Human papillomavirus (HPV) and cervical cancer
- Human papillomavirus (HPV) is a common sexually transmitted infection (STI)
- HPV can cause serious illness if left untreated. It usually shows no symptoms and often goes away by itself but there are various treatment options.
- Certain strains of HPV can cause cervical cancer and other cancers.
How common is HPV?
The US Centers for Disease Control and Prevention (CDC) lists HPV as the most common STD globally. Many people will get at least one type of HPV in their life. As there are no obvious symptoms you may not even know you have it. You can have HPV for many years without it causing problems.
How is HPV spread?
HPV is transmitted through sexual contact. You can get it from vaginal, anal and oral sex, and from touching genitals with someone who is infected. You can get HPV from the first time you are sexually active.
People with weaker immune systems are at greater risk of HPV infections. In many cases the infection will go away on its own. However, when a high-risk HPV infection lingers it becomes a ‘persistent’ HPV infection.
What is the link between HPV and cervical cancer?
There are more than 100 types of HPV, of which at least 14 are considered high-risk and cancer-causing, according to the World Health Organisation (WHO).
Persistent high-risk HPV infection can cause abnormal cells to develop on the cervix which may develop into cervical cancer or other HPV-related cancers if left untreated.
The two HPV types 16 and 18 cause 70% of cervical cancers and pre-cancerous cervical lesions.
The HPV virus is also responsible for some less common cancers affecting women and men, including anal, vulval, vaginal, mouth and throat, and penile cancers.
Low-risk HPV causes genital warts and does not cause cancer. Genital warts are very common and highly contagious.
How to treat HPV
There are various medications available that treat genital warts, eliminating them after ongoing treatment. These medications are applied directly to the lesion and can cause irritation and burning. Examples include:
- Salicylic acid. Removes layers of the wart bit by bit.
- Imiquimod. Boosts the immune system to help fight warts.
- Podofilox. Destroys genital wart tissue.
- Trichloroacetic acid. Burns off warts including genital warts.
Warts can be removed by different methods including:
- Freezing off with with liquid nitrogen (cryotherapy)
- Burning off (electrocautery)
- Surgical removal
Treatment for HPV in the cervix
HPV or Pap tests are taken to identify if there are abnormal cells on the cervix. If the test comes back with abnormal results, a gynecologist will perform a colposcopy where samples of the cervix are taken in a biopsy. These samples are tested for cancer.
Any precancerous cells need to be removed either by cryosurgery, laser, surgical removal, loop electrosurgical excision procedure (LEEP).
How to protect yourself against human papillomavirus
While the NHS states you “cannot fully protect yourself against HPV”, there are things that can help:
- Get vaccinated against HPV. Vaccines that prevent against 9 HPV types, including types 6 and 11 which cause 90% of genital warts, are recommended by the WHO and are approved for use in many countries. It’s advisable to have the HPV vaccination as early as possible and definitely before sexual exposure.
- Avoid genital contact with people whose sexual history you do not know. Prophylactics can help protect you but remember they don’t cover all the skin around your genitals, so you are not fully protected.
- Get screened regularly. During cervical screening a sample of cells is taken and tested for HPV and any abnormal cell changes in the cervix.
HPV needs to be treated if it develops into genital warts or if any abnormal cell changes are detected in the cervix.
Your doctor may recommend removal of the abnormal cells or pre-cancerous lesions to avoid the risk they might become cancerous if left untreated. This will be followed by another cervical screening within 6 months.
If you have any concerns about HPV you should seek medical advice from your doctor or a sexual health clinic.
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CDC, “Genital HPV Infection – Factsheet” https://www.cdc.gov/std/hpv/stdfact-hpv.htm
World Health Orrganization, “Human papillomavirus (HPV) and cervical cancer” https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer
Mayo Clinic, “HPV Infection” https://www.mayoclinic.org/diseases-conditions/hpv-infection/diagnosis-treatment/drc-20351602
NHS, “Human papillomavirus (HPV)” https://www.nhs.uk/conditions/human-papilloma-virus-hpv/