Papilloma or squamous cell papilloma is a tumor resulting in outward extensions similar to a finger or fond. In fact, these extensions can grow anywhere that have squamous cells such as skin (cutaneous papilloma and warts), lips, oral cavity, eyelids, tongue, pharynx, larynx, esophagus, cervix, and genital tract. Although papilloma is often benign and will clear on its own, there’s also a chance that it turns into a recalcitrant active tumor. Unfortunately, screening for papilloma is not possible while cervical cancer, which is one of the cancers Human Papillomavirus might cause, can be screened.
Causes of papilloma:
While sun damage or smoking can be reasons of this disease, the most common is a sexually transmitted infection (STI) by the human papillomavirus (HPV). Besides, the latest is widely spread in the US with around fourteen million cases each year. Moreover, recent studies in Sweden found that tobacco smoking while having HPV infection leads to a higher risk of cervical cancer in women compared to non smokers.
What is human papillomavirus (HPV)?
HPV pathogenicity targets the uterine cervix and vagina mostly since the tissues present there are vulnerable to HPV carcinogenicity. The step-wise process for cervical cancer is as follows:
1-Infection by HPV
2-Persistence of HPV
3-Development into precancerous lesions
Did you know that you can carry HPV and develop no signs at all? In most cases (90% of time) the immune system will get rid of the HPV on its own with a duration interval of two years. In fact, it is the most common viral infection as you start having sexual intercourse, and a high risk of cancer is unlikely to happen.
How to identify papilloma:
You can recognize papilloma just by looking. However, diagnosis through histology and cytology microscopic analysis or molecular methods is more professional.
How does papilloma spread among people?
It’s safe to say that this is a skin-to-skin contact matter at the level of mucosal and cutaneous epithelial membranes. Thus, that's why it is considered a sexually transmitted virus. Vaginal, anal or oral sex are common, meanwhile is can also be transmitted by the mouth, genitals and anus contact.
How do you prevent papilloma “precautions”?
Simply get the vaccine! Obviously, the vaccine minimizes the cases and the advice is that men necessarily take the vaccine more than women. The reason behind this fact is a study that found circumcision decrease HPV infection in men and thus it won’t be transmitted to women causing them cervical cancer. Proof is data about Muslims and Jewish where women are less likely to acquire cervical cancer. A side note that sexual protection methods as condoms does prevent the transmission but its not exclusive.
Major strains of HPV and cancer:
Currently more than 130 types of human papilloma viruses (HPVs) exist with 50% infecting the genital area. These strains are classified as high-risk and low-risk HPVs because they’re relevant in cervical cancer and sparsely in other cancers such as oropharyngeal and anogenital ones. In addition to some strains (HPV-5) discovered in patients with skin cancers suffering from epidermodysplasia verruciformis “EV” or non-melanoma skin cancers. The strains are named with numbers in which 50% of cervical cancer is caused by HPV-16, while squamous (minority) and adenocarcinoma are caused by HPV-18.
Some high-risk HPV strains:
The highly common strains are HPV-16 and HPV-18 both contributing to high percentage of cervical cancer worldwide (80%). Both HPV-16 and HPV-18 might cause skin cancer as well. With the presence of vaccination, you shouldn’t worry about these strains’ infection and thus cervical cancer.
Some low-risk HPV strains:
Here we can consider HPV-6 and HPV-11 that do not cause any active tumor and are treatable by medication. These strains cause benign laryngeal papilloma and genital warts (90%) that can also be prevented by vaccination have you took it before becoming sexually active.
GARDASIL 9 HPV vaccine:
The Gardasil 9 vaccine works on specific HPV strains including HPV-6, HPV-11, HPV-16, HPV-18, HPV-31, HPV-33, HPV-45, HPV-52, and HPV-58. You may start taking the vaccine during adolescence but you may also still be able to get it as an adult below the age of 45. Taking the vaccine while being infected will still prevent being infected with a different strain than the one you currently have.
-IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. Lyon (FR): International Agency for Research on Cancer; 1995. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 64.) 1, Human papillomavirus (HPV)
-IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. Lyon (FR): International Agency for Research on Cancer; 2007. (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 90.) 1, Human Papillomavirus (HPV) Infection.
-Xi LF, Koutsky LA, Castle PE, Edelstein ZR, Meyers C, Ho J, Schiffman M. Relationship between cigarette smoking and human papilloma virus types 16 and 18 DNA load. Cancer Epidemiol Biomarkers Prev. 2009 Dec;18(12):3490-6. doi: 10.1158/1055-9965.EPI-09-0763. PMID: 19959700; PMCID: PMC2920639.