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HPV is ubiquitous in the human population. It is estimated that approx. 80 percent. sexually active people have come across or come into contact with it in their lifetime. There are over 120 types of the virus, most of them low-oncogenic. More than a dozen types, however, can contribute to the development of HPV-dependent tumors, including the most common cancer of the cervix. The human papillomavirus is responsible for approximately 95 percent of the total. cases of this disease.
- The human papillomavirus is not only responsible for the development of cervical cancer
- The pathogen also leads to other cancers, mainly in the head and neck area
- HPV-dependent tumors are most often diagnosed in young people
- More current information can be found on the Onet homepage.
The most frequently used screening method for the detection of precancerous conditions and cervical cancer in Poland is still cytology. Contrary to popular opinion, however, it is definitely not the most effective method (the conventional version of the test – when the material taken from the neck is placed directly on a glass slide and fixed, it is able to detect only about 60% of all cases of women who can develop cancer) . Much more effective, although unfortunately not so popular, are genetic tests for highly oncogenic types of HPV, the sensitivity of which allows the diagnosis of over 90%. all cases.
The relatively low popularity of this method is due to, inter alia, from the fact that, paradoxically, most women are easier to accept information about an abnormal cytology result than about an STI (although HPV is also transmitted through other routes). A patient with a positive cytology result usually immediately mobilizes to act and care for herself, while a woman with a positive HPV test result begins to wonder what to do in such a situation. As evidenced by a positive HPV test result and what steps to take after receiving it, says Dr. Maciej Mazurec, obstetrician-gynecologist, founder, director and doctor of the Corfamed Women’s Health Center in Wrocław.
What is the purpose of the test?
Standard tests performed in Poland and around the world detect 13 or 14 highly oncogenic types of HPV. The purpose of the tests, however, is not to detect the smallest possible amount of the virus, but one with a potential risk of precancerous conditions. These, in turn, are caused only by highly oncogenic types. There is no justification for testing for low-oncogenic HPV types in cervical cancer screening. Infection-related changes with these types of virus can manifest as genital warts or other skin warts of questionable aesthetics, but there is practically no risk of cervical cancer or other cancers, says Dr. Mazurec.
How, then, can a patient find out about an infection with a low-carcinogenic type of HPV, if not through the test result? For a doctor – a dermatologist or gynecologist – the aforementioned skin symptoms are usually so typical that their appearance alone is enough to make a diagnosis and implement treatment. Usually, it is not easy, and the body is rarely able to fight off the painful symptoms on its own.
Usually, the treatment consists in local destruction of the warts, which is currently usually performed with the use of laser therapy – explains Dr. Maciej Mazurec. In the past, cryotherapy was also used for this purpose, and in some centers it is still used today. For the patient, however, this method is less effective and also less comfortable. The therapy also uses topical immunomodulatory drugs, which significantly reduce the risk of recurrence of symptomatic infection, says the gynecologist.
If left untreated, skin changes will not necessarily pass over time. They can be chronic, they can overgrow, create giant eruptions. All this can make life very difficult – both due to the aesthetic aspect and the mental discomfort caused. These skin warts, caused by yet other types of the virus, can also occur elsewhere in the body, and dealing with them is the domain of dermatologists.
– explains the doctor.
What does a positive test result mean?
If the HPV test was performed at the request of a doctor (although modern diagnostics also offer patients self-sampling tests – a response to their own initiative), and the obtained result is positive, the patient should visit the doctor, listen carefully, understand, possibly ask additional questions and then follow its recommendations.
Perhaps it will be colposcopy with biopsy right away or it will be necessary to perform additional risk assessment tests: usually liquid cytology, but more and more often also the p16 / Ki-67 test (specialized immunocytochemical test). In order to assess whether a colposcopy with biopsy is necessary in this particular case, explains Dr. Maciej Mazurec.
If the self-collection result is positive, then of course it is also necessary to see a gynecologist. Further proceedings will require specialist medical knowledge.
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Does a positive test result mean that the patient will become ill?
A large proportion of women fear that a positive HPV test result is tantamount to the battle against cervical cancer that awaits them. Luckily it is not so! A positive test result means only (and as much as!) That a highly oncogenic type of virus present in the body can lead to the development of the disease. Maybe, but it doesn’t have to be. For this to happen, the patient would have to be unlucky, because 90 percent. infection with these types of virus goes away on its own. Second, she would have to begin to avoid further medical visits altogether for at least the next few years. Because although the human papillomavirus can lead to the development of cervical cancer, it happens as a result of a really long, often several or even twenty-year process – explains the specialist.
However, a positive HPV test result absolutely requires monitoring, i.e. staying under medical care more often than it results from the standard screening (depending on the model – every three or five years). Management of a positive test result must be carried out according to the precise indications of not only a gynecologist-obstetrician, but also a doctor of this specialization with special, directional knowledge. Such a patient should be referred to specialists in the field of cervical cancer screening, who will appropriately guide further management.
A positive test result does not mean that you have cervical cancer or that you will definitely get it. What’s more – modern medicine is able to give a patient with a positive HPV result a guarantee that if she is under the care of appropriate specialists, she will not develop cervical cancer. It is possible thanks to a high degree of control of the situation of early detection of conditions that may lead to the development of cancer.
There is, however, a condition. The patient must remain under the supervision of a doctor and follow the indications received, which ensure her such safety – concludes Dr. Maciej Mazurec.