A Closer Look at HPV

Megan Cole, Diana Zuckerman, PhD, Brandel France de Bravo, MPH, and Janet A. Phoenix, MD, MPH, Cindy Min, MPH, National Center for Health Research

What is HPV?

The human papillomavirus virus, also known as HPV, is the most common sexually transmitted infection in the U.S. and around the world. In fact, approximately 20 million Americans are currently infected with HPV, and another 6 million become newly infected every year.[1]

Males and females can become infected with the virus and are able to transmit it to others. There are approximately 130 strains of HPV, some of which may cause warts and others which may cause cancer. The virus is transmitted through skin-to-skin contact and is usually sexually transmitted – vaginally, anally, or sometimes, orally. However, many of the HPV types can be transmitted through non-sexual contact as well.[1]

Out of 130 strains of HPV, two types (strains 16 and 18) are associated with 60% of penile cancer and 90% of cervical cancer cases. Two other types (strains 6 and 11) cause 90% of genital warts cases.[1,2] HPV may lead to several types of cancer in men and women, including cervical and vaginal cancer in women and penile cancer in men. Anal cancer and oropharyngeal cancer, which is a cancer of the soft palate, the throat, and the back third of the tongue, can occur in either women and men.[4]

Most HPV infections in adolescents are short term: 70% of infections disappear within a year and 90% disappear within two years. However, when high-risk types of HPV infections persist, abnormal cells can develop on the penis, cervix, vulva, vagina or anus. If those high-risk abnormal cells are not detected and treated, they can eventually cause cancer.[5] It takes about 15-20 years for this to happen, and meanwhile, men and women are unlikely to have symptoms. That lack of symptoms makes HPV so dangerous, and why it is important to have regular Pap smears or other medical care.[6]

Since HPV is associated with more than 90 percent of cervical cancer cases, it is important to consider which women are most at risk. HPV and cervical cancer are a concern for all women, but in the U.S., the women with the highest rates of cervical cancer are minority and low-income women. While far fewer women die of cervical cancer in the U.S. compared to many other countries, it is still a deadly disease for thousands of women every year. Cervical cancer rates are higher for Black women compared to White women. This has improved in recent years, but Black women continue to have a rate of cervical cancer than White women. According to a study published in 2016, non-Hispanic Whites had a cervical cancer rate of 6.8% compared to non-Hispanic Blacks (NHB), which was 9.0%.[7]

Poverty is a risk factor as well: A study published in 2018 found that the incidence rate of cervical cancer for the poorest counties (9.5 per 100,000 women) was much higher compared to the affluent counties (5.4 per 100,000 women).[8]

Prevention of HPV

To reduce the risk of getting HPV-associated cancers, the best prevention methods are:

  1. Get regular Pap smears or high-risk human papillomavirus (hrHPV) testing. For women, aged 21 to 29 years, it is recommended to get a Pap smear every 3 years. For women aged 30 to 65 years, there are three different options: Pap smear every 3 years, high-risk human papillomavirus (hrHPV) testing every 5 years, or hrHPV testing in combination with a Pap smear every 5 years (cotesting).[9]
  2. Use condoms. They reduce your chances of getting infected with HPV but they don’t eliminate your risk, because skin-to-skin contact still occurs when a condom is used.[1]
  3. Limit your number of sex partners.[1]
  4. Get an HPV vaccine. For more information about the HPV vaccine, you can read this(link) article.[1]

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

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References

    1. Centers for Disease Control and Prevention (CDC) (2009) Genital HPV Infection Fact Sheet. Retrieved from http://www.cdc.gov/STD/HPV/STDFact-HPV.htm
    2. Products – Data Briefs – Number 280 – April 2017. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db280.htm. Published April 6, 2017.
    3. How Many Cancers Are Linked with HPV Each Year? Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/hpv/statistics/cases.htm. Published September 3, 2020.
    4. Kjaer SK, Nygard M, Sundstrom K, et al. Final analysis of a 14-year long-term follow-up study of the effectiveness and immunogenicity of the quadrivalent human papillomavirus vaccine in women from four nordic countries. EClinicalMedicine. 2020;23:100401. https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30145-0/fulltext.
    5. Cullins M. (2009) HPV: Planned Parenthood. Retrieved from http://www.plannedparenthood.org/health-topics/stds-hiv-safer-sex/hpv-4272.htm
    6. American College of Obstetricians and Gynecologists (20 Nov. 2009). First Cervical Cancer Screening Delayed Until Age 21– Less Frequent Pap Tests Recommended.
    7. Yoo W, Kim S, Huh WK, Dilley S, Coughlin SS, Partridge EE, et al. Recent trends in racial and regional disparities in cervical cancer incidence and mortality in UnitedStates. PLoS ONE. 2017;12(2): e0172548. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5325259/
    8. Kollman J, Sobotka HL. Poverty and Cancer Disparities in Ohio. Prev Chronic Dis. 2018;15:E152. https://www.cdc.gov/pcd/issues/2018/18_0332.htm
    9. Cervical Cancer: Screening. United States Preventive Services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening. Published August 21, 2018