Pop quiz! What is the most common STD in the United States? Nope, not Chlamydia. Whew, it’s not drug-resistant gonorrhea, either. Give up? It’s HPV.
The Centers for Disease Control and Prevention estimates that at least 80% of people in the US will contract HPV at some point in their lives. Allow me to share a quick story: My supervisor during my grad school summer internship told me that she and some of her friends sat around one night tallying up a completely unscientific survey of their female friends, trying to determine how many friends had HBO and how many had HPV. Friends with HPV outnumbered friends with HBO by a substantial margin. HPV is everywhere!
The letters “HPV” stand for human papilloma virus. What is a papilloma? It’s just a fancy medical term that means wart. HPV is the virus that causes warts in humans. HPV does not live in any other species (Feel free to touch all the toads you want! So there, grandma.) Warts tend to erupt at the site where HPV entered the body, so they can happen almost anywhere on the skin. Warts especially love epithelial cells – the thin skin cells that line your mucous membranes (mouth, throat, genitals, anus). Here is a mildly gross picture of warts, for those of you who are visual learners. Here is a grosser picture of warts, for those of you who like to look at icky medical stuff (my people!). Warts are unattractive and can sometimes get in the way of important body functions (I will spare you by not providing a photo link; use your imagination.), but they’re pretty harmless and can be removed with minor surgery.
Unfortunately, HPV also has a malignant side. Some strains of the virus can lead to cancer. Perhaps you’ve heard about the recent statements actor Michael Douglas made regarding the origin of his throat cancer. Yep, HPV. And yes, you can get HPV from oral sex. His publicist later retracted Mr. Douglas’ statement that he acquired the virus through cunnilingus. Regardless, Michael Douglas is still a public health super star in my book because he started a conversation about HPV and its link to a variety of types of cancer. He did so just in time, too. A study published earlier this year found that mouth and throat cancers caused by HPV are on the rise here in the United States. Of course, the main type of cancer that sexually-transmitted HPV causes is cervical cancer. And just in case anyone was feeling left out, be assured that HPV can cause penile cancer and anal cancer, as well. No one’s epithelial cells are safe, I’m afraid. The treatment for HPV-related cancers are the same as those for any other type of cancer: chemotherapy, radiation and/or surgery.
I realize that this link between sex and cancer is rather distressing. Let’s take a step back and focus on some of the good news about HPV. Yes, we’ve all probably had HPV at some point, but very few strains actually cause cancer. There are around 150 strains of HPV, but only around a dozen are categorized as high-risk for causing cancer. Still need more reassurance? 99% of HPV infections are cleared-up by the body’s immune system within a year or two. Most of the 80+% of us who’ve had HPV didn’t know we had it because we never had symptoms and it went away on its own.
Need to hear one last piece of good HPV news? There’s a vaccine for it. Vaccines exist that protect against HPV strains 16 and 18, which are the most common high-risk strains. The HPV vaccines have generated some controversy because it is recommended that girls and boys get the vaccine when they are 11-12 years old. Some people believe that protecting pre-teens against a potentially deadly virus somehow encourages them to have sex at an early age. A recent study by the CDC found no difference in rates of sexual activity between adolescents who have received the HPV vaccine, and those who have not. What the study did find was a dramatic drop in rates of HPV in teen girls since the vaccine became available a few years ago. So there: the vaccine works and it won’t cause kids to have sex any earlier. One of the reasons why the vaccine is recommended for kids is that since HPV is so common, it’s best to give the vaccine way before a young person starts to have sex. However, virginity is not a requirement; the vaccine is approved to be given to women up to age 26 and men up to age 22. And of course, I would like to remind you all that using condoms (or dental dams) is another effective way to prevent sexual transmission of HPV.
Hopefully, those pieces of good news made you feel better, but not so good that you disregard everything else I’ve told you. HPV-related cancer is still a risk. Ladies, that’s why it’s so important to get those regular Pap smears. The current recommendation is for healthy women to get a Pap every 3 years. The Pap smear technique is now being used to screen people for anal cancer, too. It is not a very common test, but it is growing in popularity and availability. Other than Pap smears for women, there is no other routine screening test for HPV or HPV-related cancer. It is not included on the basic panel STD tests because most people will clear an HPV infection on their own. Usually a doctor won’t test for HPV unless some kind of potentially cancerous lesion is present.
If you’re an ardent Infectious Selections follower, you know I love to make lists, so let’s summarize some take-away points:
- (Practically) everybody has or will have HPV during their lives.
- A few types of HPV cause cancer. Most just cause warts (or no symptoms at all!).
- Ladies, get your Pap smears regularly.
- Everyone, get any suspicious lesions examined by a doctor.
- Get the HPV vaccine. If you’re too old, then make sure your kids get it.
Wrap it up!
Featured image: VCU CNS