HPV: AN INVISIBLE THREAT OR A MANAGEABLE RISK?

March 4 marks International HPV Awareness Day. Human papillomavirus (HPV) is one of the most common sexually transmitted infections. According to the WHO, most people contract HPV at some point in their lives. In most cases, the infection is asymptomatic, but certain types of the virus can lead to malignant tumors, including cervical cancer, as well as cancers of the anal canal, oropharynx, and other areas.

Today, we are speaking with Maria Alexandrovna Lyushnenko, an obstetrician-gynecologist at the P. Hertsen Moscow Oncology Research Institute – branch of the Federal State Budgetary Institution of the “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation. We will discuss the link between HPV and cancer, the diagnostic methods that help detect the infection at an early stage, and the steps to take if the virus is identified.

HPV AND ITS LINK TO CANCER

Which types of cancer are most commonly associated with HPV?

HPV is a key cause of not only cervical cancer but also malignant tumors of the vulva, vagina, oropharynx, anal canal, and penis. The highest oncogenic risk is associated with HPV types 16 and 18, as they are the most aggressive in affecting epithelial cells.

Who is at the highest risk of contracting HPV?

HPV infection is most commonly detected in women aged 20–30, but in recent years, there has been a trend toward younger cases. HPV poses a particular danger to women because their target organs—the cervix, vulva, and vagina—are more vulnerable to the virus.

HPV DIAGNOSTIC METHODS

How effective are cytological tests and the Pap test in detecting precancerous conditions?

Cytological examination and the Pap test are primary methods for diagnosing precancerous changes in cervical epithelial cells. These tests help identify cellular abnormalities that may indicate HPV infection. However, for more accurate diagnosis, it is recommended to undergo HPV testing once a year.

How often should women be tested for HPV?

The optimal frequency is once a year. The PCR test is used to detect the presence of HPV DNA in the body. In addition, cytological examination of the cervix is performed. Liquid-based cytology is not mandatory; standard testing methods are sufficient.

Are there recommendations for HPV testing in men?

HPV diagnosis in men requires consultation with a urologist. Currently, testing is conducted only when medically indicated—if a male partner’s female partner has tested positive for HPV or if he exhibits clinical signs of infection.

WHAT TO DO IF HPV IS DETECTED?

Is it possible to completely eliminate HPV from the body?

HPV remains in the body for life; there is currently no complete cure. However, in most people with a strong immune system, the virus remains in a latent state and does not cause disease.

What control measures are available?

If the virus is detected in significant amounts, it is important to reduce its activity. Antiviral medications and immunomodulators are used for this purpose. In more complex cases, where standard therapy is ineffective, patients are referred to an immunologist to identify possible immune system dysfunctions.

What steps should be taken if oncogenic HPV types are detected?

If the virus is present in low concentrations, a follow-up cytological examination is recommended after six months. If the viral load is high, measures should be taken to reduce it. However, if cytological results remain normal, regular check-ups should be conducted every six months.

What if the virus is not detected?

If HPV test results are negative and cytology is normal, an annual examination is sufficient.

TREATMENT OF HPV-INDUCED PRECANCEROUS CONDITIONS

What are the most effective treatments for precancerous epithelial changes?

The choice of treatment depends on the location of the lesion. Treatment options include surgical removal of affected tissues and photodynamic therapy, which is particularly effective for lesions of the vulva and perianal region.

CAN HPV INFECTION BE PREVENTED?

Does using condoms provide full protection against the virus?

A common misconception is that condoms fully prevent HPV transmission. However, the virus can spread through contact with uncovered skin areas, such as the vulva, perianal region, base of the penis, and scrotum. Therefore, the risk of infection remains even with the use of barrier contraception methods.

What are some common misconceptions about HPV and cancer?

One widespread myth is that if a person has HPV, they will inevitably develop cancer. In reality, the outcome depends on the viral load, HPV type, immune system status, and timely medical supervision.