Eight out of every 10 women face the risk of encountering HPV at some point in their lives.
HPV (Human Papilloma Virus) infection is among the most common sexually transmitted diseases, with an average occurrence frequency of around 10% (varies by age).
It leads to the fourth most common cancer in women, cervical (uterine cervix) cancer. Often asymptomatic and if not eliminated by the body, it can silently and insidiously lead to cervical cancer over the years.
The HPV types 16 and 18, which are the main causes of cervical cancer, have vaccines that provide nearly 100% protection against them.
HPV is a double-stranded DNA virus that frequently affects the genital region in both men and women, causing diseases. Generally, HPV types that cause infection are categorized as low-risk and high-risk HPV based on their susceptibility to cancer.
Low-risk HPV types:
Most common HPV types: 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81
High-risk HPV types:
Most common HPV types causing cancer: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68. Among these, types 16 and 18 are the most causative types for cervical cancer.
Transmission Routes:
- Sexual contact
- Skin or mucosal contact is sufficient for transmission (Incomplete or sexual contact = contact of the man’s penis, scrotum, vagina, or genital area)
- Kissing = weak evidence
- Shared towels, clothes, bedding = No evidence
Incubation Period = average 2-3 months (2 weeks-8 months)
HPV Symptoms:
There may be no symptoms. Most common: genital warts that appear 2-6 months after the virus is transmitted. Genital Warts in Women: vulva, vagina, cervix, and/or anus
In Men: lesions on the penis, scrotum, and/or anus, which can be seen as flat lesions or cauliflower-like protrusions or swellings.
Most Lesion-Causing Types in the Genital Region:
Low-risk HPV 6-11.
- The important point is that not every HPV leads to cancer, and if it does, it usually takes many years.
Does HPV Resolve on Its Own? What Prevents its Regression or Spread?
It regresses in 90% of cases within two years.
Factors Preventing the Regression of HPV:
- Weakening of the immune system
- Chemotherapy and radiotherapy treatments
- Smoking
- Recurrent genital diseases unrelated to HPV
- Trauma
- Immune system-suppressing drugs such as steroids
- Sleep deprivation, fatigue
- Pregnancy
- Folate and/or B-Carotene deficiency
Diagnosis: It is made by examining the warts detected during gynecological and anal examinations or by taking a sample from the lesions or smears and examining the DNA related to the HPV virus. Typing is performed, and high-risk types are identified. In the presence of high-risk HPV, it is important to consult the relevant department (Gynecology/General Surgery).
According to the National Cancer Screening Standards in our country: Every woman aged 30-65 is screened every 5 years with a Pap smear test. This interval can be shortened in the presence of HPV positivity. (PERSONAL OPINION)
TREATMENT
There is currently no drug treatment that completely eliminates the HPV virus. In 80% of healthy individuals with a normal functioning immune system, the body can clear this virus. In HPV treatment, a specific treatment plan is designed for the lesions caused by the virus. If they are in the form of condylomas, surgical treatment such as electrocautery (radiofrequency) can be planned.
PREVENTION
*Every sexually active individual carries the risk of HPV.
*Condoms reduce the risk of transmission but do not provide complete protection.
*The most accurate approach is to avoid high-risk behavior.
*The number of sexual partners should be limited to one.
*Vaccination.
VACCINES
*BI-VALENT (2-valent vaccine): Targeting types 16-18 (Responsible for approximately 70% of cervical cancer)
*QUADRIVALENT (4-valent vaccine): Effective against low-risk types 6-11 (common causes of genital warts) and types 16-18
*NONAVALANT (9-valent vaccine): Not yet available in Turkey. Effective against types 6, 11, 16, 18, 31, 33, 45, 52, and 58.
ADMINISTRATION AGE:
*The ideal age for administration is between 9-14 years when sexual activity has not started, and the best immune response to the vaccine can be obtained.
*Up to the age of 26 (15-26), a catch-up vaccination is recommended.
UNDER 15 YEARS: Strong immune response / 2 doses are sufficient. For individuals OVER 15 YEARS, both males and females, the FDA recommends 3 doses of HPV vaccines until the age of 45.
NOT RECOMMENDED FOR
- Pregnant individuals.
- Those with severe illness.
- If known allergies develop, additional doses should not be administered.
SIDE EFFECTS:
*Pain, swelling, redness at the injection site.
*Dizziness.
*Rest should be taken after vaccination (15 minutes).
*Headache, nausea, weakness = Rarely.
Can Cervical Cancer Still Occur After HPV Vaccination?
HPV vaccines provide protection against high-risk HPV types 16-18, which are associated with cervical cancer. It is important to note that individuals who have received the vaccine still carry a risk of developing cervical cancer.
RECOMMENDED VACCINE AGE AND DOSAGE
For Females: The routine vaccination age is 11-12 (2 doses), with a catch-up vaccination age of 15-26 (3 doses) for all three shots.
For Males: The routine vaccination age is 11-12 (2 doses), with a catch-up vaccination age of 15-26 (3 doses) for the 4-valent and 9-valent vaccines. For individuals under 14, a 2-dose vaccine protocol (0-6-12 months) is recommended, with the second dose administered a minimum of 6-12 months after the first. For those over 14, a 3-dose vaccination protocol (0,1-2, 6 months) is recommended, with a minimum interval of 4 weeks between the first and second doses, 12 weeks between the second and third doses, and a minimum of 24 weeks between the first and third doses.
