Genital Warts and Cervical Cancer Relationship

The vast majority of warts that occur in the genital area are skin lesions caused by a virus called Human Papillomavirus (HPV). These lesions are usually seen in the genital area, vulva, vagina, anus, or perianal region.

What is HPV?

HPV is a sexually transmitted infection with many different types. It enters healthy human cells and causes them to proliferate rapidly and uncontrollably. Types called high-risk have a higher potential to cause cancer. Genital warts are typically small, skin-colored lesions. In some cases, they may not be visible to the naked eye due to their small size or being hidden between skin folds. Symptoms of HPV are usually noticed when warts are present on the skin. While they are more common in women, symptoms are rarely seen in men. A strong immune system in the infected person can result in mild symptoms and clearance of the disease.

How is the Diagnosis of Genital Warts Made?

The diagnosis of genital warts is made through examination by a gynecologist. Diagnosis typically involves the following steps:

• Visual Examination: The diagnosis of genital warts is usually made through visual examination. Warts typically appear as flesh-colored protrusions, resembling small cauliflower heads.
• Pap Smear Test: Genital warts caused by HPV also cause abnormalities in the cells of the cervix. HPV testing is done simultaneously to detect the virus. HPV DNA is examined to determine the type. The risk situation is determined.
• Biopsy: Rarely, a tissue biopsy may be performed for pathological diagnosis purposes.

It is of great importance to diagnose and determine the type of HPV in order to plan treatment options and follow-up process.

What are the Treatment Options?

The treatment of genital warts is performed for cosmetic and functional purposes. These treatments include:

• Topical Medications: These medications, applied to the skin, prevent the proliferation of warts locally and promote drying and shedding of the skin. This treatment should be performed by a specialist as healthy skin may be damaged during this process.
• Cryotherapy: This is the process of freezing warts with a cooled substance like liquid nitrogen to destroy them. It is performed by a specialist physician.
• Electrosurgery or Laser Therapy: Electrosurgery involves burning warts using electrical current. Laser therapy uses intense light to treat warts.
• Surgical Methods: Large or widespread warts can be surgically removed. It is performed under local or general anesthesia.
• Immunomodulatory Treatments: In some cases, immunomodulatory drugs may be used. These drugs help the immune system fight against warts, with the goal of their disappearance within a certain period. Interferon therapy may also be applied. 

There is a possibility of warts reappearing after treatment. Additionally, HPV infection may persist, so regular follow-up, maintaining general health, and avoiding smoking are very important.

Is Prevention Possible?

• HPV Vaccine: The HPV vaccine provides protection against sexually transmitted HPV infections. Vaccines are currently administered in 3 doses at 0-2-6 months. In the 9-15 age group, 2 doses are administered at 0-6 months. The vaccine reduces the risk of cervical cancer caused by HPV.
• Condom Use: Condoms are an effective method in preventing sexually transmitted infections. However, condoms do not provide 100% protection against HPV. HPV is transmitted through mucosal contact, so condoms reduce the risk of infection but do not completely eliminate it. Their use is recommended.
• Regular Check-ups and Screenings: Regular gynecological examinations and smear-HPV or CO-test screenings can evaluate the risk of cervical cancer caused by HPV by monitoring changes in cervical cells. They can detect possible malignant conditions early.
• Education and Awareness: Receiving education on sexual health topics and being aware of them helps reduce the risk of infection. It is important to be aware of the risks of multiple partner relationships.
• Avoiding Risk Factors: Avoiding factors that weaken the immune system can reduce the risk of HPV infection. The most important factor in this regard is smoking. Smoking increases the risk of cervical cancer caused by HPV by impairing both general health and causing local damage in the cervical area.

Preventing the formation of warts and avoiding HPV transmission, these methods will be effective, but none of them completely eliminate the risk.

In Conclusion

Warts resulting from HPV infection and cervical cancer in later stages are common conditions. There is a lot of information and guidance available on this subject. There is a screening program under the Ministry of Health, and individuals should request this from Family Physicians or Obstetricians and Gynecologists. It is necessary to have annual gynecological examinations to avoid encountering advanced cancer at the time of diagnosis.

I would like to conclude my writing with a saying that always remains valid; 'Early diagnosis saves lives.'

Op. Dr. Kadir Şahin

Obstetrician and Gynecologist