What is human papillomavirus?
It is a DNA virus of the Papillomaviridae family. There are several different human papillomaviruses, but they can be differentiated into two groups according to their oncogenic potential.
It is transmitted by skin-to-skin contact during sexual intercourse, and its incidence is very frequent, although most of the time it is eliminated spontaneously.
What are the symptoms?
It is usually asymptomatic. It depends on the type of virus:
- In the case of low-risk human papilloma, condylomas may appear.
- In the case of high-risk human papilloma it is asymptomatic until advanced stages, so cytological screening is important. It can cause cervical cancer and premalignant cervical lesions and in other areas of the lower genital tract.
It is important that in addition to the cytological screening that is usually performed in the public health system, a personalized study of each patient is carried out in order to avoid false negatives, that is, patients who appear to be HPV-free in the screening but who may later be found to have HPV.
This personalized study would include techniques such as colposcopy, microcolpohysteroscopy, hysteroscopic study of the endocervical canal (diagnostic hysteroscopy) and the study of mRNA E-6/E-7.
What is the link between this type of virus and cervical cancer? What is the incidence rate?
Virtually 100% of cervical cancer cases are HPV-dependent.
Eighty percent of women are infected at some time in their lives, but most of them eliminate it, and cytologic screening allows the diagnosis of premalignant lesions that can be treated to prevent cancer.
What is the treatment? What types are there?
- In the case of condylomas, by topical treatment (creams…) or cryotherapy.
- In the case of premalignant lesions, it is necessary to differentiate their grade:
If they are low grade, observation is recommended initially, since they usually eliminate spontaneously (80%) and also topical treatments would be added to help re-epithelialize the cervical mucosa and balance the vaginal microbiota.
- If these premalignant lesions are already high grade, the treatment is the removal of the affected area avoiding the progression of the disease. This is usually done by techniques such as LLETZ or LEEP, a kind of mini-conization, which eliminates the disease with practically no sequelae for the woman.
What are the risk factors for this disease and can it be prevented?
The risk factors are:
- Multiple partners
- Not using a condom
- Tobacco
- etc.
It can be prevented with routine cytology and especially with vaccination.