Gynecologist-obstetrician explains the relationship between human papillomavirus and cancer

Dr. Sandra Patricia Zapata, gynecologist and ophthalmologist, addressed a fundamental issue for public health: the relationship between the human papillomavirus (HPV) and cancer.

The specialist explained to CityTV in detail the characteristics of the virus, its forms of transmission, the complications it can cause and the importance of prevention through early detection and vaccination, both in men and women.

Dr. Zapata explained that it is a virus that is related to various human conditions. She indicated that it is a very common infection that affects men and women, and recalled that, thanks to the studies carried out, in 2008 there was the opportunity to have a Nobel Prize winner worldwide who investigated the effects and risks of this infection.

The specialist stressed that HPV is a slow-growing virus that can remain in tissues, particularly in the stratified mucosa. She pointed out that the infection can occur on the skin and in specific areas such as the vaginal, penile, anal and oropharyngeal areas.

In relation to the location in women, she explained: "In women, it is located at the tip of the cervix, the area that leads to the vagina is a place where the papilloma virus likes to stay and that is where it can cause cervical cancer."

The doctor also explained that in men the infection can be located at the tip of the penis, in the anal mucosa and in the oropharyngeal region , and can even cause recurrent papillomatosis or cancer.

He mentioned that transmission occurs through direct contact from mucosa to mucosa and stressed that, although HPV is classified as a sexually transmitted disease, the condom only protects around 80% of the possibility of infection.

The specialist pointed out that, despite the high prevalence of HPV, out of 100 infected people, 90% eliminate the virus in one or two years through their defenses, in a similar way to how the flu virus is eliminated.

However, he added that "the point is that there are 10% of people who do not eliminate the virus, the virus gets into the DNA of the cells, alters the genetic information and produces mutations in the genetics of those cells that cause precancer and cancer."

Regarding genotypes, the doctor explained: "We have more or less 200 genotypes of papillomavirus that can affect humans. We have one that is six and 11 that can cause genital warts or what we call condylomas and very rarely do these genotypes progress to cancer. But we have some that are like the most specific and here, in Colombia, they cause approximately 70% of cervical cancer, which are 16 and 18. We have others like 31, 36, 45, 52 that are also considered high risk, that is, they could cause cancer."

In response to concerns about how to detect a critical phase of the disease in patients who do not regularly visit the doctor, Dr. Zapata explained that it is "a treacherous virus, it is a slow-progressing virus" and that "between the time you become infected and the appearance of advanced cancer, it may take between 5 and 10 years , and really, until it is a very advanced process, it may not give you any symptoms."

In this context, she stressed the importance of sexual education, reducing multiple partners, condom use, vaccination and screening tests. She recalled that, traditionally, vaginal cytology was used to detect alterations in the cells of the cervix, but currently this test is complemented by the PCR test, which specifically looks for high-risk genotypes.

She recommended that "two or three years after starting sexual relations, a woman should include a vaginal cytology test to detect problems in her check-up" and that, starting at age 30, the search for the virus should be included in her check-up.

The doctor also addressed the issue of vaccination, emphasizing its effectiveness in individuals who have not yet begun their sexual life.

"It is more effective in groups that have not started sexual life. Therefore, the ideal is to vaccinate boys and girls now. They are vaccinated from the age of 9 and it is included in the mandatory vaccination plan within the PAI," he said.

She explained that, until three or four years ago, vaccines were used that protected against four strains (6, 11, 16 and 18), offering 80% protection against cervical cancer.

It was specified that, once adolescence has passed, the vaccine can be administered to men up to 26 years of age (outside the national scheme, with an additional cost) and to women up to 45 years of age, regardless of whether or not they have started their sexual life. It also pointed out that, in the case of having previously eliminated the virus, vaccination is still recommended to protect against other strains.

Finally, the specialist stressed the need for regular medical follow-up when the virus is detected. She indicated that "once it has been detected, you have to see what stage the disease is in" and stressed that, although most people eliminate the virus, it should not be assumed that medical attention is not required: "They have to be checked every 6 months, every year until tests show that one has eliminated the virus."

"Go to a doctor specializing in men if you notice any lesions, warts, or any external injury and have regular check-ups with the urologist," he added.

*With information from CityTV.