Human papillomavirus: high-risk testing times

Human papillomavirus (HPV) causes genital disease both in men and women and can be spread through sexual intercourse. Persistent infection with HPV is necessary for the development of cervical cancer, but vaccination against HPV infection has shown a statistically significant reduction in genital warts and cervical abnormalities. Subsequently, a national programme of vaccination of girls aged 12–13 years in schools in the UK was introduced to reduce the burden of cervical disease. The reasoning behind the programme was to vaccinate girls before they are likely to have become sexually active, and therefore infected with HPV.1

Cancer protection
While HPV causes more disease in women, men are just as likely to be infected. Around 80% of people who are ever sexually active will have contracted HPV at some time, but most will not be aware of the infection. Understanding how common the infection is removes the stigma of considering this as a vaccine against a sexually transmitted infection. Diminishing barriers to immunisation is all about public education and understanding. The outcome seen so far shows that vaccination provides a benefit to vaccinated girls, and that benefit should extend beyond the prevention of genital warts to real protection against cervical cancer.1

Triage and test of cure
The identification of the link between HPV, especially the so-called high-risk genotypes (hrHPV), and cervical precancer and cancer has resulted in the introduction of HPV testing into the screening and post-treatment phases of care.2