The HPV–Cervical Cancer Connection
Human papillomavirus (HPV) is the necessary cause of virtually all cervical cancers. Persistent infection with high-risk HPV strains — particularly types 16 and 18 — drives a sequence of cellular changes in the cervix: from normal epithelium to low-grade dysplasia (CIN1), high-grade dysplasia (CIN2–3), and eventually invasive carcinoma. This process typically takes 10–20 years, which is why cervical cancer is one of the most preventable cancers in the world.
Prevention: The Three Lines of Defence
- HPV vaccination — the 9-valent vaccine (Gardasil-9) protects against 9 HPV strains including types 16 and 18. Most effective when given at age 9–14 before sexual debut, but beneficial up to age 45. The Indian Academy of Pediatrics recommends routine vaccination.
- Cervical screening — Pap smear (every 3 years from age 21) or co-testing with HPV DNA (every 5 years from age 30). Screening detects precancerous changes that can be treated before cancer develops.
- Early treatment of precancerous lesions — high-grade changes (CIN2–3/HSIL) detected on screening are treated with LLETZ (loop excision) or cone biopsy, preventing progression to invasive cancer.
Screening After HPV Vaccination
Vaccination does not eliminate the need for screening. The current vaccines protect against the most dangerous HPV strains, but not all of them. Vaccinated women should continue regular cervical screening according to national guidelines.
When HPV Leads to Cancer: What Happens Next?
If screening detects invasive cervical cancer, staging with MRI and PET-CT determines the treatment pathway: early-stage disease is treated with radical hysterectomy (performed by a gynaecological oncologist), while locally advanced disease requires concurrent chemoradiation. The key is catching it before it reaches this point — which is exactly what vaccination and screening achieve.
For HPV vaccination counselling, cervical screening, or specialist assessment of abnormal results in Ahmedabad, contact Dr. Nishtha Tripathi Patel: +91 76988 00333.