HPV itself does not cause any signs or symptoms. Warts in or near the genital area can often be felt with a finger and are visible to the naked eye. Dysplasia does not usually cause any obvious symptoms.
While a blood test can check for HPV infection, a positive result doesn't really say much. Being infected with HPV does not mean that genital warts will develop, nor does it mean that dysplasia or cancer will occur.
Genital warts should be reported to a health-care provider. The warts should be biopsied – a sample collected in a minor surgical procedure – to determine if they might go on to cause cancer.
To check for dysplasia or cancer, a health-care provider can perform a Pap smear, in which cells are scraped from the cervix or anus and examined under a microscope. If the cells are found to be abnormal, a second Pap smear should be conducted to confirm these results.
Women should have their first cervical Pap smear by age 18 or when they become sexually active, whichever comes first. It is recommended that HIV-positive women have a cervical Pap smear every six months. Men and women who practice anal sex should also have regular anal Pap smears.
An abnormal Pap-smear result calls for closer examination. At this point, a colposcope or anoscope – two magnifying devices – are used to look for cancerous or pre-cancerous patches, or lesions, inside the anus or cervix. These lesions are often referred to as either anal or cervical intraepithelial neoplasia (AIN or CIN). If lesions are found, a biopsy can be performed to learn more about the abnormal cells.
Depending on the results of the biopsy, AIN and CIN are given a stage number, either I, II, or III. The stage of dysplasia depends on the thickness of abnormal cells within the cervical or anal wall. AIN or CIN I is considered to be a mild form of dysplasia and generally does not require therapy (but must be monitored closely), whereas AIN or CIN II or III are considered to be more advanced forms of dysplasia and are more likely to develop into cancer. Advanced forms of AIN or CIN often require therapy to prevent them from developing into cancer.
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