GynecologyHPV – PAP TEST – colposcopy

24/09/2020

HPV or Human Papilloma Virus is a mostly sexually transmitted virus that accounts for 99.7% of cervical cancer cases.

90% of people, men and women, come into contact with the virus within the first 2-3 years of starting their sex lives. The virus is very easily transmitted, so the use of a condom does not provide adequate protection. Once it enters the body, HPV causes a transient ” infection ”, which usually reverses itself within 2-3 years. If the body’s immune system does not respond to the virus, then a malfunction will occur, the form of which depends on the type of HPV that has infected the body. More than 100 HPV types have been found so far. Some cause skin lesions, others, mainly types 6 and 11 known as genital warts, and others cause cervical lesions, which are essentially precancerous lesions.

The well-known Pap test is to capture a few cells from the surface of the cervix and examine them under the microscope for HPV lesions. Test Pap does not check for the presence or not of the virus, but for the presence of virus damage. This painless, fast and inexpensive test should be done every year from the beginning of a woman’s sex life to the age of 70. If such lesions are found, cervical colposcopy should be performed.

Colposcopy is a simple examination done without anesthesia using a special microscope called a colposcope. The cervix is stained with special fluids and checked for HPV lesions. If lesions are found, a biopsy may be taken to determine its size and severity.

The presence of precancerous lesions in the cervix should in no way panic the woman. These lesions are usually low grade and regress on their own in about 70%.

In the event of a Low Grade SIL, regular monitoring with Pap tests and colposcopy is usually recommended every 6 months. It is possible, in certain cases, to standardize the virus, that is to examine the type of HPV, in order to know if it is high or low risk. If this lesion persists for a long time, or if it develops to a high grade (High Grade SIL), then the lesion should be treated. There is no medical cure. The treatment is always surgical, simple and consists of removing the damage from the cervix. It can also be done with local anesthesia and the patient usually leaves the hospital shortly.

In summary, it should be emphasized that:

  • HPV is a virus that will virtually infect us all at the beginning of our sex lives.
  • The presence of the virus does not necessarily mean harm.
  • Annual Pap testing detects an HPV injury at a very early stage, allowing either simple follow-up or simple local treatment
  • The existence of precancerous lesion of the virus by no means is equal to compulsory progression to cancer. These lesions are usually low grade and regress on their own, especially at young ages.
  • The presence of damage does not necessarily mean surgical removal. If the low-grade lesion does not subside for a significant period of time or if it develops into a high-grade lesion, it should be surgically excluded. Especially in young women, and if there is regular monitoring every 6 months, the long wait usually prevents cervical surgery.
  • Smoking cessation and a healthy lifestyle (diet, exercise, good mental health, etc.) help the body to deal with the virus on its own. Condom use offers relative but not complete protection.
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The Doctor

Dr. Nikolopoulos maintains a private practice in ATHENS, while collaborating exclusively with MITERA’s maternity hospital and the new HYGEIA IVF Athens Assisted Reproduction Unit. At the same time, he is in charge of the Fertility and In Vitro Fertilization clinic at City Hospital, in the city of KALAMATA.

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