a male you can get tested for HPV DNA but it is not as accurate as in women. Studies have shown that HPV detection is highest when a swab of the penile shaft is done and is LOWEST in the urethra and in semen.

Cervical Dysplasia, even severe, should be considered pre-cancerous but not cancer. It is important to realize dysplasia is limited to the "skin" of the cervix, and has not invaded into the underlying tissue. Without treatment however, severe cervical dysplasia is much more likely than CIN 1 dysplasia to develop into cervical cancer. This is a long, slow, process taking 10-20 years for severe dysplasia to progress to invasive cancer. It is extremely uncommon for dysplasia to progress to cancer if it is properly treated and you have regular follow up exams.

below is a response from a women who is a biostatistician in a cancer center; who responded to a womens concerns about pap test accurcey and hpv developing to cancer which i thought was very helpful putting my mind at ease.

"Pap smears are highly accurate, especially now with ThinPrep. Even if you have one false negative (suppose the sample was contaminated, or the doctor did not sample appropriately), the chance of having multiple false negatives over time is very very small. And the fact that you have had normal paps since 12 years old (assuming you have gone once a year) with no apparent history of HPV makes it highly highly unlikely that you have any dysplasia, let alone cervical cancer.

I research HPV and cervical cancer in immune-compromised women (I am a biostatistician in a cancer center). And even in this high risk and poor immune functioning group that I have years of data on, cervical cancer is rare. And the few cases of cervical cancer in this group are all women with years of abnormal paps, quite a slow progression to cancer CINI->CINII->CINIII..., plus the majority have a history of unresolved oncogenic HPV infections.

Everything I wrote your doctor will verify. You may have an infection or inflammation, but it is highly highly highly unlikely that you have cervical cancer. Your doctor did everything she needed to do to rule out other things. I really think you need to trust in her diagnosis - especially given how common something like cervicitis is."

i hope this helps someone suffering from anxiety from HPV. as always HPV should not be something to get worked up over IF you are going for you follow ups and listening to your docotr. Relax ! you have a better chance being killed driving to work tommrow then getting cancer from HPV; but please unlike a car accident this is something you can prevent easily so listen to your doctor and relax.


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