Human Papilloma Virus (HPV)

HPV are transmitted sexually and are responsible for the development of a number of forms of cancer in the genital region and throat, and cervical cancer in particular. Vaccination can protect against infection with important types of the virus.

Pathogens and transmission

There are many different types of human papilloma virus (HPV) that infect the skin or the mucous membranes. While most types of the virus are harmless, some can cause cancer. Particularly in the genital region, papilloma viruses are transmitted through vaginal, oral or anal intercourse. Depending on the sexual practice involved, however, they can also be transferred to the throat, where they can cause precancer or cancer.

Clinical picture

Two-thirds of infections proceed asymptomatically. High-risk types of HPV, however, can lead to several forms of precancer and cancer, e.g. cervical cancer. There is also a causal link between HPV and other forms of cancer, some of which affect men. Low-risk types of HPV manifest - if symptoms appear at all - as warts (condyloma). These occur inside the vagina or in the anus, among other places, and sometimes require a targeted medical examination to be detected. But they may also appear as cauliflower-type growths in the genital and anal regions.

Frequency and distribution

An estimated 70% to 80% of sexually active women and men are infected with HPV in the course of their lifetime. In 70% of these cases the virus disappears within one year of infection, and in 90% of cases within two years. Young people aged 16 to 25 are particularly affected. The frequency of HPV infections increases with the number of sexual partners, and the risk of infection is highest at the beginning of sexual activity.

Persistent infection with a high-risk type of the virus can develop into precancer or cancer. In recent years, 250 new cases of cervical cancer and some 5,000 cases of precancer have been diagnosed annually in Switzerland. In our country it is the fifth most frequent type of cancer in women aged 20 to 49. The warts and precancerous cells can be surgically removed by a doctor. The earlier that treatment is started, the higher the success rate.

Prevention by vaccination

There are two different vaccines against HPV. Both of them protect against two types of HPV which often cause cervical cancer and other cancers (16 and 18); one also covers two other types (6 and 11) which cause genital warts. Vaccination is best administered before sexual activity starts, i.e. before an infection with HPV viruses can occur. Ideal protection against cervical cancer is provided by two injections within the course of six months for girls prior to their 15th birthday, and by three injections within the course of six months for girls 15 years and over. The aim of this vaccination for women is to prevent surgical procedures for precancer, new cases of cervical cancer and deaths due to this type of cancer.

Target groups for vaccination

The benefit of vaccination is greatest if it is completed before sexual activity begins. The FOPH and the FCV recommend vaccination against HPV for all adolescents aged 11 to 14 years. Since HPV-related diseases are more common in women than in men, routine vaccination is recommended for girls and optional vaccination for boys. Vaccination may also make sense for 15 to 26 year-olds, which is why it is recommended as a catch-up or supplementary vaccination. If you have any questions, you should talk to your doctor.

Vaccination adhering to these guidelines is free of charge for girls and women aged 11 to 26 years within the framework of the cantonal vaccination programmes. This has been extended to boys and young men aged 11 to 26 years as well since 1 July 2016.

Other preventive measures

1. Screening: Switzerland established the cervical smear (Pap smear) in the 1970s; it is the most widespread method of early detection. In the case of normal findings it is recommended at regular intervals (and covered by health insurance every three years). However, ir cannot prevent HPV infection. Depending on the finding and the treating physician's judgement, further examinations may be added. Important: Since the vaccine doesn't cover all types of cancer-causing HPV, regular Pap smears are recommended even after HPV vaccination.

2. Consistent adherence to the safer sex rules - 1. Penetration always with a condom, 2. No sperm or blood in the mouth, and 3. If itchiness, stinging or discharge develop, go and see a doctor; this is important in general so that sexually transmitted infections can be diagnosed and prevented. However, the effectiveness of these rules in preventing an HPV infection is limited, since infection may also occur through the skin. If you have a lot of sexual partners, you should have yourself tested regularly for sexually transmitted infections.

If you have any additional specific questions on this topic, please consult your general practitioner or gynaecologist. For questions regarding vaccination, you may also contact the vaccination hotline (phone number 0844 448 448).

Last modification 31.01.2019

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