Everything You Need To Know About HPV Types, Testing & Associated Risks
What to know about HPV
HPV is one of the most commonly spread sexually transmitted infection in men and women. It’s estimated that at least 70% men and women come in contact with the virus in their lifetime. Most cases do not cause any symptoms and our body’s immune system clears it off within two years of the infection naturally. However, in a fewer percentage, the virus remains inside the body and causes multiple diseases such as genital warts and even cancers such as cervical cancer.
The HPV virus being a sexually transmitted virus, spreads through any type of sexual contact, skin-to-skin contact and but not through bodily fluids which is a unique property of this virus. For those who have had multiple sexual partners are at a greater risk of getting infected with this virus.
HPV and the cervical cancer connection
There are more than 40 HPV types that can infect the genital, anal areas as well as the mouth and throat linings. These HPV types are categorized according to their potential for developing cancer.
The lower risk types generally causes genital warts appearing around the anus and genitals, and some visible areas in vagina and cervix. The HPV types 6 and 11 are termed as low-risk types and cause 90% of genital warts reported.
The reason why they are termed ‘low’ is because the genital warts formed never really progress into cancer. They are much more of a cosmetic concern and may cause discomfort, itching and burning.
High-risk HPV types that cause cancer
Moving on to the villains in the story are the high-risk HPV types which progress into cancer. It takes almost 10-20 years for the cancer to develop without any classical symptoms. Hence, it is considered very critical to get yourself tested regularly and get vaccinated for the HPV at a certain age in order to reduce the cancer risk.
The cancers linked to HPV infection are: cervical, anal, vaginal, vulvar, penile and throat cancers. In regards to cervical cancer, most of the cases are due to HPV infection, out of which 70% are caused due to the high risk types 16 and 18 (coded as HPV test code-87625).
By age 50, at least four out of five women will have been infected with human papillomavirus (HPV) at some point in their lives. HPV is also very common in men. HPV infection often has no symptoms or visible changes and can resolve on its own, so many people will never know they had it.
HPV testing: When, why and the risks
In layman terms, the HPV test detects the presence of the virus in your samples such as blood and DNA. The test is available only for women.
Your doctor may likely recommend it if:
The pap screening results were positive and showed some abnormal changes in the cervix cells termed as atypical squamous cells of undetermined significance (ASCUS).
Your age is 30 and above.
Since we’ve already discussed the villains above, the reason to opt for this test is to find those high-risk HPV types. If positive, it is important to discuss the next steps forward with your doctor. They may include a follow-up or further testing and biopsy to determine the treatment of the abnormal cells.
But with every screening test, comes some risks such as the probability of the results being false positive or negative.
- A false-positive test result can mean you may have a high risk of developing the cervical cancer, even if you really don’t. It could also lead to unnecessary follow-ups and never-ending anxiety that comes with it.
- A false-negative test result means just the opposite. It means you really are at a risk; however, the test says something else. In this case, such results may cause unnecessary delays in the much needed follow up procedures.
Genotyping to manage the risk
In recent times, genotyping has developed a way to help patients and the healthcare providers (HCPs) manage the risks associated with HPV testing. HPV test is basically a DNA test which allows the detection of 14 different types of HPV (16, 18- the villains, remember?).
Genotyping can help the HCPs in planning the appropriate patient care according to their unique risk factors associated. This genotyping also includes the routine pap tests and the HPV vaccine.
In today’s digital world, the HCPs make use of some apps which allows them to enter the relevant information such as women’s age group, the pap and HPV test results and what the genotyping suggests. Using this and the patient’s screening history, the HCPs can develop a personalized management guideline for the patient and figure out the best tactics for a follow up care.
In summary, the HPV brings a lot of trouble along with it, especially cancer. But it’s really important to understand the actual risks associated and differentiate the ones which are common. It's hoped that this piece clears all the confusion and helps you understand the risks and necessary steps to be taken. Do check out the sources below in case you need to know more.
- Petry, K. U. (2014). HPV and cervical cancer. Scandinavian Journal of Clinical and Laboratory Investigation, 74(sup244), 59-62.
- Cohen, P. A., Jhingran, A., Oaknin, A., & Denny, L. (2019). Cervical cancer. The Lancet, 393(10167), 169-182.
- Perkins, R. B., Guido, R. S., Castle, P. E., Chelmow, D., Einstein, M. H., Garcia, F., ... & Schiffman, M. (2020). 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. Journal of lower genital tract disease, 24(2), 102
- Harper, D. M., & DeMars, L. R. (2017). HPV vaccines–a review of the first decade. Gynecologic oncology, 146(1), 196-204.
- Halfon, P., Benmoura, D., Agostini, A., Khiri, H., Martineau, A., Penaranda, G., & Blanc, B. (2010). Relevance of HPV mRNA detection in a population of ASCUS plus women using the NucliSENS EasyQ® HPV assay. Journal of clinical virology, 47(2), 177-181.
- Shah, U. J., Nasiruddin, M., Dar, S. A., Khan, M. K. A., Akhter, M. R., Singh, N., ... & Haque, S. (2020). Emerging biomarkers and clinical significance of HPV genotyping in prevention and management of cervical cancer. Microbial pathogenesis, 143, 104131.
- Holmström, O., Linder, N., Kaingu, H., Mbuuko, N., Mbete, J., Kinyua, F., ... & Lundin, J. (2021). Point-of-Care Digital Cytology With Artificial Intelligence for Cervical Cancer Screening in a Resource-Limited Setting. JAMA network open, 4(3), e211740-e211740.
- Ricard-Gauthier, D., Wisniak, A., Catarino, R., van Rossum, A. F., Meyer-Hamme, U., Negulescu, R., ... & Petignat, P. (2015). Use of smartphones as adjuvant tools for cervical cancer screening in low-resource settings. Journal of lower genital tract disease, 19(4), 295-300.