Warts the matter?

MANILA, Philippines - While cervical cancer continues to be a big problem worldwide, there’s another HPV (human papillomavirus) disease that affects a greater number of men and women around the globe — genital warts.

Genital warts are a significant public health concern because the virus that causes them — HPV— has been associated with cervical cancer and has also been linked to other types of genital cancers.

As the name suggests, genital warts affect the moist tissues of the genital area. They may appear as small bumps or have a cauliflower-like appearance.

In women, genital warts can grow on the vulva (area outside the vagina), the area between the external genitals and the anus, and the cervix. In men, they may occur on the tip of the penis, the scrotum, or the anus.

“Genital warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person,” notes Dr Gerard Wain, visiting chief examiner in Gynecological Oncology for the Royal Australian and New Zealand College of Obstetricians and Gynecologists.

Citing data from the Health Protection Agency of the United Kingdom, Dr. Wain disclosed that the incidence of genital warts in the UK has increased by 18 percent in females and 34 percent in males from 1996 to 2005.

In the United States, an estimated half to one million new cases of genital warts occur every year. About one percent of sexually active Americans have genital warts at any one time.

“As we all know, many HPV information campaigns have centered on cervical cancer of which virtually 100 percent or nearly half a million cases per year worldwide are associated with the HPV. However, there’s another side of the HPV story and that is genital warts,” notes Wain.

Most Common STI

Genital human papillomavirus is the most common sexually transmitted infection (STI). There are more than 40 HPV types that can infect the genital areas of men and women, including the skin of the penis, vulva, and anus, and the linings of the vagina, cervix, and rectum. The types of HPV that can cause genital warts are not the same as the types that can cause cancer.

“HPV types are often referred to as ‘low-risk’ (wart-causing) or ‘high-risk’ (cancer-causing) based on whether they put a person at risk for cancer,” Dr. Wain explains.

A CDC fact sheet released by the Department of Health and Human Services USA states that if left untreated, genital warts may go away, remain unchanged, or increase in size or number.

“However, HPV can cause normal cells on infected skin or mucous membranes to turn abnormal and thus lead to cancer in the process,” stresses Dr. Wain.

Genital warts are a very infectious agent and transmission of the virus is very common. If a couple has unprotected sexual activities for years and one happens to be infected with genital warts, there’s a 75-percent chance of transmitting the virus to his/her partner.

“The burden of the disease caused by HPV is beyond the numbers,” adds Dr. Wain. “Those who have been affected by genital warts reported medical problems, sexual difficulties, psychological distress, financial burden, and social isolation.”

Prevention Is Key

Don’t be shy to seek medical advice if you’ve developed bumps or warts in your genital area or if your sexual partner has developed genital warts or has been diagnosed with them. When it comes to the treatment of the disease, there’s a whole range of topical creams, medications, even surgery.

“Don’t use over-the-counter wart treatments in the genital area,” advises Dr. Wain.

Sexually active young people have the tendency of developing genital warts. In fact, a higher incidence of this disease is found in the younger population.

If you feel that you’re at risk, a vaccine can now protect you from the types of HPV that cause genital warts or most genital cancers. The vaccine is recommended for girls, 11 and 12 years old, before the onset of sexual activity. It is also ideal for girls and women 13 to 26 years of age who have not yet been vaccinated or completed the vaccine series.

Dr. Wain notes that a quadrivalent HPV recombinant vaccine has been shown to help protect against four types of HPV: types 16 and 18, which cause approximately 70 percent of cervical cancers; and types 6 and 11, which cause approximately 90 percent of genital warts

“The World Health Organization recommended that young girls be vaccinated against HPV and that it should be included in their regular vaccination programs. As with most vaccines, the quadrivalent HPV recombinant vaccine works best if it’s given before any infection … before the patient is exposed to the virus,” stresses the Australian oncologist.

In the Philippines, the said quadrivalent HPV recombinant vaccine, which has been indicated for use among women ages nine to 45 years old, was also recently approved by the Bureau of Food and Drugs (BFAD) for men ages nine to 26 years old.

“This will help protect men falling within such age range against genital warts,” adds Dr. Wain.

The quadrivalent HPV recombinant vaccine is given in three doses.

“The first shot primes the immune system. The second shot should be administered after two months to make the response much stronger. The third shot is given six months after the first dose. It provides the body a higher level of protection against the virus. It’s important to get all three shots for maximum protection,” explains Dr. Ma. Angela Bandola, obstetric-gynecologist, Infectious Diseases-UP PGH.

The price of the vaccine ranges from P4,000 to P6,000 per shot.

Asked how long the vaccine can protect the body from HPV infection, Dr. Wain replies, “We don’t know yet. Theoretically, it’s likely to last forever. The same thing goes for the hepatitis B vaccine. When that vaccine was first launched in the early 1980s, it wasn’t clear to us how long it would protect the body from infection. Well, it has been almost 30 years and the hepa B vaccine I got still works to this day.”