It's thought that almost 80 million Americans are currently infected with human papillomavirus (HPV), a sexually transmitted virus that can cause genital warts and cancers of the cervix, vagina, vulva and penis, among others. In fact, almost all men and women are exposed to it as some point in their lives.
Thankfully, though, the HPV vaccine can prevent most cancers from developing. In fact, experts predict that about 30,000 of the 32,500 cancer cases that occur in the United States as a result of HPV infection every year can be prevented with the vaccine.
Although most HPV infections never cause any symptoms or serious problems and will go away on their own within two years, it's important to take precautions with regular screenings and vaccinations. They could save your life—or the life of a loved one.
What is HPV and how does it spread?
As the most common sexually transmitted infection in the United States, HPV is a collection of more than 200 associated viruses, 40 of which are spread through direct sexual contact and 13 of which are high-risk strains that can cause cancer. Some types of HPV cause warts or skin growths and some may never cause any problems at all.
Some of the strains are little nuisance types of viruses that don't do much and some of them are cosmetically distressing. But more significantly, certain strains are what we call high-risk strains and they can contribute to cancer, because they damage DNA and make the cells grow abnormally.
A total of 40 strains are spread only through intimate skin-to-skin interaction—in other words, vaginal, anal or oral sex. So, if you have sex with someone who has HPV, you can get it even if your partner doesn't have any symptoms. Other strains that cause warts on areas like the hands and feet can be transmitted by touching surfaces.
What is the HPV vaccine?
The immunizations that protect against HPV encourage the body to make antibodies, which proteins used by the immune system to fight viruses. If these antibodies are ever exposed to HPV, they bind to the virus and prevent it from invading the body's cells.
The US Food and Drug Administration recommends three different vaccines for protection against infections associated with HPV: Gardasil, Gardasil 9 and Cervarix.
All of the vaccines protect to varying degrees against the HPV types associated with cervical cancer and other cancers, including anal, oropharyngeal, vulvar, vaginal and penile cancer. Gardasil in particular protects against the HPV types related to genital warts, while Gardasil 9 protects against these cancers, genital warts and an additional five HPV strains, too.
In May 2017, Gardasil 9 became the sole HPV vaccine recommended in the US, while the other two are still used in other countries around the world.
HPV vaccine recommendations for the United States are as follows:
- Children ages 11 to 12 should receive two shots, 6 to 12 months apart
- If your teen hasn't gotten the vaccine yet, talk to his or her doctor or nurse about getting it as soon as possible:
- After age 14, three shots are needed instead of two
- Females can be vaccinated up to age 26, males up to 21
There are some slight exceptions to those recommendations. The following adults should receive the HPV vaccine if they didn't receive it according to the general recommendations listed above:
- Young men through age 26 who are in sexual relationships with men
- Transgender men through age 26
- Young adults through age 26 with immunocompromising conditions like human immunodeficiency virus (HIV)
It's important for young people to remember that even if they missed their early dose of the vaccine, they should still consider getting vaccinated because there are lots of different strains out there. While the vaccine won't necessarily go back and reverse the course of the prior exposure, it can help prevent future exposures from other strains that they haven't been exposed to yet.
Regular screenings are important, too
Not all cancers associated with HPV have screening options available—specifically anal, penile and oropharyngeal (back of the throat).
But there is one very important screening method for women: In addition to getting the HPV vaccine, it's imperative that women get regular cervical cancer screenings in the form of Pap tests, as well as a specific HPV test. The American College of Obstetricians and Gynecologists' guidelines are:
- Women ages 21 to 29: Pap test every three years
- Women 30 to 65: Pap test and specific HPV test every five years (continuing to have a Pap smear alone every three years is an option, too)
Sometimes, your OB GYN may suggest an HPV test as a follow-up if your Pap test comes back abnormal. However, when it comes to screenings and testing, it's important for women to talk with their doctors. How often you need a Pap test depends on your age and health history.
It's also important to remember that both men and women should have routine checkups with their primary care physicians.
If you get the HPV vaccine, it's likely you'll be protected against most cancers and other diseases HPV can cause. But if you notice genital warts, see your doctor.
Women who have irregular vaginal bleeding such as bleeding after menopause or after sex, abnormal discharge between periods or pain while having sex should see their OB GYN. Although these symptoms can be signs of many other conditions, they could be signs of cervical cancer or precancers.
The best thing you can do to protect yourself against HPV and the conditions related to it is to be proactive. The HPV vaccine is extremely effective when taken well before you become sexually active, so it's best to get vaccinated as a teen or young adult. And continuing regular screenings is important, too.
If you're going to your primary care physician and OB GYN regularly, your doctor should be able to detect any problems before they become too significant.