What Is HPV? Symptoms, Screening and Prevention

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide. The great majority of sexually active people encounter HPV at some point, and most infections clear on their own. This article explains what HPV is and how screening and prevention work.

What is HPV?

There are more than 200 types of HPV, about 40 of which affect the genital area. Types are divided into “low-risk” and “high-risk” according to their association with cancer: low-risk types (for example 6 and 11) cause genital warts, while high-risk types (mainly 16 and 18) are associated with cancers of the cervix, vulva, vagina, anus and oropharynx. According to the World Health Organization, almost all cervical cancers are caused by persistent high-risk HPV infection.

How is it transmitted?

HPV spreads through skin and mucosal contact; sexual intercourse is the most common route, but transmission is possible without full intercourse. Condoms reduce but do not eliminate the risk. Because the infection usually causes no symptoms, a person may not know they carry the virus.

Symptoms

Most HPV infections are symptomless and are cleared by the immune system within one to two years. Low-risk types can cause cauliflower-like warts in the genital area. Persistent high-risk infection may progress over years to cervical cell changes (CIN) and, if untreated, to cancer; because this process is usually silent, screening is vital.

Screening: smear and HPV test

Cervical screening uses two methods: the smear (Pap) test looks for changes in cells taken from the cervix, and the HPV DNA test looks for high-risk virus types. In Türkiye the national programme recommends an HPV test every five years for women aged 30–65; between 21 and 29 a smear every three years may be used. For abnormal results the physician arranges colposcopy, a magnified examination, and biopsy if needed. A positive HPV test does not mean cancer; it calls for follow-up and further assessment.

Treatment approach

There is no drug that eliminates the virus itself; treatment is directed at the lesions it causes. Genital warts can be treated with creams, freezing (cryotherapy), electrocautery or laser, and may recur. Cervical cell changes are either monitored or removed by methods such as LEEP or conisation, depending on their grade. The appropriate option depends on the grade of the lesion and the individual’s circumstances.

Prevention

• HPV vaccination: the World Health Organization prioritises girls aged 9–14, recommends catch-up vaccination up to age 26 and vaccination up to age 45 after medical assessment. The vaccine protects against the types most often linked to cancer; it does not treat an existing infection.
• Regular screening: screening should continue even in vaccinated people.
• Condom use and stopping smoking: smoking increases the risk that HPV infection becomes persistent.