HPV and Cancer
January is both Cervical Health Awareness Month, and from the 24th to the 30th, HPV Awareness Week. Let’s take a few minutes to better understand HPV, the health risks, and what everyone can do to prevent HPV infections.
What is HPV?
Human papillomavirus (HPV) is one of the most common viruses out there. Around 80% of people in the US will be exposed to and get an HPV infection during their life and most HPV infections do not cause any symptoms. There are more than 150 strains of HPV in total, but only about 40 strains are transmitted to the genitals—vagina, cervix, penis, anus—and throat during sexual contact. Some strains of HPV are commonly referred to as “high-risk” because they increase the risk of certain types of cancer, including cancer of the cervix, vagina, and vulva; cancer of the penis; cancer of the anus; and cancer of the throat. HPV strains 16 and 18 are responsible for nearly 70% of cervical cancer diagnoses.
How to Prevent HPV?
The best prevention of HPV infection is vaccination before sexual activity. Getting the vaccine before sexual debut protects people from nine strains of HPV—6, 11, 16, 18, 31, 33, 45, 52, and 58. These strains include the high-risk strains that are most likely to cause cancer as well as the low-risk strains that cause genital warts. While the HPV vaccine is most effective if given to young people before sexual debut, it is recommended for all sexually active people up to age 45. Even people who have been diagnosed or exposed to HPV can still benefit from vaccination as it can protect them from other strains that they may not have been exposed to.
Currently, there are an estimated 34,800 new cases of HPV related cancer annually in the US, with more than 90% of those cancers caused by HPV strains that are in the current HPV vaccine on the market—Gardasil 9. That means that vaccination could help prevent more than 90% of HPV related cancers!
Since HPV is passed between people anytime there is skin-to-skin contact, in addition to vaccination, using barrier methods, such as condoms, internal condoms, and dental dams, can decrease, but does not eliminate, the risk of HPV transmission.
How to Test for HPV?
Routine tests for HPV are currently only recommended to screen for cervical cancer and for anal cancer in people who are at higher risk, such as though with HIV infections. There are no routine screening tests for other HPV related cancers.
The 2019 ASCCP guidelines for cervical cancer screening and management of abnormal results focus on a more individualized, risk-based approach that prioritize HPV testing results. Based on these updated guidelines, in 2020 the American Cancer Society updated its guidelines for cervical cancer screening and now recommends that anyone age 25-65 with a cervix be screened with a primary HPV testing every five years. This means that starting at age 25 you would receive only HPV testing to screen for cervical cancer, if results are negative you do not need another HPV test for five years.
However, The American College of Obstetricians and Gynecologists (ACOG) and the United States Preventive Services Task Force (USPSTF) both still recommend screening for cervical cancer start at age 21 take place every three years up to age 29 with Pap smears without HPV testing, and then every five years with a Pap smear and HPV testing at the same time, called co-testing.
How to Treat HPV?
There is no medication to treat the high-risk strains of HPV that cause cancer and for most people, especially people under age 30, HPV infections go away on their own. While having an HPV infection increases the risks of developing certain types of cancer, having HPV does not mean someone will be diagnosed with cancer. Certain factors, such as smoking tobacco or having a weakened immune system, make it harder for the body fight an HPV infection increasing the chances of developing HPV related cancers.
People who have been diagnosed with a cervical HPV infection or had an abnormal pap smear, especially if they are over age 30, may need to have additional follow up testing and procedures, such as a colposcopy, to prevent cervical cancer.
Spread the Word!
While HPV vaccination rates were increasing before the pandemic, more than half of young people in the US had not completed their HPV vaccine series and less than 40% of adults have ever received a single dose. During the pandemic, many people are skipping recommended preventative care, such as vaccinations, so the number of young people who are vaccinated against HPV is likely to decrease even further as a result of the pandemic. So, in addition to taking steps to decrease your personal risk of HPV related cancers, talk to friends, family, and social networks to spread the word about the importance of HPV vaccination.
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