What you should know about HPV and cancer

The human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. It can be spread vaginally, orally, or anally. It’s so prevalent that most people will get it at some point in their lives, says Gretchen Homan, MD, a pediatrician affiliated with Wesley Medical Center in Kansas.

There are 200 strains of HPV, but only about a dozen have been linked to cancer.

While most HPV infections show no symptoms and eventually go away on their own, sometimes the virus remains inside the body and can cause genital warts or cancer. In fact, the Centers for Disease Control and Prevention (CDC) estimates that more than 47,000 new cases of HPV-related cancer are diagnosed each year.

The link between HPV and cancer

Almost all cervical cancers are caused by HPV virus strains, according to the CDC, along with 91 percent of anal cancers and 70 percent of cancers of the throat, tongue, and tonsils (oropharyngeal cancers). HPV has also been linked to penile, vaginal, and vulvar cancers.

How to prevent HPV and associated cancers

Fortunately, HPV can be prevented with a vaccine.

• It's recommended that all boys and girls receive the two-dose vaccine between the ages of 9 and 12, with the first dose coming at age 9 or 10.
• Women and men who have not previously been vaccinated can also receive the vaccine up to age 26.
• In special circumstances, a healthcare provider (HCP) may recommend receiving the vaccine up until age 45.

While practicing safe sex with condoms is always a good idea, doing so cannot provide complete protection against HPV. That’s because HPV can infect areas that aren’t covered by the condom.

How is HPV detected?

The U.S. Food and Drug Administration (FDA) has approved several tests that can detect the strains of HPV that cause cervical cancer in women.

• As a starting point, women in their 20s should get a Pap test every three years.
• The HPV test is not recommended for people with a cervix aged 21 and older, but it’s advised they get the HPV test in certain cases as a follow-up to an abnormal Pap test.
• Women aged 30 and older should get either a Pap test alone every three years, an HPV test every five years, or a Pap test with an HPV test every five years.

Just because you test positive for HPV doesn’t mean you will get cancer. Most of the time, problems that are detected early can be treated before they develop into cervical cancer. If you do test positive for the infection or have an abnormal Pap test, your doctor will do follow-up exams or perform a cervical biopsy to see if the cells are cancerous.

There is no routine screening to check for anal, penile, or oral cancers unless an HCP sees the presence of genital warts, says Dr. Homan. However, some experts may recommend anal Pap smears for some men and women at higher risk of anal cancer.

Treatments for HPV

There aren’t any treatments for the HPV virus itself, but there are procedures HCPs can perform to remove abnormal, precancerous cells before they grow into cervical cancer. These procedures include:

• Cryosurgery: a cold probe destroys abnormal cell tissue by freezing it
• Loop electrosurgical excision procedure (LEEP): a thin wire loop, through which an electrical current passes, removes abnormal cell tissue
• Laser therapy: a laser destroys abnormal tissue
• Cold knife conization: a scalpel eliminates a cone-shaped piece of tissue

Since removing the cells doesn’t necessarily kill the virus, you may need to get Pap tests more often to make sure the abnormal cells don’t grow back. Usually, the virus will go away by itself.

Benign respiratory tract tumors or genital warts caused by HPV may be treated with topical chemicals or drugs or removed surgically through excision or by cryosurgery, electrosurgery, or laser surgery.

If you’re sexually active, talk to your HCP about the HPV test and whether it is right for you. And if you have children, talk to your pediatrician about the importance of having them receive the HPV vaccination between the ages of 9 and 12.