Cervical Health: Concerns About HPV and Cancer Risk

Cervical issues

Hello doctor, this is my last series of questions.
I kindly ask for your assistance in clarifying this one last doubt.
The questions I previously asked are indeed related to my experiences, just in different contexts, and I apologize for any inconvenience.
I am also regularly seeing a psychiatrist.
A few years ago, my boyfriend confessed to me that he had solicited prostitutes in the past, but he cannot confirm if he always used protection.
I am now 38 years old, and I had sexual intercourse before the age of 18.
I suffer from severe health anxiety and have been with my current boyfriend for 20 years.
In my lifetime, I have only been intimate with my ex-boyfriend and my current boyfriend.
The timeline is as follows: Before 2012, my boyfriend would solicit prostitutes.
He mentioned that 2012 was his second-to-last time doing so.
I remember that between 2012 and 2014, my boyfriend and I had unprotected intercourse (if my boyfriend had HPV, he should have transmitted it to me).
In 2014, my boyfriend claimed it was his last time soliciting prostitutes, but he said it was unsuccessful, and he only took a shower afterward and used a towel from the establishment (the chance of my boyfriend contracting HPV seems low).
After that, he assured me he no longer solicited prostitutes.
From 2014 to 2016, I don't clearly remember if we had unprotected intercourse.
Since 2016, we occasionally have unprotected intercourse.
In 2016, I underwent a colposcopy, paid for a Pap smear, and HPV testing, all of which returned normal results.
In 2018, I recall having a government-funded Pap smear, which indicated inflammation, but after seeing a few doctors, I didn't follow up on it.
Until now, I haven't had any further examinations, but I have been experiencing issues with abnormal discharge, including yellow-green secretions, and I have consulted a gynecologist.
Currently, my health anxiety has intensified, and I am very worried about cervical cancer.
Therefore, I went for a colposcopy again on Monday, and the doctor who examined me informed me that I have cervical erosion.
I also had a Pap smear and HPV testing done today, and I am waiting for the results.
Aside from the discharge issues, I have no other symptoms.

Doctor, at this moment, what is the likelihood that I have cervical cancer compared to an average person? I hope my risk is similar to that of an average person.
The internet suggests that having early sexual intercourse and multiple sexual partners can significantly increase the risk of cervical cancer, potentially up to nine times, and I am truly scared...
Please help me one last time.

Lastly, I imagined a chilling scenario: I fantasized that my boyfriend contracted a carcinogenic type of HPV from soliciting prostitutes (from 2005 to 2012), and after he stopped soliciting in 2012, we had unprotected intercourse from 2012 to 2014 without transmitting HPV to me.
Then, in 2014, he attempted to solicit again but was unsuccessful and only used a towel from the establishment.
From 2014 to 2016, I don't remember if we had unprotected intercourse, but he still did not transmit HPV to me during those two years.
In 2016, my Pap smear and HPV test results were normal.
After a few days or months of receiving the report, my boyfriend transmitted HPV to me, and now I have cervical cancer.
Doctor, can you tell me if I am overthinking this? Is this scenario highly unlikely?
Note: The doctor who performed my Pap smear told me that my cervical erosion is actually very mild and that I shouldn't worry.
I also shared my concerns about cervical cancer with this doctor, who reassured me that my risk is similar to that of a passerby and advised me to relax.

vicky, 30~39 year old female. Ask Date: 2022/06/10

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if this test result is negative, then your risk is the same as that of a normal person, and there is no need to worry.
Wishing you good health.

Reply Date: 2022/06/10

More Info

Understanding your concerns about cervical health, particularly regarding HPV and the risk of cervical cancer, is crucial. It’s understandable to feel anxious given your history and the information available online. Let’s break down your concerns and provide some clarity.

Firstly, it's important to understand that Human Papillomavirus (HPV) is the primary cause of cervical cancer. There are many types of HPV, and while some are high-risk and can lead to cancer, others are low-risk and do not. The majority of sexually active individuals will contract HPV at some point in their lives, but most will not develop cervical cancer due to the body’s ability to clear the virus naturally.

Regarding your specific situation, you mentioned that your boyfriend had a history of engaging with sex workers and that you have had unprotected sex during your relationship. While this does raise the potential risk for HPV transmission, it’s important to note that not everyone who is exposed to HPV will develop cervical cancer. The progression from HPV infection to cervical cancer typically takes many years, and most HPV infections resolve on their own without causing any health issues.

You also mentioned that you have undergone several screenings, including Pap smears and HPV testing, with normal results in the past. This is a positive indicator of your cervical health. The fact that your recent examination showed mild cervical erosion (cervical ectropion) is not uncommon and is usually not a cause for concern. It’s often a benign condition that can occur due to hormonal changes, and it does not necessarily indicate cancer.

Your fear of developing cervical cancer due to your boyfriend's past and your sexual history is understandable, but it’s essential to focus on the facts. The risk factors for cervical cancer include persistent infection with high-risk HPV types, smoking, a weakened immune system, and long-term use of oral contraceptives, among others. While early sexual activity and multiple sexual partners can increase risk, your history of regular screenings and the absence of abnormal results are significant factors that suggest your risk may not be as high as you fear.

In terms of your current anxiety, it’s crucial to manage your mental health alongside your physical health. Anxiety can exacerbate your worries about health issues, leading to a cycle of fear and stress. It’s good that you are seeing a mental health professional, as they can help you work through these feelings.

Finally, while it’s natural to worry about the "what ifs," it’s important to focus on the present and the facts at hand. If your recent tests return negative for HPV and show no signs of cancer, your risk is likely similar to that of the general population. Continue to follow up with your healthcare provider, maintain regular screenings, and practice safe sex to further reduce your risk.

In summary, while your concerns are valid, the evidence from your past screenings and the advice from your healthcare provider suggest that your risk of cervical cancer is not significantly elevated. Focus on your health, both mental and physical, and continue to seek support from your healthcare team.

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