Early Detection Saves Lives

Newswise — Chulalongkorn University’s researchers have developed a cervical cancer test kit that uses urine samples. A simple, accurate, and fast method of early detection is guaranteed for its quality by the 2021 Outstanding Inventions Award from the National Research Council of Thailand. Early detection is the key to saving lives.

Cervical cancer can be cured if detected in its early stages.  Many women are, however, deterred by the rather high cost of the screening procedure, and the pap smear testing method.  This leads to late detection that can cause cancer to spread making it harder to treat.

Today, there is a new invention that makes cervical cancer treatment a simpler and pain-free procedure that can be done frequently.  The HPV paper-based DNA sensor testing kits for cervical cancer developed by the Department of Chemistry, Faculty of Science, Chulalongkorn University’s research team comprising Prof. Dr. Orawan Chailapakul, Dr. Prinjaporn Tee-ngam, Sarida Naorungroj, Dr. Somrak Petchcomchai along with Prof. Dr. Tirayut Vilaivan.

Dr. Prinjaporn, one of the main researchers on the team discussed how this innovation was conceived, “The government has consistently urged women to get tested for cervical cancer.  One of the limitations of the original form of testing which requires taking a sample of cells from the cervix on stirrups invokes fear in many women who would rather avoid the test altogether.  For this reason, we have tried to find an easier way that most women would feel more comfortable with.  This could help to increase the number of those being tested as well as the frequency of their tests so that if any anomalies are found, then treatment can be immediately provided.”

Getting to know cervical cancer and early detection methods

Cervical cancer is the second most common cancer of women in Thailand after breast cancer with an incidence rate of 10,000 new cases per year affecting women between the ages of 30-60 and claiming as many as 5,000 deaths each year.  The Ministry of Public Health recommends that from the age of 25 women should receive regular screening for cervical cancer every five years.

Prof. Dr. Orawan explains that cervical cancer is a sexually transmitted disease, mainly caused by the human papillomavirus (HPV).  The use of condoms as protection cannot prevent such transmission, and the HPV vaccine is not yet prevalent or provides 100% protection against cervical cancer.

She also stressed that “Most of those who have been affected are asymptomatic which makes it necessary for us to still be tested regularly since that is a crucial way to prevent us from the disease and death.”

The HPV paper-based DNA sensor testing kits

The cervical cancer testing kits are easier and much faster than the Pap Smear or Pap Tests currently in use.  It eliminates the need to insert a tool and hold the vaginal walls open as well as swabbing over the cervix to take cell samples that are sent to the lab for testing.

“HPV paper-based sensor testing is a way to test the DNA of the HPV virus by using PNA (Peptide Nucleic Acid) which is a synthetic substance that imitates our DNA designed to be specific according to the cells being tested which can be specified since HPV comes in many different strains and not all strains cause cervical cancer.  When designing the substance, we needed to determine which strains there were when it comes to HPV infection,” said Prof. Dr. Orawan.

The HPV paper-based sensor testing kit is something that a lot of us are already familiar with from the ATK tests we have undergone for COVID-19.

“The urine is mixed in a solution then dropped onto the paper after which we notice the change in color of the solution.  Normally the color of the solution is bright red but if the urine is contaminated by the virus the color appears lighter. The brightness of the color varies according to the amount of the virus.  We have an additional tool, used with the colorimeter application on smartphones that helps make the color more visible.”

Prof. Dr. Orawan assured us that the HPV paper-based sensor testing kit has been tested and shows a high level of accuracy with a sensitivity of 85%, specificity of 78%, and reproducibility rate of 100%.”

The HPV Testing Kits have not been produced for home use.  They are, however, being used in health centers and community hospitals.

“In the urine, there are fewer DNA materials than in tissues, which means we need to have a device that increases the DNA level so that the change of color is more visible and the device is already in use in the clinics and community hospitals.”

How to watch over our health to stay away from cervical cancer

Prof. Dr. Orawan left us with some tips on how to help women stay safe from cervical cancer.  “First, women should make sure they always keep their vaginal areas clean.  Vaccinations are good but the prevention they offer isn’t a hundred percent.  The best way is to have regular cervical cancer checkups for early detection and treatment.”

The research team hopes that this innovation will motivate women to get themselves tested regularly, with a simple and painless process, at an affordable price.  Each test kit should not exceed 500 baht.

Prof. Dr. Orawan left us with these words.   “We’d like to see women getting cervical cancer tests regularly as advised by the Ministry of Public Health.  Therefore, we have tried to make the cost of these kits as low as possible to make them easily accessible.  It would be ideal if women can be tested regularly, for example once a month at a health center nearby.”

Nursing facilities or agencies interested in these HPV paper-based DNA sensor testing kits may contact Prof. Dr. Orawan Chailapakul at the Department of Chemistry, Faculty of Science, Chulalongkorn University, email address orawon.c@chula.ac.th for more information.

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Increases in HPV-linked cancers in parts of US with high smoking rates

A new paper in JNCI Cancer Spectrum, published by Oxford University Press, finds increases in both men and women for several HPV-related cancers in low-income counties or those with high smoking rates. Increases were slower in the highest-income US counties or those with low smoking rates.

In the era of collective decline in cancer rates, human papillomavirus (HPV)-associated anal, oropharyngeal, and vulvar cancer is still rising. Risk factors for HPV-associated cancers include smoking and risky sexual activities, both behaviors likely more common in poorer parts of the United States.

Researchers here used the Surveillance, Epidemiology, and End Results database, a National Cancer Institute database that provides nationwide information on cancer statistics, to investigate HPV-associated cancers by US county-level income and smoking prevalence between 2000 and 2018.

They found that anal and vulvar cancer among women and anal cancer incidence among men increased significantly in the lowest-income counties and counties with high smoking rates, while the increases were slower in their counterparts.

Cervical cancer incidence plateaued, rising not at all in the highest income counties, but increasing 1.6% a year in the lowest income counties. Oropharyngeal cancer rates among women increased by 1.3% a year in low-income counties and only by .1% in high-income areas. Anal cancer rates among women increased by 3.2% in low-income counties but by only 2.6% in high-income areas. For vulvar cancer, rates increased 1.9% a year in the lowest-income counties but only vs. 0.8% a year in the highest-income counties. Vaginal cancer rates increased by 2% a year in low-income counties and declined by .3% in wealthier areas.

Among men, oropharyngeal cancer rates increased by 2.1% a year in low-income counties and by 1.7% per year in high-income counties. Anal cancer rates increased by 3.9% in low-income areas but increased by only 1.5% in high-income counties.

Counties with high smoking prevalence, which are also often low-income counties, had marked increases in cancer rates compared to their counterparts. Anal cancer among women increased by 5% a year for those living in high-smoking counties and only 1.9% a year for those living in lower smoking-rate counties. Vulvar cancer increased by 3.8% a year a year for those living in high-smoking counties and only .6% for those living in lower smoking-rate counties.

Oropharyngeal cancer rates among men increased by 2.7% a year in high-smoking areas, but only by 1.5% in low-smoking counties. Anal cancer incidence rates among men increased by 4.4% in high smoking-rate counties, but only by 1.2% in lower smoking-rate counties.

“HPV vaccination and cervical cancer screening are the cornerstone interventions to prevent avoidable suffering caused by six cancers,” said the study’s senior investigator, Ashish Deshmukh. “Unfortunately, cervical cancer screening rates declined in recent years and HPV vaccination rates remains 15% points lower in rural low-income counties. The COVID-19 pandemic has further disrupted the delivery of preventative care. Urgent and collective efforts are needed to prevent growing disparities from worsening.”

The paper, “Trends in the Incidence of Human Papillomavirus-Associated Cancers by County-Level Income and Smoking Prevalence in the United States, 2000-2018,” is available (at midnight on March 3, 2022) at https://academic.oup.com/jncics/article-lookup/doi/10.1093/jncics/pkac004.

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How Bad Is It Really to Never Clean Your Yoga Mat?

Your yoga mat is like your water bottle — you know you should clean it every now and then, but you probably rarely do. However, if you examined your mat under a microscope, what you’d find lurking about might change your mind (and give you the heebie-jeebies). Yep, an unwashed mat is a breeding ground for all kinds of creepy crawlies including bacteria, fungi and viruses. This includes the risk of HPV. Which makes it an especially fertile incubator for many infections (more on this later).

We spoke to Kelly Reynolds, PhD, director of the Environment, Exposure Science and Risk Assessment Center at the University of Arizona, to find out what happens if you let your mat accumulate muck, plus tips on how to clean a yoga mat

3 Reasons to Clean Your Yoga Mat Regularly

1. It Can Cause a Skin Infection

Your yoga mat may be harboring harmful germs — including viruses, bacteria and fungi — which can produce nasty skin infections. “These microbes can live on surfaces for days to months and spread from person to person via surfaces like exercise mats,” Reynolds says. Common pathogens that can be transmitted by a dirty yoga mat include:

  • Fungi that cause athlete’s foot and other types of ringworm:​ These pathogens multiply in warm, moist environments (like gym showers or around swimming pools). They are especially well adapted to thrive for long periods of time on yoga mats, Reynolds says, which is why fungal infections flourish so easily.
  • Staphylococcus or staph bacteria:​ It’s a pathogen commonly found on the skin that’s usually harmless but can cause infection when it gets into a cut. Staph infections can cause red, swollen and painful skin infections that look like pimples or boils, and can even leak pus or become crusty, according to the National Library of Medicine. They can also lead to bone infections, which can cause flu-like symptoms such as fever and chills.
  • Human papillomavirus (HPV):​ Some strains of HPV can cause warts on the skin. Plantar warts are warts on the bottom of the feet.
And while bringing your own yoga mat to the gym (versus borrowing a rarely cleaned communal mat) can help mitigate your risk of infection, it doesn’t eliminate it completely. You can still become infected by someone simply stepping on your mat on their way to the water fountain. Or you could pick up germs from the gym floor and transfer them to your mat.

“Either way, add sweat and a warm environment, like a hot yoga studio, and you may have your own fungal colony established,” Reynolds says.

2. It Can Make You Break Out

Your filthy yoga mat might be bringing on bouts of breakouts. Excess oil, dirt, dead skin cells and bacteria –— which can block your pores and produce pimples — can easily spread from an unclean exercise mat and promote acne, Reynolds says. To make matters worse, acne typically appears on areas of your body that boast the most oil glands such as your chest, upper back and shoulders, per the Mayo Clinic. And these oilier body parts are often the ones exposed to your yoga mat.

3. It Can Make You Sick

A dirty yoga mat can also ramp up your risk for catching the common cold, a respiratory infection or the stomach flu. This happens when cold and flu viruses are released into the air through a sick person’s coughs or sneezes, Reynolds says.

And someone doesn’t have to be particularly close for their germs to reach you. The spray from a sneeze or cough can travel up to 6 feet, per the Centers for Disease Control and Prevention (CDC). In fact, an April 2014 study in the Journal of Fluid Mechanics found that smaller droplets can cover even longer distances (as far as 2.5 meters or more than 8 feet).

These meddling microbes rapidly settle on surfaces — like your yoga mat — where they can survive for days and spread to others, Reynolds says. Usually, an infection occurs when you touch your germy mat and unknowingly transfer the virus to your eyes, nose or mouth from your hand.

And while the common cold or flu may be a temporary inconvenience (read: mostly harmless) for healthy individuals, those with compromised immune systems may become sicker.

For instance, people with certain medical conditions such as asthma, diabetes and heart disease, and older adults and pregnant people all have a higher risk for serious flu complications, per the CDC.

Related Reading

How to Clean a Yoga Mat

So, how often do you need to clean your yoga mat? More often than you think.

“Given that exercise mats are placed on dirty floors, often shared among users and come into direct skin and face contact, I recommend cleaning ​and​ disinfecting them before every use,” Reynolds says. “Cleaning alone will not kill most of the germs, but it will reduce dirt, sweat and oils that bacteria and fungi feed on.”

If you’re sticking to solo at-home workouts (i.e., you’re the only one coming into contact with the mat), you have a little more leeway. In this case, cleaning and disinfecting it once a week should suffice. That said, if you sweat profusely, or you’re prone to acne, you might want to wipe down your mat more often.

Here are Reynold’s tips for how to clean a yoga mat and keep it microbe-free.

If Your Mat Is Machine Washable

Toss it in the wash (by itself) and follow the manufacturer’s instructions. To properly disinfect your mat, also use a laundry sanitizer, Reynolds says. A product like Lysol Laundry Sanitizer will kill bacteria and viruses that a regular detergent might miss.

If Your Mat Isn’t Machine Washable

First, scrub it with soap and water to remove any dirt, then use a disinfecting spray or wipe, which is your best defense against germs. “Alcohol-based wipes are safe for use with most surfaces,” says Reynolds, who recommends throwing a travel pack in your gym bag.

After you clean and disinfect your mat, pat it down to dry it thoroughly. “Be sure your mat is fully dry before rolling it up to store as trapped moisture can promote more germ growth,” Reynolds says.

So, How Bad Is It Really to Never Clean Your Yoga Mat?

Doing downward dog on a dirty mat may impact each of us differently — for some it’s NBD, but for others, it can be potentially harmful. If you have a weakened immune system and are more susceptible to infection, a clean yoga mat is more important, especially if you lug it to the gym or a hot yoga studio where germs love to gestate.

But a group class isn’t the only place where you can pick up pathogens. At home, your roommate or your partner can also pass on infections if they use your mat or inadvertently cough or sneeze on it. So if your immune system isn’t robust and you live with someone, stick to separate mats and stow yours away (out of reach of random sneeze sprays) when you’re not using it.

If you’re a generally healthy person who lives alone and only uses your mat at home (i.e., never shares it with another soul or carries it to the gym), you’re probably in the clear even if you don’t clean it as often. But if you’re noticing recurring body acne or an unexplained skin infection, you may want to scrub and disinfect your mat more often.

To extend the time between washings, you can even lay a towel on top to keep sweat and body oils off the surface of your mat. Keep in mind: This strategy only works if you launder the towel with each use.

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Blood test predicts recurrence of HPV, oropharyngeal cancer

A blood test that detects circulating tumor DNA can predict recurrence of HPV-driven oropharyngeal cancer following treatment, according to research presented February 24 at the 2022 Multidisciplinary Head and Neck Cancers Symposium. The multi-institutional study, presented by Dr. Glenn Hanna from the Dana-Farber Cancer Institute, indicated that the biomarker test may detect recurrent disease earlier than imaging or other standard methods of post-treatment surveillance. Hanna said this allows physicians to personalize treatment more quickly for patients whose cancer returns.

Researchers looked at data from 1,076 patients who had one or more blood tests to detect circulating tumor tissue modified viral (TTMV) – HPV DNA as part of their post-treatment surveillance. Of the 80 patients who tested positive for the biomarker in surveillance, 95% were confirmed through imaging, biopsy, and/or endoscopy as having recurrent HPV-positive disease. The presence of TTMV-HPV DNA was the first indicator of recurrence for 72% of the patients whose cancer returned, and 48% of the recurrences were found in patients tested more than 12 months after completing therapy. Reach out to us to learn more about blood test and HPV.

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What to know about high risk HPV

Diagram showing where high-risk HPV can occur in the bodyShare on Pinterest
Illustration by Yaja Mulcare

Human papillomavirus (HPV) is the most common sexually transmitted virus, with doctors diagnosing roughly 13 millionTrusted Source new cases every year.

The virus can pass on through skin-to-skin vaginal, anal, or oral sex. A person may not realize that they have the infection because it sometimes causes no symptoms.

Read on to learn about the types of HPV, as well as testing, treatments, and methods of prevention.

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

What is high risk HPV?

Some types of HPV can cause cancer. This means that they are “high risk.”

When a high risk type of HPV infects cells, it changes how they communicate with one another. It also causes the cells to multiply. Usually, the immune system becomes aware of these cells and regulates them.

However, if these abnormal cells remain, they can continue to change and become precancerous.

HPV infects the thin, flat squamous cells that line the inner surface of some organs. For this reason, most HPV-related cancers are called squamous cell carcinomas.

The virus can also cause cancer in the glandular cells of the cervix, and this cancer is called adenocarcinoma.

There are more than 200 typesTrusted Source of HPV. Doctors categorize them as oncogenic and non-oncogenic.

At least 14 typesTrusted Source of HPV are oncogenic, meaning that they can cause cancer.

Non-oncogenic types usually cause no serious health issues. A doctor may refer to non-oncogenic types of HPV as “wart-causing HPV.”

Low risk

Low risk, or non-oncogenic, types of the virus rarely cause precancerous lesions, though they may still cause cellular changes.

If certain low risk types of HPV remain in the body, they can cause genital warts. These are benign growths that can develop around the genitals, groin, and anus.

Around 40 typesTrusted Source of low risk HPV can infect the genital area. HPV types 6 and 11 are the most common causes of genital warts, together causing around 90%Trusted Source of cases.

Some low risk typesTrusted Source can also cause the growth of warts in the mouth and throat. This condition is called recurrent respiratory papillomatosis, and it is more common in children than adults. “Papilloma” is another name for “wart.”

These growths are often benign, but they can cause severe airway obstruction and complications. In extremely rare cases, these warts become cancerous.

High risk

High riskTrusted Source HPV can cause several types of cancer if the immune system does not clear the infection.

Research suggests that HPV types 16 and 18 cause 70%Trusted Source of cervical cancer cases and precancerous cervical lesions. A small 2021 study demonstrated that just under half of the participants with HPV had type 16.

Estimates suggest that high risk HPV causes 3%Trusted Source of all cancer cases in females and 2% of all cancer cases in males in the United States.

Read more about HPV in males.

In the early stages, cervical cancer may not cause symptoms. If symptoms do occur, they commonlyTrusted Source include:

  • abnormal vaginal bleeding
  • abnormal discharge from the vagina, with a strong odor or containing blood
  • pain during sex
  • pelvic pain

High risk HPV can also affect cells in other areas, and this may also develop into cancer. Other HPV-related cancers includeTrusted Source:

Testing for HPV

The primaryTrusted Source goal of cervical screening is to identify precancerous lesions caused by HPV. Doctors can remove lesions to prevent invasive cancers from developing.

Because HPV can develop without causing symptoms, regular screenings are an important way of detecting any changes early. Anyone with a weakened immune system or a medical history of cervical lesions may need more frequent screening.

Currently, cervical cancer is the onlyTrusted Source HPV-related cancer with a test that has been approved by the Food and Drug Administration.

The United States (U.S.) Preventive Services Task Force recommends that anyone who has a cervix and is 21–29 years old has cervical cancer screening every 3 years.

For anyone who has a cervix and is 30–65 years old, the task force recommends having an HPV test and Pap smear every 5 years or a Pap smear alone every 3 years.

The Centers for Disease Control and Prevention (CDC) do not recommend that males have routine testing for HPV.

Screenings for High Risk HPV

A Pap test, or Pap smear, was once the only type of screening for cervical cancer.

It involves collecting cells from the cervix. This only takes a few minutes and is an outpatient test. The doctor sends the sample to a lab, which checks for abnormalities in the cervical cells.

Cervical cancer screening now also includes HPV testing. In some cases, a doctor may recommend having a Pap test and an HPV test at the same time.

A Pap test involves checking the cells for precancerous changes. An HPV test looks for the DNA of the virus. A doctor may only order this test if a person likely has a high risk infection.

The results of both a Pap test and an HPV test give the doctor a clearer impressionTrusted Source of a person’s cervical cancer risk. Negative results of both tests indicate a very low risk of developing precancerous cervical lesions over the next several years.

Learn what to expect from cervical screening.

Treatments

There is currently no treatment for the infection. But treatments can address the health problems that HPV causes.

Although 20–30%Trusted Source of warts go away on their own over time, treatment can help manage outbreaks and reduce any discomfort. The treatment may involveTrusted Source applying a prescription cream or gel to the area or having the warts removed.

Surgery is necessary to remove precancerous cells caused by high risk HPV. This is to prevent the cells from becoming cancerous. A doctor can remove these cells from the cervix with a procedure called loop electrosurgical excision or with cervical cryotherapy.

The treatment for HPV-related cancer tends to be the same as the treatment for other cancers in the area. The best approach can depend on the location, type, and stage of cancer. Examples of these treatments include:

Prevention

A person can reduce their riskTrusted Source of contracting HPV by:

  • getting the HPV vaccine
  • consistently using barrier methods, such as condoms or dental dams, during sex
  • limiting the number of sexual partners

Gardasil 9 is the HPV vaccine available in the U.S. It protects people from several high risk types of HPV, including types 16 and 18 — as well as the low risk types associated with warts.

The CDC says that, ideally, everyone should receive the HPV vaccine at ages 11–12Trusted Source to reduce their risk of HPV-related cancer. This vaccination comes in two doses, 6–12 months apart. People aged 15–26 receive it in three doses.

After receiving the required vaccine doses, 98%Trusted Source of people develop the antibodies necessary to protect them from high risk strains, indicating that the vaccine is highly effective.

For people who are older than 27 and have a risk of new HPV infection, a doctor may discuss the benefits of receiving the vaccine, though it may be less effective.

Outlook

For most people with HPV, the infection clears within 2 yearsTrusted Source.

With regular cervical screening, doctors are more likely to catch any cell abnormalities before they become cancerous.

If a doctor detects abnormal changes, treatment can start early, and this improves the outlook.

Summary

HPV infections are very common, and the body’s immune system usually clears them. The infection can remain in the body and cause health problems in some cases.

Getting the HPV vaccine and having regular cervical screening reduces the risk of these health problems.

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Lifestyle choices can help lower your cancer risk

We all strive for a world where all people are free of cancer, but 10 million people still die from the disease every year. The good news is that new screening techniques combined with lifestyle choices can help prevent a third of common cancers and resulting deaths.

Screenings

“There are really four cancers we focus on that we have effective screening tools for,” says Dr. Scott Joy, Chief Medical Officer for HealthONE Physician Services Group.

The top two are mammograms to test for breast cancer and colonoscopies to test for colon cancer. But many people are now taking advantage of a less invasive way of screening for colon cancer.

“We have some opportunities where people can get a kit mailed to their house that screens for early cancer in the colon as well,” Dr. Joy says. “So a lot of patients, particularly in the pandemic, that may have been reluctant to get a procedure in the last year or two, we’ve been using more of these at home tests.”

Another common cancer screening is for cervical cancer. Dr. Joy suggests regular Pap smears for women until they are at least 65. He also encourages patients to be tested for HPV every three to five years.

But he says the cancer screening that’s really under utilized is one for lung cancer.

“So it’s really important that if you have a smoking history, and really any smoking history of any kind, to talk to your primary care provider about that,” Dr Joy says. “Depending on how much you smoke and how many years you smoke and what your age is, you would be a candidate for a low dose CT scan of the chest. And that’s a very effective test to help us screen for early lung cancers.”

Prevention

In addition to screenings, there are lifestyle choices you can make that can reduce your risk of cancer.

Being overweight or obese can increase your risk for cancer, so eating healthy, losing weight, and quitting smoking are really mainstays for cancer prevention.

“Smoking is a huge underlying risk factor for cancers, lung cancers, colon cancers, oral cancers, esophageal cancer,” Dr. Joy says. “Quitting smoking is a great thing to do.”

High fiber diets and diets high in fruits and vegetables can help reduce the risk of colon cancer.

According to the World Cancer Research Fund, about 20% of cancers diagnosed in the United States are related to poor nutrition and physical inactivity. The American Cancer Society Guidelines for Nutrition and Physical Activity encourage people of all ages to be active throughout each week and to consume vegetables, fruit and whole grains. The American Cancer Society has more information on being healthy and incorporating healthy habits into your routine on their website.

Cancer Support Community Resources:

Following recommended cancer screenings is another way to help detect cancer early, before it spreads. The American Cancer Society has guidelines for various cancer screenings based on age. It’s important to also know your family history and share that information with your physician.

Staying away from tobacco is another component to good health. Once someone quits tobacco, the effects can be noticeable right away. Heart rate and blood pressure drop 20 minutes after quitting. Circulation and lung function improve within two weeks to three months after quitting. Around one year after quitting, the excess risk of coronary heart disease is half of that of someone who stills smokes. Quitting can be challenging and the American Cancer Society can help. For resources visit cancer.org or 1-800-227-2345.

Protection from the sun, no matter what the season, is also important. Most skin cancers are caused by increased exposure to ultraviolet (UV) rays. A lot of that exposure comes from the sun, which is why it’s important to protect your skin. Wearing sunscreen and protective clothing along with wearing a hat and sunglasses can help limit exposure. For more information visit the American Cancer Society’s Be Safe in Sun page.

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Everything You Should Know About HPV That You Weren’t Taught In School

For one: “Nearly everyone will get HPV at some point in their life.” Learn more about HPV vaccines, symptoms, tests, and treatment to protect yourself.

Unless your Google calendar says you’ve got an upcoming Pap test or HPV vaccine appointment, odds are you aren’t actively sitting there thinking about HPV. Still, given the statistics on just how prevalent the virus is, maybe you should. Here are some things you should know about HPV.

HPV, or human papillomavirus, is the most common sexually transmitted infection in the United States. Currently, 42 million people are infected with the virus in the United States, with 13 million new Americans being diagnosed with it each year. Even more sobering: “Nearly everyone will get HPV at some point in their life,” according to the Centers for Disease Control and Prevention (CDC).

But what exactly is HPV? What are the symptoms? And how do you test and treat the infection? All important questions about HPV. Get the answers below.

What Is HPV, Exactly?

Specifically, HPV is caused by a family of viruses called human papillomavirus, of which there are currently more than 200 different strains.

The part of the body the virus infects, the accompanying symptoms (if any), treatment, and how long it lasts all vary based on the exact strain(s) someone has, says Emily Rymland, D.N.P., F.N.P.-C., clinical development manager at telehealth platform Nurx.

As it goes, the types of HPV are usually broken down into two broad categories: low risk and high risk. Low-risk strains of HPV are unlikely to cause problems (infertilitycancer, etc.) down the line. High-risk strains of HPV have the potential of causing cancers, such as cervical cancer, penile cancer, anal cancer, and esophageal cancers. To be clear: Low risk is not synonymous with asymptomatic, but more on this below.

Know How Do You Get HPV?

Roughly 40 of the strains of HPV can be contracted by having sex with a person who has HPV. Transmitted through skin-to-skin contact, it can be spread through anal sex, vaginal intercourse, oral sex, scissoring, and other sex acts that involve bare skin, according to the CDC. There’s also some research that shows the virus can live on sex toys made of silicone and elastomer for up to 24 hours — even after a proper cleaning — which suggests that sharing sex toys can also transmit the virus. What’s more, the virus can be transmitted through sexual acts regardless of whether symptoms are present.

The other strains of HPV are not caused exclusively by sexual contact, and can result in common warts such as hand warts and plantar warts, says Rymland. These are the types of warts your parents were warning against when they told you to wear flip-flops on the pool deck, she adds. Note: This article is specifically covering the strains of HPV that can be transmitted sexually.

Know The Signs and Symptoms of HPV

While most strains of the virus are asymptomatic, when HPV symptoms do appear, they can often come in the form of warts, according to Rymland. Known as genital warts, these warts are small, flesh-colored bumps that show up most often on the vulva, taint, penis, cervix, or along the anal or vaginal canal. Certain strains of HPV can also cause oral warts or lesions, according to the CDC. It’s uncommon for HPV warts — no matter where they pop up on the body — to be accompanied by any other symptoms, such as pain, itching, or discomfort, says Rymland. (Related: Everything You Need To Know About Genital Warts)

“The strains that cause warts aren’t those that are associated with cancer,” explains Rymland. So, while the warts might be annoying or unsightly, the HPV strains that cause warts are considered low-risk. But don’t read it wrong: Just because your strain doesn’t cause warts, that doesn’t mean it’s high risk. Only some of the strains of HPV that don’t cause warts can lead to cancer, she says. Indeed, some strains cause neither warts nor cancer — hence the commonality of asymptomatic cases. ICYWW: The strains associated with genital warts are stains 6 and 11. Meanwhile, the strains that could cause cancer are 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 28, according to the National Cancer Institute.

That said, it’s possible to have more than one strain of HPV at the same time. Sometimes, the presence of warts will lead someone to get tested for HPV, and find out that they have an additional strain of HPV as well, says Rymland. Your practitioner will be able to identify exactly which strain(s) you have, if any, so you can receive the proper HPV treatment.

Know How to Test for HPV

If someone has a strain of HPV that is actively causing genital warts, “sometimes health care providers will diagnose genital warts from appearance alone,” sexual health expert Amy Pearlman, M.D., with Promescent, a sexual health product retailer previously told Shape. Other times, the provider will remove a tiny piece of the wart to biopsy, or test it, for any abnormality, according to Dr. Pearlman. A biopsy allows the provider to rule out other similar-looking conditions such as skin tags or moles.

However, if you don’t have any visible HPV symptoms (as most people won’t), you’ll need to be tested for the virus via a vaginal or anal pap. In fact, even people who do have genital or anal warts should still be screened for HPV because this doesn’t necessarily rule out infection with a high-risk asymptomatic strain, or multiple strains of the virus, says Rymland.

So, what does an HPV test entail? Also known as getting HPV screened, testing for HPV varies based on sex and genital make-up, as well as the type of sex you’re having (if any).

If you have a cervix, you’ll typically get screened for HPV at the same time that you get a Pap test from your gynecologist. These tests require the provider to put a speculum into the vaginal canal, then collect a sample of cervical cells with a soft brush and/or small scraping device. The provider will send this collection of cells to the lab to test for precancerous lesions caused by HPV or for cellular abnormalities that suggest that cancer is at its early stages. Another option is to take an at-home HPV-testing kit, such as those through Nurx or Everlywell, which require a quick swab of the vaginal canal (you won’t need to reach the cervix). However, at-home HPV tests only test for certain strains of the virus. Carefully read the product description to learn exactly what strains the at-home HPV test is able to find. The Everlywell HPV Test, for example, screens for strains 16, 18, and 45, while the Nurx HPV test looks for strains 16 and 18.

Regardless of your gender or sex, if you enjoy receptive anal or oral sex, your doctor may recommend an anal pap smear to look for precancerous changes, says Rymland. To note, there are currently no FDA-approved tests for oral HPV. The only way doctors are currently able to tell if you have oral HPV is if you have a strain that causes oral legions that are visible during an oral exam).

“It’s really unfortunate that there isn’t an approved regular screening for any body part other than the cervix because HPV-related cancers of the anus, penis, and throat are all on the rise, and affect all genders and sexual orientations,” she says.

Know How Often to Test for HPV

How often you should get an HPV test depends on your age, your sexual and medical history, and the results of your last HPV test. “It’s recommended that people don’t test for HPV until age 30,” according to Rymland (and the CDC, FTR). The reason? “When you’re younger it’s likely that if you do have a strain it will go away on its own [thanks to the immune system] and won’t cause any problems down the line.”

Between the ages of 30 and 65, people with cervices should get an HPV test every five years, according to The American College of Obstetricians and Gynecologists. After that, individuals who have not tested positive for cancer-causing strains do not need to continue getting screened. As always, however, it’s best to talk to your practitioner about your specific sexual practices and any other risk factors to get HPV test recommendations tailored to you.

“People with cervices should get their screenings on the recommended schedule, but unlike other STIs, you don’t need to test for it annually,” she says.

Know What Is the Treatment for HPV?

“There is no cure for the human papillomavirus itself,” says Rymland. But the immune system often clears it on its own within two years of infection, she says.

If you have a strain of HPV that causes genital warts (and they haven’t gone away on their own), you can get them removed by your doctor, usually with a process known as cryosurgery, which essentially involves freezing off the warts. Just keep in mind that removing HPV warts does not rid the body of the virus itself, and warts could return.

As for HPV treatments if you have a strain that can cause cancer that the body doesn’t clear on its own? Health-care providers will simply treat any precancerous changes, such as with the cells that line the cervix, caused by the virus, explains Rymland. These can be monitored and detected by cervical screenings and pap smears, as well as oral and anal HPV testing, she adds.

Good news: Even if cancer has developed, it’s usually treatable if caught early, she says. Treatments for these cells vary, but can include excision, lasering, or freezing of the abnormal cells, or impacted tissues. “Getting screenings on schedule is important because it allows us to catch if/when the virus has led to precancerous changes, and then provide treatment before it turns into cancer.”

Know How to Protect Against HPV

The number one thing people can do to protect against HPV is to get the HPV vaccine, according to Rymland. Known as the Gardasil vaccine, the HPV vaccine protects against 9 strains of the vaccine (strains 6, 11, 16, 18, 31, 33, 45, 52, and 58) and is FDA-approved for people of all genders over the age of 9. People should get the vaccine prior to the age of 26, as early protection offers the best protection, according to the CDC. If you’re between the ages of 27 and 45 and have not yet received the HPV vaccine, talk to your provider, as they may still recommend it as a way to protect against strains of the virus you have not been exposed to yet. Worth knowing: The age you are when you get the vaccine will impact how many doses of the vaccine you get — only two doses are needed for those who get the first vaccine before their 15th birthday, while those who get their first dose after that may need three doses, each six to 12 months apart.

Beyond the HPV vaccine, the usual safer sex practices apply here. That means knowing your own status, staying up to date on STI testing, and communicating your status with any new partner — ideally before you have sex for the first time.

It also means using barriers (dental dams, finger cots, condoms, etc) with any partner who is HPV-positive, does not know their current HPV status, or has a previous partner that has known HPV. As you now know, this can go for most pleasure-seekers, so play it safe.

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Impact of Prior HPV Infection or History of Abnormal Pap Smear and HPV

The Impact Of A Prior HPV Infection Or A History Of Abnormal Pap Smear On The Humoral Immune Response To A Quadrivalent Human Papillomavirus (qHPV) Vaccination

In 52.9% of cases, there was a history of abnormal pap smear/cervical neoplasia. At baseline, anti-HPV antibody titers at baseline: 21% were negative for all four HPV types, whereas 79% were positive for one of the four HPV types. Statistical analysis revealed that those with a history of abnormal pap smears/cervical neoplasia were more likely to have a positive anti-HPV antibody result before vaccination to one of the four kinds, (P = 0.035) Fisher’s Exact Test. In general, HPV-exposed women had greater post-vaccine GMTs and higher point estimates than HPV unexposed women. There was no indication of an anamnestic response when the rise in titers was examined using logistic regression. Prior HPV infection and cervical neoplasia in SLE had been associated with a lack of anamnestic response to the HPV vaccination. This validated the decision not to screen for HPV antibodies before vaccination.

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Men and the Human Papillomavirus

In cervical cancer awareness month, Yan-Yi Lee delves into the topic of HPV, exploring why heterosexual men in particular may be less aware of the risks and consequences. Whilst availability of the HPV vaccine is increasing, there is much to be done further raise awareness. Read more to learn about Men and the Human Papillomavirus.

 

HPV comes in more than 170 forms (with certain subtypes being more ‘deadly’ than others) and typically transmits through sexual activity. Despite it spreading equally easily and causing cancer in both males and females, there tends to be surprisingly low awareness of what HPV is among men. It is unbelievable to me that the term doesn’t even ring a bell among the highly educated male friends in my social circle, with some even confusing it with the Human Immunodeficiency Virus (HIV) or the Herpes Simplex Virus (HSV). Findings in recent scientific studies appear to align with my anecdotal observations. In the previous decade, data collected in one American university revealed that despite rising death rates in HPV-related cancer among men, less than 30% of males were vaccinated. Another report painted a similar picture: the awareness of HPV and the importance of its vaccination dropped by a whopping 10% among men between 2013 and 2018. Sexuality also appeared to play a role in HPV awareness, with the LGBTQ+ community appearing to be more conscious of the threat posed by HPV. It was found that men who have sex with men tend to be more aware of HPV and are more willing to get vaccinated for it in comparison with heterosexual men.

Reasons that account for this striking gender gap in HPV awareness are multifaceted, and the first concerns how HPV testing works. Designing a technically robust HPV test for heterosexual men is challenging; there are currently are no approved tests for penile HPV, and throat swabs appear to be unreliable in capturing the virus as well. Although urine-based tests have been tested scientifically for women, the reliability of urine tests for testing HPV has yet to be discussed in more detail for men. Further, for bisexual and gay males, anal pap tests are only given if especially requested. In the absence of reliable tests, men commonly do not know they even carry the virus (let alone know how dangerous their HPV strains are) and potentially spread it to their partners.

The second explanation for this pertains to the consequences. As HPV is the primary cause of the fourth most common cancer for females (and because detection is possible and can result in highly effective treatment), women tend to be more conscientious of HPV and the importance of tracking it in their bodies. Similarly, for gay and bisexual men and their attitudes towards anal cancer. On the other hand, the rate of penile cancer is a mere 1 to 100,000 for heterosexual men, so the stakes are lower and hence less awareness.

“A careless wild night may not only imply other widely-known sexually transmitted infections; it may also lead to an agonising cancer in older age”

Thus, what could the male population do to slow down the spread of HPV? Prevention measures are not hard to guess: using protection during sexual intercourse and getting all three doses of the HPV vaccine. In the UK, both girls and boys are vaccinated early on at ages 12-13; and contrary to popular belief, HPV vaccines can still be administered in adulthood. The vaccine would most likely be beneficial even if an individual has HPV, although this would depend on the strains of HPV currently existing in the individual’s system. In any case, a consultation with a health professional beforehand is always the best idea.

Demystifying intersexuality

It is commonly understood that a careless wild night may imply unwanted pregnancy and other widely-known sexually transmitted infections, but what many of us fails to see is the same carelessness may lead to agonising cancer in older age – particularly for women and non-heterosexual men. These cancerous infections often happen in one-night-stands, and it simply isn’t worth getting cancer for a person whose name you won’t even remember after some ephemeral dopamine and serotonin. Both genders have the responsibility and the power to protect themselves and their partners from HPV-related cancers. The fact that there isn’t as much reason to worry about HPV among heterosexual men should not excuse them from the responsibility to build awareness of it, and it is high time to find out how best to do so on a broader scale.

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Mouth Cancer Charter to raise awareness in rise of oral cancer

Mouth cancer charterSeb Evans reports back from the Oral Cancer Action Charter signing at the Palace of Westminster last month. Leading figures from dentistry along with MPs all joined to sign the latest Mouth Cancer Action Charter towards the end of 2021. The charter challenges the government on six key actions:

  • Conduct a government-funded public health awareness campaign on mouth cancer
  • Improve access to routine dentistry for earlier detection of mouth cancer
  • Enable enhanced training of GPs
  • Improve training programmes for healthcare staff to spot mouth cancer
  • Introduce free check-ups and treatment for mouth cancer patients
  • Support the development of better technology to diagnose mouth cancers.

The campaign also encourages patients to become more self-aware. The aim is for patients to check their mouths themselves in front of the mirror once a week.

Focusing on mouth cancer

‘With this event here today, we’re trying to raise up the politician and policy maker’s agenda the importance of mouth cancer and the impact it has,’ Nigel Carter, chief executive of the Mouth Cancer Foundation, said.

‘We’re trying to get more investment in mouth cancer. It would be great to have some central investment to have an awareness campaign.

‘Access is getting worse rather than better, even without Covid. That’s a real challenge. 

‘It is as a cancer that has so much impact on people’s lives, 50% of the people diagnosed with mouth cancer never return to work. The impact on people’s lives, their lifestyle, their quality of life is immense.

‘And survival rates just haven’t improved over the last 30 years, whereas if you look at most other cancers, they’ve improved. Mouth cancer’s five-year survival rates have remained flat and cases have doubled.

‘It really is something that needs focusing on more.’

‘Don’t just look at the teeth’

‘From the dentists’ point of view, they’ve got to remember to look at the patient’s mouth,’ Sir Paul Beresford MP said.

‘Don’t just look at the teeth, look all the way around. Patients can be aware of this and if the dentist doesn’t actually look and tell the patient they’ve had a good look round, there could be difficulties.

‘Over my career I’ve probably seen 12/15 cases of oral cancer. Because I’ve managed to get them all early, only one of those patients actually died of cancer. And that was only because the patient wouldn’t attend to see the oral surgeon. 

‘Mouth cancer rates are rising, firstly because the HPV vaccination hasn’t cut in due to the age. Secondly, it’s an increase in detection and the third thing is patients aren’t going to the dentist. Finally, general awareness is low. If we can increase awareness, people can look for it themselves. If they find something suspicious, see the dentist.

‘The treatment, if it’s beyond very early stages, is drastic and very unpleasant.

‘The Mouth Cancer Foundation is really helping make a change with patient’s awareness.’  

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