Understanding HPV and the Cancers It Can Cause

What is HPV and Why Should You Be Concerned?

The Human Papillomavirus (HPV) is a very common group of viruses. In fact, it's estimated that nearly everyone will contract HPV at some point in their lives. While most HPV infections are harmless and clear up on their own without causing any health problems, a small number of strains are linked to certain types of cancer. Understanding which cancers HPV can cause, their symptoms, and how to prevent them is crucial for maintaining good health.

HPV Strains and Cancer Risk

There are over 150 different strains of HPV. Fortunately, only a few of these are considered high-risk and have the potential to cause cancer. The vast majority of HPV infections do not lead to cancer. As Dr. Michelle Forcier, a clinician with virtual healthcare service FOLX, explains, “Over 90% of persons with HPV will clear the infection over time. Only a very small fraction of persons with known or unknown HPV will eventually get cancer.” Despite this, it's estimated that around 36,000 HPV-related cancers occur each year in the United States. For context, approximately 13 million people contract HPV annually, and in 2018, about 43 million Americans had HPV.

Cervical Cancer: The Most Common HPV-Related Cancer

Cervical cancer is the fourth most common cancer among individuals assigned female at birth, and a staggering statistic is that more than 95% of all cervical cancer cases are linked to HPV. The American Cancer Society (ACS) recommends regular screening for cervical cancer between the ages of 25 and 65. This screening can be done in a few ways:

• An HPV test alone, performed at least once every 5 years.
• An HPV/Pap co-test, which includes both an HPV test and a Pap smear, every 5 years.
• A Pap smear alone every 3 years (though HPV testing is preferred).

Dr. Syed G. Husain, a colorectal surgeon, notes that “Most cancers that are caused by HPV are caused by HPV strains 16 and 18.” These are particularly aggressive strains. It's also important to be aware that HIV is a significant risk factor for cervical cancer. Individuals who are HIV-positive are up to five times more likely to develop cervical cancer compared to those who are HIV-negative.

Symptoms of Cervical Cancer

Early-stage cervical cancer often does not present any symptoms, which is why regular screening is so vital. Dr. Forcier emphasizes, “That’s why every person with a cervix should be opting for cervical cancer screening at the intervals recommended by an expert.” When symptoms do appear, they can include:

• Unusual or unexpected vaginal bleeding, especially after intercourse, between periods, or after menopause.
• Pain during vaginal penetration.
• General pelvic discomfort or pain.

These symptoms can also be indicative of pre-cancerous changes in the cervix, which are often caused by HPV strains 16 and 18. These strains are responsible for nearly half of all high-grade cervical pre-cancers. Dr. Lyndsey Harper, OB-GYN and founder of the sexual wellness platform Rosy, highlights the importance of vaccination: “All HPV vaccines protect against these two strains. So, the most important piece of preventing cervical cancer is the HPV vaccine.”

Oropharyngeal Cancer: Cancers of the Throat

Oropharyngeal cancer is a broad term for cancers that affect the back of the throat, including the base of the tongue and the tonsils. While these cancers are relatively uncommon, HPV is a significant contributing factor, causing an estimated 70% of oropharyngeal cancers in the United States, according to the CDC. Oral HPV infection can occur through oral sex with someone who has genital HPV.

Symptoms of Oropharyngeal Cancer

Similar to cervical cancer, oropharyngeal cancer may not cause symptoms in its early stages. When symptoms do manifest, they can include:

• Persistent sore throat that doesn't improve.
• Difficulty swallowing (dysphagia).
• Ear pain, particularly on one side.
• A lump or sore in the neck.
• Unexplained weight loss.
• Hoarseness or changes in voice.
• Bumps or warts in the mouth or throat.

It's important to note that while HPV is a major cause, other risk factors can interact with HPV to increase the likelihood of developing oropharyngeal cancer. Tobacco use (smoking, chewing, or dipping) and alcohol consumption are two of the strongest risk factors for these types of cancers.

Anal Cancer and HPV

HPV is also a known cause of anal cancer. While some individuals with anal cancer may not experience any symptoms, others might develop symptoms that can be mistaken for common conditions like hemorrhoids or anal fissures.

Symptoms of Anal Cancer

When symptoms of anal cancer appear, they can include:

• Bleeding from the anus or rectum.
• A lump or mass in the anal area.
• Pain or a feeling of fullness in the anal area.
• Itching or discomfort around the anus.
• Changes in bowel habits, such as narrowing of the stool.

Certain factors can increase the risk of developing anal cancer, including a history of other HPV-related cancers (like cervical, vulvar, or vaginal cancer) and the use of tobacco products.

Penile Cancer and HPV

Although less common than cervical or oropharyngeal cancers, HPV can also contribute to the development of penile cancer. While there are no specific screening tests for HPV in individuals with penises, symptoms of penile cancer often involve changes in the skin of the penis.

Symptoms of Penile Cancer

Early signs of penile cancer can include:

• A sore or rash on the penis that doesn't heal.
• Changes in the color of the skin on the penis.
• Thickening of the skin on the penis.
• Discharge or bleeding from the urethra.

Being uncircumcised may also slightly increase the risk of penile cancer. Additionally, smoking cigarettes or using other tobacco products significantly elevates the risk.

Prevention: The Power of the HPV Vaccine

The most effective way to prevent HPV-related cancers is through vaccination. The HPV vaccine is highly effective at protecting against the HPV strains that are most commonly responsible for causing cancer, particularly strains 16 and 18. It is recommended for both boys and girls, ideally before they become sexually active. Regular screening for cervical cancer is also a critical component of prevention for individuals with a cervix.

When to Consult a Doctor

It's important to consult a doctor if you experience any persistent or unusual symptoms related to the cancers discussed above. This includes:

• Unexplained bleeding, pain, or discomfort in the pelvic or anal area.
• Persistent sore throat, difficulty swallowing, or lumps in the neck.
• Any unusual sores, rashes, or skin changes on the penis.
• Any concerns about your sexual health or potential HPV exposure.

Remember, early detection is key to successful treatment for all types of cancer. Don't hesitate to seek medical advice if you have any health concerns.