HPV and Cervical Cancer: Key Questions Answered

Questions related to HPV infection?

Hello, doctor.
Last year during my health check-up, I was diagnosed with dysplastic cells and could not rule out high-grade squamous intraepithelial lesions.
Later, a large hospital confirmed that it was carcinoma in situ.
I underwent a cone biopsy on March 1.
After that, I went to another clinic for a check-up, where the doctor informed me that the report indicated that the area of cervical lesions was not completely excised.
I also underwent HPV testing, which confirmed the presence of HPV type 58.
The doctor has scheduled me for a Pap smear on June 1.
If the results are good, I will continue to be monitored with Pap smears approximately every six months to a year.
If the results are not good, I may undergo LEEP surgery.
I would like to ask: 1.
Is carcinoma in situ considered cancer? 2.
If LEEP surgery is performed and the margins are still not clear, can LEEP surgery be done again? How many times can LEEP be performed in total? 3.
I have already received the nine-valent HPV vaccine.
Will the HPV type 58 virus in my body resolve on its own, or will I carry this virus for life? If so, how can my family prevent transmission?

Ms. H, 20~29 year old female. Ask Date: 2024/05/13

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, currently in Taiwan, in situ carcinoma is not recognized as cancer by the National Health Insurance Bureau.
LEEP refers to loop electrosurgical excision procedure, which is a type of cone biopsy.
Sometimes cancer cells can extend into the cervical canal, and it is not guaranteed that the cone excision surgery will remove all of them.
It is recommended to follow up with a hospital for further management.
As for whether the virus will disappear, it depends on your immune system; at this point, we can only monitor the situation.
Wishing you good health.

Reply Date: 2024/05/13

More Info

Understanding HPV and Cervical Cancer: Key Questions Answered
Hello! Thank you for your questions regarding HPV and cervical cancer. It’s essential to clarify these topics, especially given your medical history and concerns. Let’s address your questions one by one.

1. Is carcinoma in situ considered cancer?
Yes, carcinoma in situ (CIS) is considered a form of cancer, specifically a non-invasive type. It refers to abnormal cells that are found in the lining of the cervix but have not spread to surrounding tissues. While it is not invasive cancer, it is a precursor to invasive cervical cancer if left untreated. Therefore, it is crucial to monitor and treat it appropriately to prevent progression.

2. If LEEP surgery does not completely remove the abnormal cells, can it be performed again? How many times can LEEP be done?
Yes, if the LEEP (Loop Electrosurgical Excision Procedure) does not completely remove the abnormal cells, it can be performed again. However, the decision to repeat the procedure depends on various factors, including the extent of the remaining abnormal tissue and your overall health. Generally, LEEP can be performed multiple times, but it is essential to discuss the risks and benefits with your healthcare provider. Repeated procedures may increase the risk of cervical incompetence in future pregnancies, so careful consideration is necessary.

3. I have received the nine-valent HPV vaccine. Will my body clear the HPV type 58 virus, or will I carry it for life? How can my family prevent infection?
The nine-valent HPV vaccine is designed to protect against nine types of HPV, including the high-risk types that can lead to cervical cancer. However, it does not treat existing infections. If you are already infected with HPV type 58, your body may clear the virus over time, as many individuals do with HPV infections. Approximately 90% of HPV infections resolve within two years without treatment. However, some individuals may carry the virus for life.

To prevent the spread of HPV within your family, it is crucial to practice safe sex, including the use of condoms, which can reduce the risk of transmission, although they do not provide complete protection. Additionally, educating your family members about HPV and encouraging them to get vaccinated can significantly reduce the risk of infection.

In conclusion, it’s vital to maintain regular follow-ups with your healthcare provider, especially after a diagnosis of carcinoma in situ and subsequent treatments. Regular Pap smears and HPV testing are essential for monitoring your cervical health. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare provider for personalized advice and support. Your health and peace of mind are paramount, and staying informed is a crucial part of managing your health.

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