Human papillomavirus (HPV) is the most common STD. Nearly half of Americans between the ages of 18 and 59 are infected with genital HPV, according to the National Center for Health Statistics. The virus is spread through vaginal, oral or anal sex with an infected person. It can also be transmitted through skin-to-skin contact with the infected area regardless of symptom presence.
There are approximately 40 types of genital HPV, but about 14 of these can be more serious. Two HPV strains (types 16 and 18) cause 70% of cervical cancers and precancerous cervical lesions. These more serious strains, including HPV-16 and HPV-18, are called high-risk HPV (hrHPV). About one in five women and one in four men have hrHPV.
Low-risk HPV infections can cause skin warts on and around the genitals, anus, mouth, or throat. There is no commercial test available to detect low-risk HPV infection. If you have warts on your body, you should see your healthcare provider for diagnosis and treatment.
HPV and Cervical Cancer
Once a woman reaches 30 years of age, the presence of hrHPV infection takes on greater significance and requires further evaluation because it can cause pre-cancerous changes to the cervix. If the abnormal cells are left untreated, HPV can cause cervical cancer. About 12,000 women in the United States are diagnosed with cervical cancer every year, and almost 4,000 women die from it.
For this reason, there is an HPV test for women over the age of 30 only. In the past, the only test available for cervical cancer screening was a Pap smear. In 2014, the FDA approved an HPV test for primary cervical cancer screening. This test detects DNA from 14 high-risk HPV types (including types 16 and 18) and can help medical providers determine the next steps following a positive hrHPV test.
What About Everyone Else?
The CDC does not recommend HPV testing for men or women under 30, but it does recommend use of an HPV vaccine for men and women under 26. In women under 30 years of age, hrHPV infections are usually cleared by the immune system in two years or less. Without long term risks, testing this population can lead to unnecessary or damaging treatment and expenses.
HPV tests for men, as well as HPV tests done on non-cervical sites such as the mouth and throat, are not currently accurate or reliable. There are also no treatments available for men with hrHPV positive tests or for anyone with hrHPV positive tests in the mouth and throat.
The proper use of condoms can reduce the likelihood of contracting HPV. An HPV vaccine has also been approved for men and women less than 26 years of age.
The problem is that HPV typically does not show symptoms until the virus is quite advanced, making it more difficult to treat. If women over 30 test regularly regardless of whether they are experiencing symptoms, the infection is more likely to be diagnosed and treated.
Worried that you might have been exposed to HPV? Don’t wait, get tested for HPV.
Reviewed by Luis Ferdinand M. Papa, MD, MHA
- External Genital Warts: Diagnosis, Treatment, and Prevention. Clinical Infectious Diseases. 2002. .
- Prevalence of Human Papillomavirus in Cervical Cancer: a Worldwide Perspective. Journal of the National Cancer Institute. 1995. .
- Early detection of cervical cancer based on high‐risk HPV DNA‐based genosensors: A systematic review. International Union of Biochemistry and Molecular Biology. November 2018. .
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