HPV- induced lesions: from condyloma to cancers
Seance of wednesday 14 may 2025 (Chirurgie proctologique)
DOI number : 10.26299/3knx-q889/2025.18.05
Abstract
There are many different types of Human Papilloma Virus (HPV), some of which are genital-tropic.
'Low-risk' viruses, mainly genotypes 6 and 11, cause condylomatous lesions and benign skin warts. In contrast, 'high-risk' viruses (HR-HPV), mainly HPV 16 and 18, are associated with cancers and high-grade intraepithelial lesions (HSIL) of the cervix, anus, and oropharynx.
The prevalence of anal cancer continues to increase. Three high-risk groups have been identified:
- men living with HIV who have sex with men;
- women with a history of high-grade vulvar lesions, or who have had a solid organ transplant for more than 10 years; and
- women living with HIV who have a history of high-grade cervical lesions.
For these at-risk populations, a screening with anal smear testing for HPV 16 is recommended in France. If the positive, a clinical examination and anal cytology should be carried out. In case of abnormalities, an examination of the anal mucosa under a colposcope with acetic acid and Lugol's iodine staining should be performed (high-resolution anoscopy or HRA).
Vaccination is effective in preventing the development of HPV-induced pathologies in HPV-naive boys and girls.
'Low-risk' viruses, mainly genotypes 6 and 11, cause condylomatous lesions and benign skin warts. In contrast, 'high-risk' viruses (HR-HPV), mainly HPV 16 and 18, are associated with cancers and high-grade intraepithelial lesions (HSIL) of the cervix, anus, and oropharynx.
The prevalence of anal cancer continues to increase. Three high-risk groups have been identified:
- men living with HIV who have sex with men;
- women with a history of high-grade vulvar lesions, or who have had a solid organ transplant for more than 10 years; and
- women living with HIV who have a history of high-grade cervical lesions.
For these at-risk populations, a screening with anal smear testing for HPV 16 is recommended in France. If the positive, a clinical examination and anal cytology should be carried out. In case of abnormalities, an examination of the anal mucosa under a colposcope with acetic acid and Lugol's iodine staining should be performed (high-resolution anoscopy or HRA).
Vaccination is effective in preventing the development of HPV-induced pathologies in HPV-naive boys and girls.