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HPV
How does Genital Human
Papillomavirus (HPV) cause genital warts and cancer?
HPV can cause normal cells on infected skin or mucous membranes to turn
abnormal. Most of the time, you cannot see or feel these cell changes. In most cases, the body fights off HPV
naturally and the infected cells then go back to normal.
Sometimes, low-risk types of HPV can cause visible changes that take the form
of genital warts.
If a high-risk HPV infection is not cleared by the immune system,
it can linger for many years and turn abnormal cells into cancer over time. About 10% of women with high-risk
HPV on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer.
Similarly, when high-risk HPV lingers and infects the cells of the penis, anus, vulva, or vagina, it can cause
cancer in those areas. But these cancers are much less common than cervical cancer.
How common is Genital Human
Papillomavirus (HPV) and related infections?
HPV infection. Approximately 20 million Americans are
currently infected with HPV, and another 6.2 million people become newly infected each year. At least 50% of
sexually active men and women acquire genital HPV infection at some point in their lives.
Genital warts. About 1% of sexually active adults in the U.S.
have genital warts at any one time.
Cervical cancer. The American Cancer Society estimates that in
2008, 11,070 women will be diagnosed with cervical cancer in the U.S.
Other HPV-related cancers are much less common than
cervical cancer. The American Cancer Society estimates that in 2008, there will be:
3,460 women diagnosed with vulvar cancer;
2,210 women diagnosed with vaginal and other female genital cancers;
1,250 men diagnosed with penile and other male genital cancers; and
3,050 women and 2,020 men diagnosed with anal cancer.
Certain populations may be at higher risk for HPV-related cancers, such as gay
and bisexual men, and individuals with weak immune systems (including those who have HIV/AIDS).
RRP is very rare. It is estimated that less than 2,000
children get RRP every year.
How can people prevent Genital
Human Papillomavirus (HPV)?
A vaccine can now protect females from the four types of HPV that cause most
cervical cancers and genital warts. The vaccine is recommended for 11 and 12 year-old girls. It is also
recommended for girls and women age 13 through 26 who have not yet been vaccinated or completed the vaccine
series.
For those who choose to be sexually active, condoms may lower the risk of HPV, if used all the time and the right
way. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer.
But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against
HPV. So the only sure way to prevent HPV is to avoid all sexual activity.
Individuals can also lower their chances of getting HPV by being in a mutually
faithful relationship with someone who has had no or few sex partners. However, even people with only one
lifetime sex partner can get HPV, if their partner was infected with HPV.
For those who are not in long-term mutually monogamous relationships, limiting
the number of sex partners and choosing a partner less likely to be infected may lower the risk of HPV. Partners
less likely to be infected include those who have had no or few prior sex partners. But it may not be possible
to determine if a partner who has been sexually active in the past is currently infected.
How can people prevent Genital
Human Papillomavirus (HPV)-related diseases?
There are important steps girls and women can take to prevent cervical
cancer. The HPV vaccine can protect against most cervical cancers (see above). Cervical
cancer can also be prevented with routine cervical cancer screening and follow-up of abnormal
results. The Pap test can identify abnormal or pre-cancerous changes in the cervix so that they can be removed
before cancer develops.
An HPV DNA test, which can find high-risk HPV on a woman’s cervix, may also be
used with a Pap test in certain cases. The HPV test can help healthcare professionals decide if more tests or
treatment are needed. Even women who got the vaccine when they were younger need regular cervical cancer
screening because the vaccine does not protect against all cervical cancers.
There is currently no vaccine licensed to prevent HPV-related diseases in men.
Studies are now being done to find out if the vaccine is also safe in men, and if it can protect them against
HPV and related conditions. The FDA will consider licensing the vaccine for boys and men if there is proof that
it is safe and effective for them. There is also no approved screening test to find early signs of
penile or anal cancer. Some experts recommend yearly anal Pap tests for gay and bisexual
men and for HIV-positive persons because anal cancer is more common in these populations. Scientists are still
studying how best to screen for penile and anal cancers in those who may be at highest risk for those
diseases.
Generally, cesarean delivery is not recommended for women with genital warts to
prevent RRP in their babies. This is because it is unclear whether cesarean delivery
actually prevents RRP in infants and children.
Is there a test for Genital Human
Papillomavirus (HPV)?
The HPV test on the market is only used as part of cervical cancer screening.
There is no general test for men or women to check one’s overall “HPV status.” HPV usually goes away on its own,
without causing health problems. So an HPV infection that is found today will most likely not be there a year or
two from now. For this reason, there is no need to be tested just to find out if you have HPV now.
However, you should get tested for signs of disease that HPV can cause, such as cervical cancer.
Genital warts are diagnosed by visual inspection. Some
health care providers may use acetic acid, a vinegar solution, to help identify flat warts. But this is not a
sensitive test so it may wrongly identify normal skin as a wart.
Cervical cell changes (early signs of cervical cancer)can be
identified by routine Pap tests. The HPV test can identify high-risk HPV types on a woman’s cervix, which can
cause cervical cell changes and cancer.
As noted above, there is currently no approved test to find HPV or related
cancers in men. But HPV is very common and HPV-related cancers are very rare in men.
Is there a treatment for Genital
Human Papillomavirus (HPV)?
There is no treatment for the virus itself, but a healthy immune system can
usually fight off HPV naturally. There are treatments for the diseases that HPV can cause:
Visible genital warts can be removed by patient-applied
medications, or by treatments performed by a health care provider. Some individuals choose to forego treatment
to see if the warts will disappear on their own. No one treatment is better than another.
Cervical cancer is most treatable when it is diagnosed
and treated early. There are new forms of surgery, radiation therapy, and chemotherapy available for patients.
But women who get routine Pap testing and follow up as needed can identify problems before cancer
develops. Prevention is always better than treatment.
Other HPV-related cancers are also more treatable when
diagnosed and treated early. There are new forms of surgery, radiation therapy, and chemotherapy available for
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