Human Papilloma Virus (HPV) Infection and Pre-Malignant Lesions of the Cervix

What Is HPV and How Is HPV Infection Transmitted?

Pre-malignant diseases of the uterine cervix are caused by a sexually transmitted infection: the human papillomavirus (HPV).
If not properly diagnosed and treated, these pre-malignant conditions can progress to cervical cancer over many years.

What are the main characteristics in reaction to the form of contagion of HPV infection?

How Is HPV Infection Diagnosed?

This test detects the presence of the virus in the blood that causes pre-malignant lesions of the cervix or cervical cancer.

The HPV virus is actually a family of numerous virus sub-types (nearly 200) that fall into two categories:

• Low risk: Two of the most common low-risk HPV subtypes are 6 and 11. They cause genital warts but do NOT cause cervical cancer.

There are two kinds:

1. Warts located on the external genitalia (easily seen): these warts are caused by certain types of HPV, especially types 6 and 11. However, the types 6 and 11 viruses are unlikely to cause cancer. These types are transmitted through sexual contact and infect the genital and anal areas.
2. Warts located on the internal genitalia (less visible): Other types of HPV, especially types 16 and 18, infect the genital area, but do not give rise to visible warts easily. They produce tiny flat warts on the cervix or anus that are only visible with a magnifying instrument called a colposcope. Warts can also appear in the vagina, vulva, and urethra.

• High risk: Two of the most frequent high-risk HPV subtypes are 16 and 18. They can stimulate the uncontrolled growth of cervical cells and cause pre-malignant lesions and, later, cancer.

How is the Diagnosis of Pre-Malignant Lesions and Cervical Cancer Made?

All women who have had sexual intercourse should periodically go to the gynecologist from the age of 25 to carry out tests with the aim of preventing female cancer.

Among them, the most important is to perform cervical cytology to detect pre-malignant lesions or cervical cancer in its very early stages.

Pre-malignant lesions are controllable, either with simple follow-up (SIL BG) or with a small surgical treatment (SIL AG) to remove the lesion from the uterine cervix (cervical conization).

It is currently known that almost 100% of pre-malignant lesions and cervical cancer are caused by HPV infection.

KEY POINTS:

What Are the Different Types of Pre-Malignant Diseases?

Cytology can report the following results:

• Normal
• SIL of BG or low-grade intraepithelial lesion: represents the beginning of pre-cancer diseases of the cervix
• SIL of AG or high-grade intraepithelial lesion: means the evolution of the above and, without proper diagnosis and treatment, could progress to cervical cancer
• ASCUS-AGUS: means a cytology result of uncertain significance. It must be repeated because, generally, pathologists cannot make a diagnosis based on the remitted sample.
• Cancer

 What is a Colposcopy And How Is It Used To Diagnose Malignant Disease in the Cervix?

The next step is to perform a colposcopy. This consists of a direct visual examination through a colposcope to assess the surface of the cervix and vagina.

The colposcope is a kind of microscope that works like a magnifying glass that increases the surface of the cervix from 6 to 40 times, allowing the evaluation of different lesions at the level of the cervix, and that are imperceptible to the human eye.

The exam bothers more than taking the cervical cytology.

What to Do If Colposcopy Shows Suspicious Lesions?

If the colposcopy reveals abnormal lesions in the cervix, a targeted biopsy should be performed.

The biopsy consists of taking a small portion of tissue to analyze through a pathological anatomy study and thus define what type of injury that organ presents and guide a possible treatment.

Cervical or vaginal biopsies are mildly painful and are usually performed in the same office. They are performed using special forceps under colposcopic guidance to offer greater precision at the site of the sample.

It is essential to perform them to confirm the diagnosis since the cervical biopsy is more precise. In this way, a suitable treatment plan can be defined for each patient and for each particular injury.

Treatment may include surgical procedures as an effective resolution for malignant cervical abnormalities.

Medical information developed by Gynecologist Oncologist Lucas Minig, specialist in Human Papilloma Virus in Valencia, Spain.

Frequently Asked Questions about Human Papillomavirus

Frequently Asked Questions about Human Papillomavirus

HPV epidemiology