Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) within the United States. It infects more than 40 million individuals, usually those in their late teens and early 20s, each year. However, these numbers are only estimates, and we will soon discuss why this is the case.
There are over 200 different types of HPV, and around 40 of them infect the genital area and the mouth/throat. The other HPV types can cause common warts, such as plantar warts on feet or hand warts, but they are not sexually transmitted.
HPV as an STI is spread through oral, vaginal, or anal sex with someone who is infected with the virus, although vaginal and anal sex are the most common ways in which it is transmitted. Even more important to note is that HPV can also spread through close skin-on-skin contact when having sex.
One reason why HPV is so commonly spread is that it is possible (and common) to transmit this infection without experiencing any symptoms. Because of this, many people are unaware they have HPV and do not know they should take precautions to prevent its transmission. In fact, some people may not even develop symptoms until years after they become infected, which provides ample time to unknowingly spread the virus to someone else.
Now that we know how common HPV is, it is only natural to wonder what the detection process for HPV looks like, but unfortunately, there is no way to determine if someone has HPV. This is yet another reason why HPV is so easy to spread, because there’s no way to know if you have it until other health problems appear.
The only HPV tests that exist are to screen for cervical cancer, but they are only intended for screening in women who are 30 years or older. This means that there is no test whatsoever for teenagers, young adults, or men of all ages.
This is why the number of HPV cases each year is only an estimate because, with no diagnostic test beyond cervical cancer screening and genital wart detection, there is no way to know for certain how many people have HPV. However, we do know that it is so common that, without being vaccinated, any sexually active person can expect to contract it.
Health Problems Associated with HPV
Most of the time, HPV goes away on its own within two years without causing any health problems. However, some types of HPV do not go away on their own and can cause genital warts or even cancer.
Unfortunately, there is no way to know who will develop genital warts or cancer from their HPV infection and who will find that it goes away on its own. The only consideration is that those with a weak immune system, such as those with HIV, may not be as capable of fighting off HPV, which may cause them to be more likely to develop health problems. However, that does not mean that those who do not have HIV or other immune-reducing health conditions are safe.
Those who develop genital warts from HPV often first notice a small bump or group of bumps in the genital area. These bumps vary in appearance, sometimes being small, large, flat, raised, or even shaped like a cauliflower. Your healthcare practitioner can diagnose any unusual bumps as genital warts through a visual examination of them.
Of the 200+ types of HPV, most cases of genital warts result from just two, types 6 and 11.
In some cases, HPV may cause cancer, including cervical cancer, oropharyngeal cancer (cancer of the back of the throat), or cancers of the vagina, vulva, anus, or penis.
There are at least a dozen types of HPV that can potentially lead to cancer, although most cancer cases stem from types 16 and 18. These two types of HPV are considered high-risk HPV, in comparison to genital warts-related HPV, which is considered to be low-risk.
How Does HPV Cause Cancer?
Taking a closer look at the way HPV affects the body, we can gain some understanding of how it can lead to cancer.
It all starts when high-risk HPV infects the cells in the body and begins interfering with how these cells communicate with each other. This then causes the infected cells to multiply uncontrollably.
Now, your immune system is good at its job, so it recognizes and controls these infected cells in many cases. However, sometimes the infected cells can continue growing, eventually forming an area of precancerous cells. If not treated, this can become cancer.
However, this is not a quick process, with research showing that it can take 10-20+ years for cervical cells infected by HPV to become a cancerous tumor.
In addition to having type 16 or 18 of HPV, which are aggressive types, smoking cigarettes or having a weakened immune system can increase the risk of a long-lasting infection that leads to precancerous cells.
Treatment for HPV-Related Conditions
There is no treatment for HPV itself; once infected, you can only let it work through your system, leaving on its own accord or evolving into something else. However, should HPV become genital warts or cancer, treatments are available.
For those with genital warts, your healthcare provider can prescribe medication or perform procedures to help them go away. Treatment is not always necessary, as genital warts may go away on their own; however, there is also a chance of them staying the same or increasing in number or size without treatment.
Cervical precancer treatments are also available to help address problems before they develop into cancer. Routine Pap tests and follow-up care are the best way to increase your chances of capturing cervical cancer early.
Other cancers related to HPV are also more easily treatable when detected early, and treatment may include chemotherapy, radiation therapy, or surgery.
How To Prevent HPV And Its Health Problems
Because of how easily HPV spreads and its potential to cause serious health problems, it is crucial for anyone who is sexually active to play their role in preventing the spread of this STI.
The first thing you can do to prevent HPV infection is to receive the vaccination. The CDC recommends that all preteens aged 11 or 12 receive the vaccine. For those who were not vaccinated as a preteen, the CDC then recommends vaccination for anyone 26 or younger.
While getting the vaccine is not recommended for anyone over the age of 26, those between the ages of 27 and 45 may decide to get the vaccine after discussing with their doctor their risk for HPV infection. However, it is important to note that vaccination within this age range provides less benefit because most sexually active adults have already been exposed to HPV.
Get Screened for Cervical Cancer
It is recommended for women aged 21 to 65 to receive routine screening for cervical cancer. This ensures that, if you develop cancer, it is detected early, which increases treatment success.
Routine screening is recommended for everyone, not just those who know they have HPV. Not only is it a crucial step in preventive care, but it also protects you in case you have HPV and are unaware.
There are 12,000 women each year who develop cervical cancer, and 4,000 die from this disease, even with screenings and treatment available. This is not considering the other conditions and cancers that result from HPV, with an estimated 19,400 women and 12,100 men experiencing cancer that stems from HPV infection.
With these statistics, early detection and treatment are key.
Use Condoms Correctly
Using condoms correctly each time you have sex, especially with a new partner, can help lower your chances of HPV significantly. However, it is important to remember that it is still possible to get HPV, even when using a condom, because it can infect the areas that the condom does not cover.
Still, next to abstaining from sex, using a condom each time you have sex is one of the best ways to help prevent HPV.
Be in a Mutually Monogamous Relationship
There is an increased risk of HPV infection with each new partner you have, so being in a relationship with someone where you only have sex with each other can help reduce your risk of HPV infection.
HPV and Cancer
HPV is the most common STI, with estimates that anyone who is sexually active is likely to come into contact with HPV at some point in their life. Most cases of HPV are not harmful and go away on their own. However, in some cases, genital warts or cancer may develop.
The most common types of HPV to cause cancer are types 16 and 18, which are aggressive and interfere with cell communication, causing infected cells to overgrow and precancerous areas to form. This cancer takes decades to develop, though, which is why routine Pap tests are crucial for detecting any abnormalities before they develop into cancer.
The best way to protect yourself from HPV is to get vaccinated and maintain a monogamous relationship. However, it also helps to receive routine cancer screening just in case something more serious develops, since early treatment gives you the best chance of cancer survival.
HPV Fact Sheet. (2022). https://www.cdc.gov/std/hpv/stdfact-hpv.htm
HPV and Cancer. (2022). https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
What Is HPV & How Do You Get It?. (2022). Retrieved 19 December 2022, from https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/hpv
About Dr. Mel Irvine
Dr. Mel Irvine, DNP and Clinical Sexologist specializes in sexual medicine and beauty in Fort Myers Florida. She earned her Doctor of Nursing Practice at Florida Gulf Coast University and her master’s degree at the University of Alabama at Birmingham. In 2018, she completed a preceptorship at San Diego Sexual Medicine with Dr. Irwin Goldstein and obtained her clinical sexologist certification from STII with Dr. Carol Clark. She is passionate about working with singles and couples to learn and explore their sexuality and sexual health needs through providing a comfortable and nonjudgmental atmosphere. As a provider she offers a balanced and holistic approach that encompasses a multimodal care delivery model.