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The highest-risk types are HPV 16 and 18; these are responsible for the vast majority of HPV-related cancers, including cancers of the cervix, vagina, vulva, penis, anus, and head and neck.
Type 6 and 11 cause 90% of all genital warts and recurrent respiratory papillomatosis that causes benign tumors in the air passages. High-risk HPVs cause cancer and consist of about twelve identified types. [10] Types 16 and 18 are responsible for causing most of HPV-caused cancers. These high-risk HPVs cause 5% of the cancers in the world.
The preferred screening for women aged 30–65 is "co-testing", which includes a combination of cervical cytology screening and HPV testing, every 5 years. [11] However, it is acceptable to screen this age group with a Pap smear alone every 3 years or with an FDA-approved primary high risk HPV test every 5 years. [11]
The cause of CIN is chronic infection of the cervix with HPV, especially infection with high-risk HPV types 16 or 18. It is thought that the high-risk HPV infections have the ability to inactivate tumor suppressor genes such as the p53 gene and the RB gene, thus allowing the infected cells to grow unchecked and accumulate successive mutations, eventually leading to cancer.
Some people can have elevated levels of p16 but test negative for HPV and vice versa. This is known as discordant cancer. The 5-year survival for people who test positive for HPV and p16 is 81%, for discordant cancer it is 53 – 55%, and 40% for those who test negative for p16 and HPV. [208] [209]
[2] HPV vaccination is the most cost-effective public health measure against cervical cancer. [14] There are six licensed HPV vaccines. [16] They protect against two to seven high-risk strains of this family of viruses and may prevent up to 90% of cervical cancers.
The Papanicolaou test (abbreviated as Pap test, also known as Pap smear (AE), [1] cervical smear (BE), cervical screening (BE), [2] or smear test (BE)) is a method of cervical screening used to detect potentially precancerous and cancerous processes in the cervix (opening of the uterus or womb) or, more rarely, anus (in both men and women). [3]
DNA tests are available for diagnosis of high-risk HPV infections. Because genital warts are caused by low-risk HPV types, DNA tests cannot be used for diagnosis of genital warts or other low-risk HPV infections. [4] Some practitioners use an acetic acid solution to identify smaller warts ("subclinical lesions"), but this practice is ...
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