And yes, you might be one of them.“There are many different types of HPV and almost all of us are exposed to some strains of the virus during our lifetime,” says Dr. Benjamin Judson, MD, chief of otolaryngology at Yale Medicine and professor of surgery at Yale School of Medicine. In fact, the CDC suggests that it’s so common that most people who are sexually active will get HPV at some point, unless they’ve been vaccinated against it. And so, you may be wondering… “Okay, so if I get HPV, do I need to do anything about it?” Maybe not. At least, not right away. “The vast majority of HPV infections–I would say well over 90 percent of them–go away entirely on their own,” says Dr. Warner Huh, MD, chair of the department of obstetrics and gynecology at the University of Alabama at Birmingham (UAB) School of Medicine.
What is HPV?
Let’s look at a little closer at what HPV actually is, and what it does. As with many other viruses, there are multiple different strains of HPV. There are low-risk strains that cause most cases of genital warts, which are a series of bumps in the genital area. And there are high-risk strains that can lead to precancerous lesions or certain kinds of cancer like cervical cancer. Most HPV infections come from strains that aren’t associated with cancers.But here’s the thing: HPV often doesn’t cause any symptoms, so you might have it and not know it. Or you might have had it in the past and never realized it.And you might not know what kind of strain you had. If you get infected with a low-risk strain, it isn’t all that worrisome. You might get genital warts, true—but you won’t have to treat them since most do eventually go away on their own. But if you do develop genital warts and they increase in number or linger, you can get them removed. It doesn’t cure the virus or make it go away, though. But you might not see any symptoms at all. “There is a lot of asymptomatic HPV, where there’s not even subtle bumps or abnormalities,” says Dr. Sangini Sheth, MD, MPH, Yale Medicine gynecologist and associate professor at Yale School of Medicine. “That is fairly common.” You can still pass the virus along to your sexual partners, even if you’re asymptomatic. But, Dr. Sheth notes, an infection with a low-risk strain doesn’t increase the risk of having HPV-associated cancer. It’s the high-risk strains of HPV that are more problematic. If you were infected by one of them, it can raise your risk of developing cancer. Two strains of HPV, known as HPV 16 and HPV 18, cause most HPV-related cancers. These cancers include cervical cancer, as well as cancers of the vulva, vagina, penis and anus. These strains can also lead to oropharyngeal cancers, which affect a part of your body called the oropharynx. That includes the back of your tongue, part of your throat, your tonsils, and your soft palate. Cervical cancer is the most common HPV-associated cancer in women, and oropharyngeal cancer is the most common HPV-associated cancer in men, per the CDC. Most people who develop an HPV-associated throat cancer first notice a painless mass or lump in the neck, according to Dr. Judson. If it lingers for more than four weeks, he suggests that they see their doctor. “Other symptoms that should be evaluated if they are present for four weeks or longer include a sore throat, pain with swallowing, blood in the saliva, or a voice change,” he adds. Women who are 21 and older should also undergo regular cervical cancer screenings, which can pick up on early changes to the cells in their cervix that might herald the development of cervical cancer. “Stay up to date on that screening because it gives us the opportunity to find abnormalities before they turn into cancer,” says Dr. Sheth. “We have very effective ways to treat precancerous abnormalities” that are also much easier on you and your body than cancer treatment would be.
Reduce your chances of getting HPV
Currently, there is no routine testing for HPV. The only people who undergo HPV testing are women over 30 who get an HPV test as part of a cervical cancer screening. The reason the test is only given to women over 30 is that a large number of people under age 30 may test positive for HPV, but the infections are likely to be harmless and will go away on their own. But after age 30, “We know there is a higher risk of women not being able to clear the infection,” says Dr. Huh. Experts tend to recommend that people who are eligible for HPV vaccination go ahead and get vaccinated. “The most important thing you can do to reduce the risk of developing one of these cancers if you are 26 years or younger is to get vaccinated,” says Dr. Judson. “Those who are up to 45 years old may consider getting vaccinated and should talk to their doctor about this.” The Gardasil 9 vaccine will protect them against nine strains of HPV, including the HPV 16 and HPV 18 strains and a few other high-risk strains. That means you won’t have to worry about whether or not you were exposed to one of those high-risk strains or not. Next up: Should you get an HPV vaccine if you’re over 35? We asked the experts.
Sources
Centers for Disease Control and Prevention: “Genital HPV Infection - Fact Sheet” Mayo Clinic: “Genital warts” Dr. Warner Huh, MD, MD. UAB School of Medicine.Centers for Disease Control and Prevention: “HPV-associated cancer statistics.” World Health Organization: “Human papillomavirus (HPV) and cervical cancer.” Dr. Benjamin Judson, MD, chief of otolaryngology at Yale Medicine and professor of surgery at Yale School of MedicineCleveland Clinic:Oropharyngeal Cancer.Dr. Sangini Sheth, MD, MPH, Yale Medicine gynecologist and associate professor at Yale School of MedicineNYU Langone Health: “Types of Human Papillomavirus.”
