HPV – What the Virus Means and What You Really Need to Do
HPV: infection, screening and vaccination – gynaecologist Basel
FMH Gynecology
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Spalenvorstadt 3
4051 Basel
HPV is a large family of viruses with more than 200 types; some affect the genital, anal and throat area. High-risk types (mainly 16 and 18) can, with persistent infection, cause cell changes and, from these, cancer – at the cervix, in the vagina, on the vulva, at the anus, in the throat and, in men, on the penis. Low-risk types (mainly 6 and 11) cause genital warts: unpleasant, but benign.
HPV is transmitted through direct skin and mucosal contact in the intimate area – even without penetration, and during oral and anal sex. Condoms reduce the risk but do not fully prevent transmission, because uncovered skin can also be affected.
An HPV infection is not rare and is not a sign of carelessness. In the vast majority of cases, the immune system clears it within one to two years on its own, without any symptoms ever appearing.
Key facts
At a glance.
- HPV is the most common sexually transmitted infection – most people become infected with it at some point in their lives.
- In the vast majority, the infection clears on its own within one to two years.
- What matters is not a single positive result, but persistence over years.
- It usually takes ten to fifteen years from a precursor stage to a carcinoma – a very wide window for screening.
- A positive HPV test means neither cancer nor infidelity and does not require immediate treatment.
- Vaccination and smear tests complement each other: vaccinated women still need screening.
Causes
Background and risk factors.
HPV is transmitted through skin and mucosal contact in the intimate area. The virus only becomes dangerous when a high-risk type remains detectable at the cervix for years: then precancerous changes can develop. Hygiene plays no role here – an HPV infection has nothing to do with a lack of cleanliness.
Risk factors
- Smoking – the best-documented cofactor: it impairs the ability to clear an HPV infection and significantly increases the risk of higher-grade changes.
- Weakened immune defence (immunosuppression, HIV) – closer monitoring intervals are needed.
- Persistent detection of a high-risk type over several years.
Frequency
By international comparison, Switzerland has one of the lowest rates of cervical cancer. This is the result of decades of well-implemented screening – not chance, and no reason to let checks slip.
Symptoms & findings
How does it present?
Typical symptoms
- Usually no symptoms at all – an HPV infection typically goes unnoticed.
- Genital warts (condylomata) from low-risk types 6 and 11.
- Cell changes at the cervix cause no symptoms and are only discovered on a smear test.
What a positive HPV finding means – and what it doesn't
A positive HPV test does not mean you have cancer or will get it.
It says nothing about when you became infected
an infection can date back years and only become detectable now – an HPV finding is therefore not evidence of infidelity, either by you or by your partner.
It also does not mean you need treatment
there is no therapy against the virus itself. What is treated – if anything – is cell changes, not the virus finding.
What it does mean
you belong in structured follow-up. The course over time is what matters, not the single result.
Diagnostics
How the diagnosis is made.
An abnormal smear or a persistently positive HPV finding leads to colposcopy: assessment of the cervix under magnification, with targeted tissue sampling if needed.
Examinations
- Pap smear – from age 21, the method covered by basic insurance in Switzerland.
- HPV test – recommended professionally as an alternative from age 30, but a self-pay service in screening (partly reimbursed depending on supplementary insurance).
- Colposcopy with targeted biopsy for an abnormal finding.
What do the findings mean?
Co-testing – Pap and HPV test at the same time – is no longer recommended: it is one or the other. Under basic insurance, the smear is done every three years with unremarkable prior findings, up to around age 70. With abnormal findings, after treatment of precursor stages, or with a weakened immune system, shorter, individually set intervals apply.
No smear is done before age 21
cervical cancer is extremely rare in this age group, and cell changes very often regress spontaneously. If intercourse has never taken place, a cervical smear is not needed; if there are symptoms, an examination with a swab is possible – a gynaecological consultation is also sensible and possible without a speculum examination.
Treatment
Possible approach.
Watchful waiting
There is no therapy against the virus itself. Milder changes (CIN 1) often regress on their own and are monitored, not operated on.
Medication
Genital warts are treated, depending on extent, with topical creams or by removal in the practice. Recurrence is possible as long as the immune system has not brought the virus under control. Vaccination also covers the two most common causative types.
Surgery
Higher-grade changes (CIN 2/3) are treated with a small outpatient procedure (LEEP/conisation) – in Dr Wagner's practice, in our own procedure room at Spalenvorstadt 3 in Basel.
Prevention
What you can do yourself.
- Primary vaccination for girls and boys aged 11 to 14, ideally completed before sexual activity begins.
- Two doses if the first dose is given before the 15th birthday; three doses thereafter.
- Catch-up vaccination from age 15 to 26 – covered by the cantonal vaccination programmes; exempt from the deductible, while the statutory 10 % co-payment still applies.
- From age 27: the nonavalent vaccine used is approved up to age 45. Individual decision and self-pay service; the expected benefit is smaller because some types may already have been encountered.
- Boys benefit too: they can themselves develop HPV-related cancers (anus, throat, penis), and their vaccination interrupts the chain of transmission.
- Do not smoke – smoking is the best-documented cofactor for higher-grade cell changes.
- Continue regular screening even after complete vaccination.
Vaccination
What the vaccine can do – and what it can't.
The vaccine does not treat an existing infection, does not make existing cell changes disappear, and does not replace screening. Vaccinated women still need the smear test, because the vaccine does not cover all cancer-causing types.
The most common misconception in the consultation
"I've been in a stable relationship for years, I don't need this." HPV infections can date back years and become relevant again at any time, and relationship situations change. Vaccination also protects against types not yet encountered.
In Dr Wagner's practice
Smear test as part of screening, HPV test on request with prior information on costs. Colposcopy and targeted biopsy (additional qualification in cervical pathology). Outpatient treatment of precursor stages (LEEP/conisation) in our own procedure room at Spalenvorstadt 3 in Basel. Treatment of genital warts. Vaccination counselling and vaccination, for adolescents under the cantonal programme.
Video
Explainer video: HPV and vaccination.
A short explainer video on HPV vaccination. It does not replace a personal consultation – advice is given during the appointment.
Frequently asked questions
FAQ.
Related topics
Medically responsible.
Dr. med. Anna Margareta Wagner is a board-certified FMH specialist in gynecology and obstetrics with her own practice at Spalenvorstadt 3 in Basel. Special focus on surgical gynecology; further focus areas: gynecological check-ups, colposcopy and dysplasia consultations, intimate surgery, pregnancy care, and consultations for girls and adolescents.
- FMH specialist certification in gynecology and obstetrics
- Special focus: surgical gynecology
- SGGG member
- Certified colposcopy diploma
- Languages: German, English
- Service area: Basel-Stadt, Basel-Landschaft, northwestern Switzerland
The content on this page is reviewed regularly against current specialist medical recommendations.
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