The recent controversy over the Human papillomavirus (HPV) vaccine has caused many women to become hip to the HPV-cervical cancer connection. But this was not always the case. Even a few months ago, when I asked some friends if they knew what HPV was and what it caused, I was greeted with blank stares. Not surprising, considering that most women with HPV don’t know they have it and won’t end up developing cervical cancer.
Funny thing though, most women are intimately acquainted with HPV. According to the Center for Disease Control and Prevention (CDC), at least 50 percent of sexually active men and women acquire genital HPV infection at some point in their lives, and by age fifty, at least 80 percent of women will have acquired genital HPV infection. 80 percent! But before you go reaching for the chastity belt and claiming yourself a born again virgin, please read on. HPV is common, but not chastity-worthy. I promise.
Human papillomavirus is the name of a group of about one hundred different types of viruses. Some of them cause the warts on our hands and feet, some of them cause the warts in our private areas, and some of them cause cancer. That’s quite a spectrum, but the important ones are the thirty or so that are transmitted sexually. Who really cares about an unsightly bump on your finger when we’re talking cancer?
Of the thirty types of viruses that are sexually transmitted through genital contact, some are low risk and some are high risk. The low risk ones can cause genital warts—raised, cauliflower-looking things that can appear on the penis, labia, inside the vagina, and on the skin around the genitalia. Both low and high risk genital viruses can cause mild Pap test abnormalities which do not have serious consequences. Approximately ten of the thirty genital HPV types are high risk and can lead, in rare cases, to development of cervical cancer and in even rarer cases, to cancers of the anus and genital areas. That’s the bad news.
The good news is that most of us will clear HPV infections without ever knowing we had them. The virus lives in the skin or mucous membranes and usually causes no symptoms, only sometimes resulting in warts or pre-cancerous changes in the cervix and vagina. In fact, the CDC tells us that for about 90 percent of women, cervical HPV infection becomes undetectable within two years. But, this good news does have a bit of a caveat: if most people don’t have symptoms, then how do we protect ourselves and our partners from getting it? And therein lies that 80 percent: without a telltale wart, it’s easy to pass on HPV, lovers none the wiser.
But protecting yourself from HPV is difficult, save for the chastity belt and a vow of celibacy. Condoms don’t totally prevent it, since the virus is spread by skin to skin contact and skin surrounding the genitalia is not covered by a condom. The best way to prevent HPV infection is to be in a monogamous relationship with a partner that is not infected. You can also try and limit the number of partners you have and make sure they have had few or no prior sexual partners. Unless you’re in the habit of dating priests, I’m not sure this advice is all that useful, so what should women do?
Get pap smears and get them regularly. Infection with HPV is not a big deal, but infection with a high risk strain followed by years of neglecting to see a gynecologist is. Pap smears (which are part of a normal gynecological exam) are THE tool in making sure you do not have abnormal changes in the cells of the cervix. If you do have abnormal cells, your doctor can do an HPV test to determine if you have high-risk types of HPV in the cervical cells. Regular Pap testing can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into cervical cancer.
