YOSEMITE, CALIF. — Patients with venereal warts should be reassured that the condition does not substantially increase their risk of developing cervical cancer, said Laura J. Grimshaw, assistant medical director of the STD Center for Excellence at Rivington House, New York.
That's because the human papilloma virus (HPV) types that cause most condylomata acuminatum are not usually associated with cancer. Even though HPV infection is so common that exposure is virtually universal, the incidence of cervical cancer is only 8/100,000 women per year.
Patients often come in having surfed the Internet and learned that HPV is associated with cancer, Ms. Grimshaw said at a meeting on obstetrics and gynecology sponsored by Symposia Medicus. These patients need to be counseled and to be told that although HPV is common, cervical cancer is rare.
Studies have shown that at any one time, 1%-2% of sexually active men and women between the ages of 15 and 49 years have genital warts, 14% have a subclinical infection detected only by looking for DNA, and 60% have antibodies indicating previous infection.
That translates into a 75% lifetime risk of being infected, Ms. Grimshaw said.
“The message here is: If you have ever had sex with anyone else who has ever had sex with anyone else, you have probably been exposed to HPV,” she said.
The types of HPV that cause condyloma acuminatum most commonly are types 6 and 11. Even though HPV is associated in 93% of cases of cervical cancer, types 6 and 11 are not. The types most commonly associated with cervical cancer are 16, 18, 31, and 45, and they are found involved in 80% of cervical cancers.
One thing you cannot tell a patient with such certainty is why the partner suddenly developed genital warts when he or she was supposed to be monogamous, Ms. Grimshaw said.
It is not known how long HPV can persist before it is eradicated by the immune system, even though in the majority of cases it has been cleared by 2 years. It is always possible the partner had a subclinical infection for a long time before the warts appeared, or that the patient had no warts but was the source of the partner's infection. “There can be a latency for years,” she said.