HPV infection is linked to over 99.7% of cancers

HPV can cause cervical cancer by 2 mechanisms:

• chronic infection of the cervix
• HPV produces 2 proteins (E6 and E7), these inhibit the tumour suppressor genes p53 and pRb (respectfully). Therefore, HPV promotes the development of cancer by inhibiting tumour suppressor genes, allows infected cells to grow unchecked

HPV

• Transmitted via sexual contact (can occasionally spread to baby during pregnancy)
• Exposure is usually controlled by the immune system, however in some individuals (e.g. immunocomprimised) the virus can survive for years - causing cervical intraepithelial neoplasia
  • involves dysplastic changes at the squamocolumnar junction
  • koilocyte formation (squamus epithelium that has undergone structural changes)

High risk HPV

HPV16 and HPV18 - present in 70% of cervical cancer cases

• These versions have an enhanced ability to inactivate tumour suppressor genes = rapid division of dysplastic cells (cervical cancer)
• Have also been attributed to an increased risk of cancer of the oropharynx, larynx, vulva, vagina, penis and anus

Immunisation

Gardasil - protects against strains 6, 11, 16, 18

All 12- and 13-year-olds (girls AND boys) in school Year 8 are offered the human papillomavirus (HPV) vaccine.

• the vaccine is normally given in school
• information given to parents and available on the NHS website make it clear that the daughter may receive the vaccine against parental wishes
• given as 2 doses - girls have the second dose between 6-24 months after the first, depending on local policy