Diagnosis
For women over the age of 20, the so-called “Pap test” is offered annually as part of cancer screening. During the routine examination by the gynaecologist, a smear of the cervix is taken with a cotton swab. Cells are taken from the cervix and examined under the microscope.
On the basis of these cells, active HPV infections can be detected in addition to other diseases such as herpes or chlamydia. The appearance of the cells is divided into 5 stages, which represent the risk of developing cancer cells. Only in a Pap test, which reveals changes in the mucosa, is a detection test for HPV recommended.
If it turns out that a “high-risk” virus type is also present, the Pap test should be performed every 6 months. A virus determination beforehand does not make sense, since there is no targeted therapy for HPV. With an accuracy of 80-90%, many types of cancer can be detected by regular annual Pap testing. Subsequently, potentially affected areas can be cut out without complications. Since the Pap test is fully covered by health insurance for women over 20, annual routine check-ups are an ideal option.A strikingly high percentage of women with cervical cancer have not had routine tests performed in previous years.
Vaccination
Vaccines for the most risky types of HPV have only been available since 2006. Many HPV types are “high-risk” viruses and a total of 13 of them have been officially classified as carcinogenic. Therefore, there are currently 3 different vaccines available to protect against the most dangerous 2, 4 or 9 HPV types.
HPV vaccination was initially controversial among critics, but current data continue to indicate that vaccination is recommended. A vaccination only works as a preventive measure against infection. It cannot alleviate or cure diseases with a risk type.
It is important that an annual Pap test should be performed despite the vaccination. In some cases, malignant diseases caused by HPV types against which no vaccination has been administered can still occur. Only the risk can be significantly reduced by the vaccinations.
In Germany, HPV vaccination is officially recommended since 2007. Since 2014, the Standing Commission on Vaccination (STIKO) in Germany has been recommending the dual vaccine against HPV types 16 and 18 for girls between the ages of 9 and 14. The vaccination is intended for children before puberty, so that immunization takes place before the first sexual contact. Although HPV viruses can also cause malignant tumor diseases in men, vaccination is not covered by health insurance. The incidence of HPV-caused diseases in men is by far not as high as the risk of cervical cancer from “high-risk” viruses.
