December 27, 2020

7 Things You Probably Don’t Know About HPV

It's about more than cervical cancer risk

illustration of the HPV virus

While human papilloma virus, or HPV, is a well-known cause of cervical cancer, there’s a lot more you should know about this common infection.

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Ob/Gyn Oluwatosin Goje, MD, shares seven things you probably didn’t know about HPV.

1. HPV is surprisingly common

HPV is the most common sexually transmitted infection in the United States. According to the U.S. Centers for Disease Control and Prevention (CDC), about 79 million people are currently infected, and it’s estimated that almost everyone who’s sexually active will end up with at least one strain of HPV at some point.

2. There are over 200 different strains of HPV, but not all of them cause cancer

In fact, only about a dozen strains of HPV are known to cause cancer, and two particular strains — HPV 16 and 18 — are responsible for about 70% of all cervical cancers. Some strains cause warts, but not cancer, and some strains cause no problems at all.

3. HPV can cause other types of cancer besides cervical cancer

HPV is the leading cause of anal cancer and oropharyngeal cancer (cancer of the back of the throat). It’s also responsible for about half the cases of penile and vulvar cancer and about two thirds of vaginal cancer cases.

4. HPV affects men, too

Actor Michael Douglas made headlines back in 2013 when he announced that he got throat cancer, not by drinking and smoking, but from HPV. In fact, white, nonsmoking men age 35 to 55 are most at risk for oral and oropharyngeal cancers caused by HPV; they’re four times more likely than women to develop these cancers.

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Penile and anal cancer, while rare, are also caused by HPV.

5. You can get tested for HPV — but results can be misleading

Although there are ways to test for at least some kinds of HPV infections, the results don’t always tell you much about your cancer risk.

HPV infections often resolve on their own thanks to the body’s natural immune response, which means that you might test positive only to find out a few years later that you no longer have HPV at all. Testing is not a reliable way to screen for cancer or cancer risk.

6. Knowing signs of HPV-related cancers can lead to early detection

Despite the limits of testing, it’s still a good idea for women to get a Pap test every few years (based on guidelines ) and for men and women to watch for other signs of HPV-related cancers so that you can catch any problems early. Here are some general recommendations.

For cervical cancer:

  • The Pap test detects abnormal cervical cells that could lead to cancer. All women should begin cervical cancer testing (screening) at age 21. Women from age 21 to 29 should have a Pap test every 3 years.
  • HPV testing should not be used for screening in this age group (it may be used as a part of follow-up for an abnormal Pap test).
  • Beginning at age 30, the preferred way to screen is with a Pap test combined with an HPV test every 5 years. This is called co-testing and should continue until age 65.
  • Women who are at high risk of cervical cancer because of a suppressed immune system (for example from HIV infection, organ transplant, or long term steroid use), history of abnormal Pap test or because they were exposed to DES in utero may need to be screened more often. They should follow the recommendations of their health care team.
  • The HPV DNA test is also an FDA-approved means of testing for HPV and screening for cervical cancer.

For other HPV-related cancers:

  • Vulvar and vaginal cancer: There’s no standard screening for these cancers, but being aware of your body is the next best thing. Potential causes of concern include changes in vulvar skin, itching, bleeding, burning, abnormal discharge, pelvic pain and changes in bathroom habits (going more or less frequently or having blood in the urine or stool).
  • Oropharyngeal cancers: There’s no standard screening for these cancers, but symptoms include patches of red, white, or black discoloration inside your mouth or throat, oral sores that do not heal within two to three weeks, painful swallowing, one swollen tonsil and a persistent sore throat.
  • Penile cancer: There’s also no standard screening for penile cancer, but sores or scaly areas on the penis are causes for concern.
  • Anal cancer: Although anal cancer isn’t routinely screened for, Pap tests and high-resolution anoscopies are sometimes used to check for cell abnormalities.

It’s always a good idea to talk to your doctor about any changes you notice in these parts of your body.

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7. There are three simple ways to reduce your HPV risk

Although HPV is widespread and in most cases doesn’t cause problems, there are ways to minimize your risks.

  • Use a condom. HPV spreads through skin-to-skin contact, and since condoms don’t cover everything, they don’t totally eliminate the risk of HPV transmission. But they can help. Dental dams can make oral sex safer, too.
  • Limit your number of sex partners. The more partners you have, the higher your risk of contracting HPV.
  • Get vaccinated. HPV vaccines are safe and effective. The CDC recommends vaccination from age 9 to 45.

Knowing your risks and watching for changes in your body will go a long way toward limiting the chances that you will have problems with HPV-related cancers. Talk to your doctor if you have questions or suspect a problem.

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