This month, I invited Dr. Amy Vance, board-certified gynecologist, to answer questions about Human Papilloma Virus (HPV).
By Dr. Sharon K. West –
HPV can lead to cervical cancer, which is diagnosed in almost 13,000 women in the United States each year. It is a small virus transmitted through contact of skin and mucosa.
What are the symptoms of an HPV infection?
Unfortunately, there are often no symptoms of HPV. While some patients might develop warts from being in contact with the virus, the changes caused by the more aggressive strains of the virus can be difficult to detect, as the symptoms are initially evident only by evaluating cells under a microscope. This is why it is very important to report unusual coughs, hoarseness, and difficulty swallowing to your primary care provider and for women to have routine gynecological screening.
How does one contract HPV?
The HPV virus is transmitted by sexual contact orally or at the genitals or both. It is such a common virus that the Centers for Disease Control (CDC) has commented that everyone who is sexually active should be considered to already have been, or certain to be, in contact with the infection during their lifetime.
How serious is HPV?
It is very serious, first because it is affects so many people. 79 million Americans are estimated to be currently infected with the virus, and there are 14 million new cases each year. And secondly, it is associated with six different cancers.
There are different strains of the virus. While mild strains cause warty growths and do not appear to be associated with progression to cancer, more aggressive strains are more likely to be associated with the following cancers diagnosed each year:
- 10,751 cervical cancers
- 635 vaginal cancers
- 2,707 vulvar cancers
- 803 penile cancers
- 5,957 anal cancers
- 12,885 head and neck cancers
How does a woman get tested for HPV?
Only cervical cancer screenings have a well-established screening protocol, so all women should take advantage of this. The American College of OB/Gyn currently recommends that screening begin at age 21. Currently, they recommend screening by a Pap smear (evaluating cells under the microscope after being collected by a gynecologist or other provider) and by checking for the presence of HPV (which can be tested on the same collected cells), based on age and other risk factors. There is currently no blood or urine test for HPV.
Yes. It is estimated that HPV is the cause of 91% to 100% of cervical cancer cases.
Can men get HPV?
Yes. HPV is responsible for 18,280 HPV-related cancers in males every year.
Do condoms prevent HPV?
Wearing a condom can decrease the spread of HPV and the risks of getting cancer from HPV when used consistently and correctly. Condoms do not prevent all oral transmission and are not able to eliminate the spread entirely.
How does HPV affect males?
Males can get genital warts, head and neck cancers, penile cancer, and anal-rectal cancers.
I understand there is a HPV vaccine. Who should get this and how often?
Because HPV is so common and is associated with so many cancers … most of which have no screening protocols so that they are caught at an early and easily treatable state, it is extremely important for everyone to receive a vaccine. The FDA has approved the HPV vaccine for all people age 45 and younger.
Does HPV affect fertility or pregnancy?
Some of the procedures needed to treat HPV can make it impossible or difficult to carry a pregnancy or for egg and sperm to unite in fertilization.
Is there a cure?
The HPV vaccine is currently the most likely way to “cure” the HPV virus, with the aim being a focus on prevention. Current data in women aged 27-45 years of age suggests there is an 88% reduction in persistent HPV infection, genital warts, vaginal and cervical pre-cancer, or cancerous lesions. The reduction is likely to be much greater if the vaccine is given at an earlier age when prior exposure has been lower.
Who tends to get HPV positive results?
Positive results tend to appear in those who have:
- multiple sexual partners or have a partner who does so
- engaged in sexual activity at an early age
- been pregnant many times
- been immunocompromised
- a history of smoking
- a history of other sexually transmitted infections
- a history of contraception use
- low socioeconomic status
- a poor diet
- been or are affected by alcoholism
African Americans have the greatest prevalence of HPV, followed by Hispanics.
The most important message to all women is this: Get your cervical screening [Pap smear] done without fail. Strongly consider receiving the HPV vaccine.