7 Things you didn't know about HPV

Find out more about HPV

HPV. Getty

1. HPV is common

It’s so common, you’ve probably had it. Kids have warts on their hands and feet from HPV. Some children are born exposed. Most sexually active adults will acquire HPV. It’s the most common STD. About 14 million will acquire HPV this year in the US.

The vaccine is recommended for everyone age 11 or 12. It consists of 3 shots. The first shot is followed by a second 1-2 months later and a 3rd 6 months later.

If this round of vaccination is missed, catch-up vaccination is recommended for females and males who have sex with males up to age 26 and for other males up to the age of 21.

2. There isn’t just one type of HPV.

Over 170 types of HPV have been named – well, actually numbered.

The two most common causes of cancer – cervical cancer in women – are 16 and 18. They have accounted for 70% of cervical cancers – but hopefully less in the future as both of these types are included vaccination reduces their prevalence.

There are other high risk types and together with 16 and 18, HPV from one of these types is found in 99% of cervical cancers: 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 69, 73, 82.

The two most common causes of genital warts are 6 and 11, which are also included in HPV vaccines, and cause 90% of genital warts (and 90% of recurrent respiratory papillomatosis).

There are many types that cause warts elsewhere (like on hands or feet): 1,2,3,4,7,8,10,63.

The characteristic look of these warts often corresponds with which type of HPV they are – flat, plantar, or common warts.

The two most common vaccines, Gardasil and Cervarix, protect against 16 and 18 (cervical cancer), while Gardasil also protects against 6 and 11 (genital warts). A new version of the Gardasil vaccine, called Gardasil 9, protects against even more cancer causing types.

They have added 31, 33, 45, 52 and 58, which are thought to cause 20% of cervical cancer, to the 16,18, which are associated with 70% of cervical cancer (and 6/11 for genital wart coverage).

3. HPV is tied to throat cancer.

Those with head and neck cancers are 15x more likely to be infected with HPV in their mouths than those who don’t have these cancers.

A study from Johns Hopkins found HPV in 25% of head and neck cancers ; 90% of those cancers with HPV had HPV 16. These cancers include: Head and Neck Squamous Cell Cancers such as throat, tongue, and tonsil.

Recent years have seen a rise in Head and Neck Cancers, including those identified as associated with HPV. Doctors have been seeing cancers in people who are younger and healthier. The disease used to be largely associated with smoking and alcohol. Men, though, still have higher rates than women and these cancers are more common in smokers and those who consume more alcohol.

3. Babies can get HPV infections too

Recurrent respiratory papillomatosis is a disease where growth from HPV occur in the respiratory tract, especially the larynx or voice box. It can occur when a child is born to a mother infected with HPV and is associated with HPV 6 and 11.

There are about 20,000 cases a year in the US. It can cause a hoarse voice or difficulty breathing if the HPV-growths become too large. There isn’t a way to prevent these growths from recurring; they simply are removed by surgeons, especially with small laser treatments.

4. Most HPV infections fade away

In a study of young men and women, HPV infections cleared in 70% in 1 year and 90% in 2 years, but persisted in 5-10% of women, which is what can be tied to cervical cancer.

5. There isn’t a test to say you’re HPV-free

The only test commonly used by healthcare practitioners is a gynecologic swab (which may be obtained while a Pap smear is performed).

In the US, women generally over 30 are tested by a swab to see whether they have a strain of HPV. It may not pick up all strains a woman carries. The test may be only run for a few types or may just pick up some types when a woman has more than one. In the future, some women may be tested only for HPV, as a replacement of the traditional Pap smear. It also does not test for oral HPV, as it is only a cervical gynecologic test. There aren’t any approved tests for men in the US to test for HPV.

6. Women still get cervical cancer from HPV

The vaccines do not cover all types of HPV. The vaccine usually covers just the 2 most common causes of cancer – not all. Many women haven’t been vaccinated and were too old when vaccination started. Pap smears don’t find all cancers; not all women regularly have their pap smears.

Worldwide, half a million women develop cervical cancer each year. It’s the second most common cancer in women worldwide. About 274,00 die each year from cervical cancer.

In 2011 alone, 12,109 were diagnosed with cervical cancer, 4,092 died in the US. In the US, rates are highest in the South – especially Texas, Louisiana, Mississippi, Florida. Transmission occurs silently; the partner who transmits the infection does not know the person newly infected does not know. The cancer may take a decade or more to develop. Women need to continue with pap smears – even if they are no longer sexually active and even if they have been vaccinated.

Using condoms or barrier protections reduce the chance of acquiring HPV, but don’t eliminate it. Fewer sexual partners reduces the amount of exposure to HPV, but transmission can occur from just one person.

Some types of HPV are also associated with vaginal cancers.

7. Men also get cancer from HPV

Oral cancer is more common in men than women. Penile cancer is associated with HPV, as is anal cancer, which occurs more frequently in men who have sex with men.

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