Our health advice – This virus is directly responsible for almost all cases of uterine cancer. Should we be worried if we test positive for HPV?
You have recently made an appointment with your gynecologist or midwife to have a papillomavirus (HPV) smear test, as recommended by health authorities every 5 years. And after a few days, the result comes: you are positive. In other words, the cells of your cervix contain one or more of the so-called “high-risk” carcinogenic papillomaviruses. A very alarming announcement at first sight, when we know that this virus is responsible for almost all cases of cervical cancer (3,159 new women affected in 2023 in France). However, there is no reason to panic. Le Figaro Take stock with Dr Jean-Luc Mergui, a gynecological surgeon specializing in the prevention of cervical cancer and papillomavirus infection.
1. It does not mean you have cancer or will get cancer
Be careful not to take shortcuts. A positive HPV test means the presence of high-risk papillomavirus. “This does not mean that the lesions are cancerous, but only that there is a risk of developing lesions in the long term.», explains Dr Jean-Luc Mergui. Indeed, the presence of a virus does not automatically lead to cancerous lesions. “Only 7% of HPV-positive patients have cervical lesions. And of those, only 10% have high-grade lesions (Onset of Cancer, Editor’s Note). In other words, only 1% of women infected with papillomavirus have precancerous lesions and are at risk of developing cancer later.», assures the expert.
Additionally, high-risk HPV takes at least five years for cells to mutate. As for cancer, it appears only after ten to twenty years of persistent HPV virus infection. It is enough to regularly monitor the presence of the virus through a smear. If it persists, colposcopy (examination of the cervix and vagina using a magnifying glass attached to a speculum, editor’s note) will make it possible to monitor the development of possible precancerous lesions to prevent the appearance of cancer. Fact to Know: A negative HPV test does not provide protection for life. You can re-infect or reactivate HPV that was dormant. Moreover “The test may be very negative even though the virus is present, but not in sufficient quantity to detect or cause potential lesions.», underlines Dr Mergui. So interested in doing it again every 5 years.
2. In most cases the infection is transient
Papillomavirus infection is extremely widespread and almost inevitable from the beginning of sexual life. “It is estimated that 80% of women are infected with HPV within the first five years of their sexual life.», informs Dr Mergui. Same for men. Another figure: every year, about 17% of the population becomes infected with one or the other of these viruses. The good news is that in 9 out of 10 people it is cleared by the immune system spontaneously within two years, without any health consequences. In most cases, HPV therefore causes no symptoms and goes completely unnoticed.
On the other hand, when the immune system fails to destroy the virus, it becomes chronic. This is where problems can potentially begin. “Lesions can develop when the virus persists. Eleven years later, 20 to 30% of infected women will have high-grade lesions on the cervix.», suggests Dr Jean-Luc Mergui. A minority of people will never get rid of the virus. “With age, immunity decreases and it happens that the virus manifests itself again, sometimes forty to fifty years after the first contamination.», informs the gynecologist. Hence HPV screening test is recommended till age 65.
3. There is no treatment to get rid of HPV
“There is currently no known treatment for this infection», immediately reminds the doctor. Surgical treatments such as conization (removal of part of the uterus) are not indicated in case of a positive HPV smear. “Conization is used only to remove high-grade lesions; This affects around 30,000 women in France every year.», suggests Dr Mergui. But this does not necessarily remove the virus. As for the anti-HPV vaccine, it is of no use if the infection has already occurred. It only helps strengthen the immune system in preparation for the first encounter with the virus. This is the reason why it should be done before starting sexual life, both for girls and boys. In adults, “theThe only solution that can be proposed is regular monitoring», notes the doctor.
4. This doesn’t mean your partner was unfaithful
A positive HPV test does not mean infidelity! First because it does not allow the infection to date. The contamination can certainly be recent, but it can also be an old infection, transmitted with another partner. It is entirely possible that a papillomavirus infection may go undetected for many years after infection. It is also possible that it was your current partner himself who infected you with the virus. “These viruses are highly contagious, they are transmitted during sexual intercourse, including digital touch. So condoms are not a guarantee of protection», underlines Dr Mergui.
Note that vaccination of young boys immunizes them against future infection by most oncogenic papillomaviruses, which will indirectly protect their future partners. But papillomavirus is also something that directly concerns men, even if they are less severely affected than women. HPV infection causes about 1700 cancers (mouth, throat, anus, penile) in men every year in France.
5. It is better to quit smoking
There is no radical and specific treatment for HPV infection but there is one factor that can be acted upon: smoking. “By disrupting the local immune system and causing the secretion of toxins into the cervical mucus, smoking increases the risk of persistent HPV infection and contributes to the risk of precancerous lesions.», Dr. explains Julia Maruani, a gynecologist at Marseille University Hospital. “Smoking reduces the chance of eradicating the virus by 50%. We accumulate problems, which will lead to lesions“, she continues. This risk will also be proportional to the duration of smoking and the amount of smoking. “Quitting smoking is a good option to reduce viral load», underlines Dr Mergui.
