Human Papillomavirus (HPV)

What is HPV?

HPV is a major risk factor for the development of cervical cancer. Protect yourself with a vaccination.

The Human Papillomavirus (HPV) is a sexually transmitted virus that causes anogenital diseases in males and females. Most men are asymptomatic carriers and unknowingly pass it to their female partners. In women, HPV is a major risk factor for the development of cervical cancer.

The incidence of cervical cancer in the United States has decreased by more than 50 percent in the past three decades because of the widely available cervical cancer screening. However, cervical cancer is still the third-most-common female cancer worldwide causing 270,000 related deaths in 2012.

About 14 million people, including teens, become infected with HPV each year. HPV has also been a known risk factor for rare cancers such as vaginal and vulva, and is responsible for at least 70 percent of vaginal cancers. It is also known to cause anal and mouth/throat cancers.

HPV infection can be transient or persistent, and most people who have it never develop symptoms. Transient HPV poses little risk of progressing to cervical cancer because it resolves on its own. Persistent HPV infection for more than 1 year is a risk factor for cervical abnormalities. Risk factors associated with persistent infection include cigarette smoking, immunocompromised state, and HIV. There are several types of HPV. HPV types 16 and 18 cause approximately 70 percent of cervical cancers and 50 percent of precancerous cervical lesions.

Does the HPV Vaccine Work?

Two vaccines are available to prevent HPV infection, Gardasil and Cervarix. Gardasil has been FDA-approved since 2006 and targets HPV types 6, 11, 16 and 18. Gardasil has also been demonstrated to reduce the incidence of genital warts and vaginal and vulvar abnormalities. Cervarix has been approved since 2009 and covers HPV types 16 and 18. HPV vaccine is most effective among females who have not been infected. Immunization is less beneficial for females who have already been infected but have a history of an abnormal Pap smear. Genital warts are not a contraindication.

Mothers, please do not fear. The recommendation for all women is a Pap smear at 21 years of age regardless of sexual activity; therefore, your daughter does not need to be tested to see if she is a candidate for this vaccine. HPV vaccination is done in three doses given over 24 weeks. Routine immunization should be offered to girls 11 to 12 years of age but can be administered as early as nine. Catch up vaccination should be offered for females aged 13 to 26 years who have not been previously vaccinated. No booster are doses recommended at this time.

The most common side effect is pain at the injection site. There is limited data regarding this vaccine’s use in pregnancy, therefore it is not recommended for pregnant women. However, lactating females can receive the vaccine since it does not affect the infant’s safety. Females who do receive the vaccine before a known pregnancy should be reassured that there is no evidence that it will cause harm to the fetus. In clinical trials, no obvious fetal abnormalities were attributed to the vaccine. Women who have begun the series but become pregnant should continue the series of shots in the postpartum phase.

Symptoms of Cervical Cancer

Symptoms of cervical cancer usually do not appear until abnormal cervical cells become cancerous and invade nearby tissue.

The most common symptom is abnormal bleeding, which may:

• Start and stop between regular menstrual periods.
• Occur after sexual intercourse, douching, or a pelvic exam.

Other symptoms may include:

• Heavier menstrual bleeding, which may last longer than usual
• Bleeding after menopause
• Increased vaginal discharge
• Pain during intercourse

The symptoms of cervical cancer may resemble other conditions or medical problems. Consult a doctor for diagnosis.