The HPV vaccine has been one of the more controversial health topics of the past few years. With massive campaigns extolling the benefits of the vaccine for preventing cervical cancer, and anti-vaccine movements proclaiming a high death count as a result of the vaccine as well as high numbers of adverse events, itâ€™s hard to find reason between the two extremes.
First, itâ€™s important to know what HPV is (cervical cancer is a such a small part) and what the actual statistics surrounding HPV are.
About HPV (Human Papillomavirus)
HPV is an infection in the skin.
There are at least 200 known strains of HPV. You can be infected with more than one strain at once, and at any given time about 26% of the US population has at least one active strain. Over the course of a lifetime, as an estimated 80% of the population will have had at least one strain of HPV at least once.
While the majority of HPV strains are relatively harmless and cause no symptoms, some can cause warts, and others (when the infection is chronic) may cause cancer.
For most young women, 90% of infections will clear up in two years or less. If you have a strong immune system, this is even more likely.
People who smoke are less likely to develop antibodies to HPV, and thus more likely to have a chronic infection that will develop into cancer.
Generally, people in their early twenties are more likely to be currently carrying HPV, possibly due to older persons having developed antibodies (immunity), and having less sexual activity with fewer partners.
You hear about cervical cancer the most because diseases that affect reproductive organs are scary, and unchecked, advanced cervical cancer may require a hysterectomy as treatment, or cause infertility in some other way.
However, itâ€™s important to know that when HPV becomes cancerous, it can infect anywhere the infection has been resting, most commonly the skin of the reproductive organs (cervix, vagina, vulva, and penis) as well as the anus, and, less commonly, it can cause oral and throat cancer (presumably through transmission from oral sex).
When Does HPV Become Cancerous?
Of the 200 or so strains of HPV, only a small number of those (usually HPV strains 16 & 18) can cause cancer, and it takes a decade or two of being chronically infected before malignant growths appear (cervical cancer mostly occurs in women aged 50-55). Most peopleâ€™s immune systems will overcome HPV shortly after transmission.
The strains that cause cancer start with infection, and then go on to promote malignant tumor growth over their cycle. Precancerous cells usually appear first, in most cases allowing doctors to discover and treat the disease before itâ€™s serious.
Only 70% of cervical cancer cases are caused by HPV.
Less than 4,000 woman in the US die each year from cervical cancer. Most of these people are in poorer areas where they may not be able to afford an annual exam, may not be informed about the benefits and need of an annual exam, or may not understand about the risks of transmission (and in general are less likely to see a doctor).
Remember, genital warts do not equate with genital cancer or tumors, they are caused by different HPV strains.
What Else Does HPV Do?
More commonly than cancer, HPV causes warts. Plantar warts, flat warts, and common warts are all caused by HPV. These can appear on hands and feet as well as other parts of the body (mouth warts are more likely to have other causes, however).
Warts caused by HPV can occur in the respiratory tract. This can severely interfere with breathing and numerous surgeries may be required (as often as the warts recur, which can be frequent).
Unsightly and highly contagious, genital warts are usually caused by HPV strains 6 and 11. Genital warts are different than the kind on your hands, thighs, and feet.
HPV is regarded as the most common STD (sexually transmitted disease) in the world, but itâ€™s more than an STD-HPV can be transmitted through skin to skin contact, and itâ€™s responsible for infecting many parts of the body not, strictly speaking, used in sex.
Why is HPV regarded as an STD?
For one, the strains of HPV that cause cancer, and the strains most people are talking about when they mention HPV, generally infect the genital region. Although HPV is transmitted by touch, the high-risk (potentially cancerous) strains are far easier and more commonly transmitted during sex (with far more skin to skin contact and the exchange of fluids).
Condoms offer a barrier that reduces the rate of transmission, but since there is other skin exposed condoms cannot be considered a 100% reliable source in preventing the spread of HPV. Still, condoms protect vulnerable skin thatâ€™s subject to micro-tears during sex that make transmission easier, so they remain an invaluable tool in reducing the spread of STDs and other diseases.
Transmission can also (rarely) occur during birth, when an infected mother passes the disease to her child, sometimes causing warts in the respiratory system that can make it difficult for the child to breath. This happens in less than 2/100,000 births.
How Do I Know If I or My Partner Has HPV?
Blood tests and Pap smears can tell a doctor if you have or have had HPV, and if it is/was a high-risk strain. However, these tests rely on finding abnormalities (either funny cells, or your immune systemâ€™s reaction to the infection). You could have the infection for years with no symptoms or any sign detectable on a test, which is why regular screening is critical.
Even in monogamous relationships, or if itâ€™s been years since your last sexual encounter, itâ€™s important to continue to get tested. The worst case scenario for HPV infection (cancer) may take over 20 years to occur after transmission.
Further, while limiting your number of sexual partners (or remaining chaste) reduces your risk of contracting HPV, it does not eliminate it (remember, it affects the vast majority of the population and is not just transmitted through sex).
What About HPV Screening?
A pap test is an annual test that looks for abnormal cells, specifically any that may be precancerous lesions or cancer.
Women should get an annual Pap test (doctors take a sample of cervical cells). Itâ€™s recommended this annual ritual begin at 21, or 3 years after sexual activity is begun (whichever comes first). You should talk to your doctor about when screening is appropriate for you, including screening for breast cancer (consider your family history and other personal risks).
For men, especially homosexual men, there is a Pap test that checks cells from the anus. Although not officially recommended, many experts are saying that it should be.
With routine testing, the majority of cancers will be caught early enough that a simple removal (with a laser, by freezing, or other similar means) can be accomplished.
HPV Treatment and Prevention
HPV treatment boils down to removing symptoms, whether warts or abnormal/cancerous cells. Treatment does not address the actual infection.
Due to the prevalence of HPV, itâ€™s unlikely you can go a lifetime without exposure.
The best way to prevent HPV is to have a strong immune system, so that your body can naturally fight the virus and develop antibodies.
Condoms are also a great way to reduce the risk of infection during sexual activity. Personal lubricants containing carrageenan may also help reduce HPV transmission.
What did you know about HPV before this article? How do the numerous ads suggesting young children might get cancer from sex make you feel? What are your thoughts on HPV in general? Let us know in the comments!