HPV most common cause of cervical cancer

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January 14, 2019 - 9:25 AM

Dear Dr. Roach: Do all cervical cancers come from HPV? — B.H.

Answer: One study estimated that 99.7 percent of all cervical cancers worldwide are due to infection from human papillomavirus, especially the high-risk strains that are most likely to cause changes in the cells that can become cancerous. However, most cases of HPV are effectively treated by the body, and do not become cancer.

A few cancers do not have evidence for HPV when they are looked at. In one recent study from the U.S., about 10 percent of cervical cancers did not seem to be associated with HPV, but on careful re-evaluation, about half of those did have an association with HPV. Still, there are some cases of cervical cancer that are not due to HPV, and the risk factors for those may include smoking and HIV. This type of cervical cancer has a worse prognosis than HPV-related cervical cancer.

Population-level vaccination of HPV is likely to dramatically reduce cervical cancer, but not eliminate it entirely. For this reason, the Pap smear, which diagnoses cancer and its precursors, is likely to remain an important screening tool.

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