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Human Papillomavirus (HPV)

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What is HPV?
A Risk Factor for Multiple Cancers

Human papillomavirus (HPV) is a common virus and a risk factor for various cancers that affect both men and women. An estimated 79 million Americans are currently infected with HPV. Most people with HPV don’t experience any symptoms. For many, the virus goes dormant, becomes undetectable, or clears up completely on its own. For others, HPV infection develops into warts and/or cancer.

HPV is Contagious

HPV is transmitted from skin-to-skin contact, including genital-genital, oral-genital, or other skin-genital contact. While most HPV transmission is genital and oro-genital, there have also been reports of transmission through the birth canal, breast milk, deep mouth kissing, and contaminated fingernails.

How Can HPV Lead to Cancer?

There are approximately 200 HPV strains. Some are low risk, while other strains can trigger inflammation that, over time, causes cancer in both men and women.

HPV infection can develop into cancers at the following sites:

  • Cervix
  • Vulva (outer part of female genitals)
  • Vagina
  • Penis
  • Anus
  • Throat (base of the tongue and tonsils)

Gynecological Cancers

Nearly all cases of cervical cancer and most vaginal cancers are tied to HPV infection. In someone with a competent/functional immune system, the time from infection to cancer can be up to 10 years. In women who are immunocompromised (HIV disease or on immunosuppressive medications), this time can be much shorter.

Anal Cancer

The number of men and women diagnosed with anal cancer each year is on the rise, and more than 90% of these cases are caused by HPV.

Penile Cancer

HPV DNA may be detected in over 20% of penile tumor cells, and 50 to 60% of penile cancers are associated with HPV infection. It may take many years before HPV infection manifests as cancer.

Oropharyngeal Cancers

Signs of HPV infection are found in more than two out of three oropharyngeal cancers, which include cancers of the back of the throat, base of the tongue, and tonsils. Diagnoses of HPV-positive head and neck cancers increased 225 percent in the last two decades. These cancers can develop 5 to 10 years after HPV infection.

How to Prevent HPV Infection

HPV Vaccination

The HPV vaccine (Gardasil in the U.S.) is designed to prevent cancers in adolescents and adults. Full vaccination can protect against 80% of HPV-caused cervical cancers and five other types of cancer.

It also prevents 90% of genital warts caused by HPV. Because both men and women can spread HPV to their sexual partners, it’s equally important for boys and girls to get vaccinated against HPV to protect themselves and their future partners.

Vaccination for Children and Adolescents

The experts at Sylvester and other leading cancer-fighting institutions recommend the vaccination of children, both boys and girls, because the virus can take decades to form into cancers.

To be most effective, the HPV vaccine must be administered before any possible exposure to the virus. Young people can first be exposed during intimate encounters with a partner that don’t involve penetrative sexual intercourse.

While parents of adolescents might be most concerned about unplanned pregnancies, sexually transmitted infections like HPV can be transmitted before your child is “having sex.”

According to the American Cancer Society, “even if a person delays sexual activity until marriage, or only has one partner, they are still at risk of HPV infection if their partner has been exposed.”

The Gardasil vaccine should be given to girls and boys between 9 and 12 years old. Before age 13, children should get two doses of the vaccine 6 to 12 months apart. Those who get the first shot after their 15th birthday need three doses, given over six months, to be fully covered.

HPV vaccination is not generally recommended for those older than age 26 because the majority of people have been exposed to the virus by this age. Based on a patient’s unique risk factors, doctors may recommend that some adults get vaccinated by age 45.

HPV Screenings

Pap smear tests are the first line of detection for abnormal (and pre-cancerous) cells in the cervix. It’s highly recommended that females (including CIS females and transgender males with a cervix) get a pap smear every three years (or every five years in combination with HPV tests). When a pap smear reveals abnormal cells, a procedure called a colposcopy or an HPV DNA test may be recommended to confirm HPV infection.

There is currently no screening test available for HPV in men and teenage boys. When genital warts are present on the penis or groin, they may be tested for HPV DNA. Because of this, the virus often goes undetected in males and spreads from partner to partner.

Sexual Protection

Nearly all sexually active people are exposed to HPV at some point in their lifetime. The majority of those who are unvaccinated for the virus get infected. Consistently using a condom or dental dam can reduce the chances of getting HPV from partners, even in sexually monogamous relationships. But, all intimate skin-to-skin contact still carries some risk of spreading and catching HPV.

What are the Treatments for HPV Infection?

When warts caused by HPV are present, they can be removed by a doctor or treated with medications. This can lower the chance of spreading the virus to others, but some risk of transmission remains even when warts aren’t visible.

There is no cure for HPV infection.