Is HPV typing important?
Dr. Bettie Steinberg believes this need for this is vastly overrated. Dr. Tom Broker disagrees. There is no consensus on this question. HPV 11 and 16 tend to be much more aggressive than HPV 6 (Derkay, Wiatrak). The incidence of malignant conversion, which we must remind readers is quite rare in any event, also seems to be higher with these types. It is particularly concerning in the case of RRP that is caused by HPV 16. HPV 16 shows up in from 1-2% of RRP samples, so we are talking about small numbers, and only a portion of those go on to convert. It seems fairly obvious that one might with to subject those cases that are known to have a higher incidence of malignant conversion to more frequent monitoring.