What To Know About HPV Transmission, Vaccines, and More

Human papillomavirus, or HPV, is actually a group of related viruses, and there are more than 200 types, according to MedlinePlus. These germs are incredibly common and can cause everything from the warts on your hands and feet to cervical cancer and sexually transmitted genital warts. Some types have no symptoms at all. (In fact, the more dangerous types are often symptomless, at least at first).

The good news is that most of the time, your immune system will eliminate these viruses with no help or treatment. However, the more you know about HPV prevention and testing the better chance you have to avoid the potentially life-threatening consequences of certain HPV strains.

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Most People Eventually Get HPV

If you're sexually active, there's a good chance that you'll be infected with HPV at some point in your lifetime. The U.S. Centers for Disease Control and Prevention (CDC) estimates that 80% of women will be infected before they are 50. Most of the time, these infections will go away on their own and there will be no long-term ill effects. In other cases, HPV can persist in the body causing cellular changes that can lead to cervical cancer or other problems.

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There Are Many Types

Fortunately, not all of these cause problems. About 40 are spread through vaginal, anal, and oral sex, according to the CDC. At least 12 have been linked to cancer and, of these, two (HPV types 16 and 18) cause most HPV-related cancers.

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Males Can Get It, Too

HPV is most often associated with cancer in females, because it's found in 99% of cervical cancers. Males don't get this type of cancer, but they can get infected with HPV. According to the CDC, almost all sexually active people will get HPV at some point through sexual contact. Again, these infections go away most of the time, cleared by the body's immune system. But if HPV persists, it can cause cancer of the throat, penis, and anus in males.

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HPV Can Cause Hoarseness

Although warts in the genital area are much more common, HPV can also result in warts in the throat, a rare condition called recurrent respiratory papillomatosis (RRP). Sometimes these growths affect the voice, causing hoarseness, the most common symptom of RRP, according to the Recurrent Respiratory Papillomatosis Foundation. They can also cause chronic coughing and breathing problems. Surgical removal is the most common treatment, although the warts often come back, leading to repeat surgery.

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HPV Can Cause Throat Cancer

The growths associated with RRP are benign, but HPV can also cause throat (oropharyngeal) cancer. HPV is believed to cause 70% of these cancers in the United States, according to the CDC.

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HPV Can Be Transmitted During Oral Sex

Throat cancers linked to HPV are on the rise. And even though smoking is also a major risk factor for throat cancer, it's becoming increasingly common in sexually active young people who don't smoke, according the the American Cancer Society. "More and more we're realizing many head and neck cancers are caused by HPV, says Lois Ramondetta, MD, professor of medical gynecologic oncology at The University of Texas MD Anderson Cancer Center in Houston.

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Brushing Your Teeth Could Protect You

One 2013 study in Cancer Prevention Research looked at 3,500 people and found that those who reported poor oral health had a 56% higher prevalence of HPV infection compared with those who thought their teeth and gums were in good shape. Gum disease, lost teeth, and using mouthwash to treat a dental problem within the past week were the factors considered. Consider this another reason to brush your teeth regularly and visit the dentist.

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There's a Vaccine for HPV

Gardasil 9, the HPV vaccine available in the United States, protects against nine types of HPV including those that cause genital warts, cervical cancers, and other HPV-linked cancers, according to the National Cancer Institute.

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Younger Is Better for the Vaccine

The CDC guidelines recommend that children get the HPV vaccine when they are 11 or 12 years old, but it can be given as young as nine. The idea is that inoculating people before they become sexually active will offer the best protection against HPV. The vaccine is also recommended for people ages 13 through 26 who never got vaccinated or didn't get the full series.

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Males Should Get the Vaccine Too

The vaccine is approved for children regardless of sex. This can protect people from developing cancers later in life. Although less common than cervical cancer, other HPV-related cancers including cancers of the mouth, throat, penis, and anus occur in males, too. And giving the vaccine to everyone can protect more people indirectly by reducing transmission of HPV.

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The HPV Vaccine Is Safe

Research, including a large 2019 study in Pediatrics, has confirmed that the Gardisal 9 vaccine is not only effective, but also safe. Side effects were few and mild and included pain at the injection site and fainting. The benefits outweighed the slight risks.

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Vaccines Are Not Recommended for Most People 26 or Older

Most people over age 26 have probably already been exposed to HPV, in which case the vaccine is not helpful. The CDC guidelines say that anyone over 26 who has not received the vaccine can talk to their healthcare provider about the possibility based their individual situation.

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An HPV Test Is Available

A test for the types of HPV that can lead to cervical cancer is now available for adult females, though there is no test to detect HPV in the mouth or throat, according to the CDC.

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The HPV Test Can Be Used To Screen for Cervical Cancer

In 2020, the American Cancer Society updated its cervical cancer screening guidelines. The HPV test alone is now recommended for everyone with a cervix between ages 25 and 65 every five years. The Pap test, the earlier type of cervical cancer screening, looked for precancerous cells and is now only recommended in situations where the HPV test is not available. (The two procedures are not noticeably different to the patient.)

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Women May Be More Likely To Transmit HPV

While many people assume men are more likely to transmit HPV to women, a 2014 study suggests that is not so. Researchers reporting in the Journal of Infectious Diseases found that the risk of new infection was 60% higher in the male partner compared to the female partner. That's another argument for vaccinating males (although the study was funded in part by a vaccine manufacturer). "We saw such a large amount of infection occurring from females to males, that begs a questions about why we would not want to vaccinate males," says study lead author Alan G. Nyitray, PhD, assistant professor of epidemiology at The University of Texas School of Public Health at Houston.

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