By Michael B. Resnick, MD
The human papillomavirus (HPV) is the most common sexually transmitted disease in the United States.
In fact, the virus is so widespread that a majority of sexually active men and women will get it at some point in their lives if they do not receive the HPV vaccine.
And though most cases of HPV will resolve on their own without complications, persistent infection can lead to severe health complications later in life, including cancer.
Parents of adolescents — both girls and boys — should talk to their pediatrician about protecting their children from HPV and its potential complications before they become sexually active.
About HPV
The Centers for Disease Control and Prevention (CDC) estimates that more than 42 million people are infected with HPV nationwide and that about 14 million new cases are diagnosed each year.
The virus spreads through intimate skin-to-skin contact, most often through vaginal, anal and oral sex with someone who is infected.
HPV typically does not have any symptoms and most people don’t even know they have it. In 9 out of 10 cases, the body’s immune system clears the virus within two years, according to the CDC.
However, if the HPV virus lingers, it can lead to serious health problems, such as:
- Genital warts
- Cervical cancer
- Cancer of the vagina and vulva
- Cancer of the penis
- Anal cancer
- Oropharyngeal cancer, which includes the back of the throat, base of the tongue and tonsils
Vaccination is Critical
Every year, HPV causes an estimated 36,000 cases of cancer in both men and women, according to the CDC.
The majority of cervical, vaginal, vulvar, penile and anal cancers are caused by HPV, and up to 70% of oropharyngeal cancer may be linked to the virus.
That is why vaccination is critical.
Vaccinating children before they are sexually active and ever exposed to the virus is the best way to protect them from infection and guard against cancer.
The CDC recommends that boys and girls who are 11 to 12 years old should get two shots of the HPV vaccine 6 to 12 months apart. The vaccine can be given to children as young as 9.
Teens and young adults who start the vaccination series later, between ages 15 and 26, will need three doses of the vaccine. Vaccination is typically not recommended for adults over age 26 because by this point, they likely have already been exposed to the virus.
However, through shared decision making with a health care provider, a patient may be vaccinated up to the age of 45 if there is an increased risk of acquiring the virus.
HPV vaccination has proven safe and effective. Like any medication, the vaccine can cause side effects, such as swelling, redness and soreness where the shot was given, but they normally go away within a day or two.
It is important to note that according to the CDC there is no evidence that the HPV vaccine has any effect on future fertility. Moreover, research has shown that that the HPV vaccine does not make kids more likely to start having sex.
In addition to the vaccine, individuals can further reduce their risk for HPV by using condoms during intercourse and limiting their number of sexual partners.
Screening and Early Detection
There is no blood or urine test to screen for HPV. Women, however, may have an HPV test as part of screening for cervical cancer, which may also include a Pap test.
In both tests, cells are taken from the cervix for evaluation. A Pap test looks for abnormal cells in the cervix that could indicate precancer or cancer. An HPV test looks for infection from the virus.
The American College of Obstetricians and Gynecologists offers the following guidelines for cervical cancer screening:
- If you are younger than 21, you do not need screening.
- If you are 21 to 29, have a Pap test alone every three years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred.
- If you are 30 to 65, you can choose one of three options:
- Have a Pap test and an HPV test (co-testing) every five years
- Have a Pap test alone every three years
- Have an HPV test alone every five years
- If you are 65 or older, you do not need screening if you have no history of cervical changes and either three negative Pap test results in a row, two negative HPV tests in a row, or two negative co-test results in a row within the past 10 years. The most recent test should have been performed within the past three or five years, depending on the type of test.
Keep in mind that even if you have been vaccinated for HPV, you still need screening. Moreover, even if you are not due for screening, you should still see your gynecologist annually for a routine checkup.
Vaccinating against HPV is the best way to prevent cervical and other types of cancer. Protect your daughter or son before they are exposed to the virus so they can reduce their risk for disease as they grow into adulthood.
To find a physician with Penn Medicine Princeton Health, call (888) 742-7496 or visit www.princetonhcs.org.
Michael B. Resnick, MD, is board certified in obstetrics and gynecology and is a member of the medical staff at Penn Medicine Princeton Health.
