9 Things You Should Know About Human Papillomavirus (HPV)

Despite greater public awareness, misperceptions remain

The human papillomavirus (HPV) is a viral infection spread through skin-to-skin sexual contact. HPV is comprised of over 100 different viruses of which at least 30 strains are linked to the development of cancer. In fact, over 96 percent of cervical cancers and 93 percent of anal cancers are associated with high-risk forms of HPV.

Penile cancer and oropharyngeal cancer (cancer of the middle part of the throat behind the tongue) are also linked to high-risk strains.

Despite increased awareness about the virus and vaccines meant to prevent it, there remains a lot of confusion about HPV in general. This can not only lead to delayed treatment should you miss the signs of infection, it can also put you at risk of either getting or spreading the virus to others

Here are 9 important facts everyone should know about the human papillomavirus:

1
HPV Is More Common Than You May Think

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It is estimated that over 20 million Americans are infected with HPV, making it the single-most common sexually transmitted disease in U.S.

According to the Centers for Disease Control and Prevention (CDC), among adults between the ages of 18 and 69, 42.5 percent are infected with a genital HPV and 7.3 percent are infected with an oral HPV

It is so common, in fact, that researchers believe almost all sexually active people will get the virus at some point in their lives. 

2
You Don't Need to Have Intercourse to Get HPV

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HPV is transmitted through skin-to-skin sexual contact. This shouldn't suggest, however, that intercourse is the sole route of infection. In fact, no penetration of any sort is needed to transmit the virus, and any area not covered by a condom can be infected.

By and large, vaginal and anal intercourse are the activities most associated with HPV transmission. Although less common, the virus can also be passed through oral sex. The risk only increases if you have multiple sex partners or have sex with someone who has had many partners. 

3
Not All Types of HPV Cause Cancer

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HPV is a group of over 100 different viruses. Some are high-risk strains associated with cancer; other are low-risk types known to cause genital warts.

The strains considered to be of high risk are types 16 and 18 which together represent five percent of all cancer cases worldwide.

There is a common misperception among many that genital warts are a precursor to cancer. This is not the case. The HPV strains responsible for genital warts are not known to cause cancer.

With that being said, having a genital wart shouldn't suggest you are "safe." Persons can be infected with multiple HPV types, and the appearance of a wart should be a warning sign of a possible exposure to higher risk strains.

4
There Is a Vaccine but No Cure for HPV

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The types of HPV that cause genital warts and cervical cancer can be managed but not cured. Similarly, genital warts can be treated by removing them, but their removal does not eradicate the underlying virus.

While there are vaccines today that can greatly reduce the risk of HPV in young men and women, they are not sterilizing vaccines and cannot neutralize the virus in people already infected.

5
Most People With HPV Do Not Have Symptoms

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You cannot know if someone has HPV by looking at them or searching for genital warts. It doesn't work that way. Most people, in fact, have no signs of infection and may only become aware of the condition if they have an abnormal Pap smear result.

But, even for people who do have symptoms, they are often either overlooked or misunderstood. One study conducted by the National Cancer Institute showed that more than half of the women with genital warts did not know that they had had HPV, while just under two-thirds were unaware that HPV could cause cancer.

6
The HPV Vaccine Does Not Protect Against All Strains

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Gardasil 9 Package. Merck

The three HPV vaccines approved for use in the U.S. can protect against some but not all of the high-risk strains:

  • Gardasil protects against four of the most common types and the two that cause 9 percent of all genital warts.
  • Gardasil 9 protects against an additional five strains.
  • Cervarix protects against the two most common high-risk strains but provides no protection against genital warts.

While these vaccines typically provide ample protection, they may fall short in women with HIV who often cervical cancer as a result of an atypical HPV type.

7
HPV Testing Is Different for Women and Men

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The HPV test can be performed in women along with a Pap smear during a gynecological exam. The U.S. Preventive Services Task Force (USPSTF) currently endorses routine testing in the following age groups:

  • Women 30 to 65 should have a Pap test and an HPV test every five years.
  • Women under 30 do not need HPV screening but may be tested in the presence of an abnormal Pap smear result.

As for men, there is currently no HPV test available to detect for genital HPV. However, some doctors may run an HPV test on an anal Pap smear in high-risk men (and women) who engage in receptive anal sex. 

Neither the CDC nor the USPSTF offer any recommendations regarding routine anal Pap screening in either men or women.

8
Some Doctors Are Reluctant to Do HPV Testing

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One of the reasons why health agencies are reluctant to issue routine testing recommendations is that the benefits of HPV testing are still largely uncertain.

While a negative HPV test is a good indication that you won't get cancer, a positive result often means nothing. This is because the majority of HPV infections go away in two years without any complications. As such, a positive result may cause more distress than necessary or direct medical investigations that are not needed.

9
HPV Vaccination Is Not Just for Young People

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The CDC currently recommends HPV vaccination for all boys and girls from at the age of 11 or 12. They also endorse its use in females ages 13 through 26 and males ages 13 through 21 years who have not been previously vaccinated.​

But, just because you're over 26 doesn't mean you shouldn't get vaccinated. Gay and bisexual men, transgender people, and immune-compromised persons (including those with HIV) are among the groups the CDC recommends for later immunization as they run a ​far higher risk of anal and cervical cancer than the general population.

If you believe yourself to be at increased risk for cervical or anal cancer, don't hesitate to ask your doctor to perform one. It's fast, simple, and costs around $100 (which your insurance may cover).

Sources

  • Centers for Disease Control and Prevention (CDC). "Prevalence of HPV in Adults Aged 18–69: United States, 2011–2014." NHCS Data Brief. 2017; 208:1-8.
  • Koshiol, J.; Finney-Rutten, L.; Moser, R.; et al. "Knowledge of Human Papillomavirus: Differences by Self-reported Treatment for Genital Warts and Sociodemographic Characteristic." J Health Commun. 2009; 14(4):331-345.
  • U.S. Preventive Services Task Force (USPSTF). "Cervical Cancer: Screening." Rockville, Maryland; March 2012.

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