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HPV FACTS AND PHOTOS
HPV
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WHAT IS
HPV Infection?
Genital human papillomavirus (HPV) is the most common sexually
transmitted infection (STI). The virus infects the skin and
mucous membranes. There are more than 40 HPV types that can
infect the genital areas of men and women, including the skin of
the penis, vulva (area outside the vagina), and anus, and the
linings of the vagina, cervix, and rectum. You cannot see HPV.
Most people who become infected with HPV do not even know they
have it. |
Symptoms
and potential health consequences of HPV?
Most people with HPV do not develop symptoms
or health problems. But sometimes, certain types of HPV can cause genital
warts in men and women. Other HPV types can cause cervical cancer and other
less common cancers, such as cancers of the vulva, vagina, anus, and penis.
The types of HPV that can cause genital warts are not the same as the types
that can cause cancer.
HPV types are often referred to as “low-risk”
(wart-causing) or “high-risk” (cancer-causing), based on whether they put a
person at risk for cancer. In 90% of cases, the body’s immune system clears
the HPV infection naturally within two years. This is true of both high-risk
and low-risk types.
Genital warts usually appear as small
bumps or groups of bumps, usually in the genital area. They can be raised or
flat, single or multiple, small or large, and sometimes cauliflower shaped.
They can appear on the vulva, in or around the vagina or anus, on the
cervix, and on the penis, scrotum, groin, or thigh. Warts may appear within
weeks or months after sexual contact with an infected person. Or, they may
not appear at all. If left untreated, genital warts may go away, remain
unchanged, or increase in size or number. They will not turn into cancer.
Cervical cancer does not have symptoms
until it is quite advanced. For this reason, it is important for women to
get screened regularly for cervical cancer.
Other less common HPV-related cancers,
such as cancers of the vulva, vagina, anus and penis, also may not have
signs or symptoms until they are advanced.
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TRANSMISSION
Genital HPV is passed on through genital
contact, most often during vaginal and anal sex. A person can have HPV
even if years have passed since he or she had sex. Most infected persons
do not realize they are infected or that they are passing the virus to a
sex partner.
Very rarely, a pregnant woman with
genital HPV can pass HPV to her baby during vaginal delivery. In these
cases, the child may develop warts in the throat or voice box – a
condition called recurrent respiratory papillomatosis (RRP).
How does HPV cause
genital warts and cancer?
HPV can cause normal cells on infected
skin or mucous membranes to turn abnormal. Most of the time, you cannot
see or feel these cell changes. In most cases, the body fights off HPV
naturally and the infected cells then go back to normal.
· Sometimes, low-risk types of
HPV can cause visible changes that take the form of genital warts.
- If a high-risk HPV
infection is not cleared by the immune system, it can linger for
many years and turn abnormal cells into cancer over time. About 10%
of women with high-risk HPV on their cervix will develop
long-lasting HPV infections that put them at risk for cervical
cancer. Similarly, when high-risk HPV lingers and infects the cells
of the penis, anus, vulva, or vagina, it can cause cancer in those
areas. But these cancers are much less common than cervical cancer
How Common
are HPV and related diseases
HPV infection.
Approximately 20 million Americans are
currently infected with HPV, and another 6.2 million people become newly
infected each year. At least 50% of sexually active men and women
acquire genital HPV infection at some point in their lives.
Genital warts.
About 1% of sexually active adults in the U.S.
have genital warts at any one time.
Cervical cancer.
The American Cancer Society estimates that in
2008, 11,070 women will be diagnosed with cervical cancer in the U.S.
Other HPV-related cancers
are much less common than cervical cancer. The American Cancer Society
estimates that in 2008, there will be:
- 3,460 women diagnosed with vulvar
cancer;
- 2,210 women diagnosed
with vaginal and other female genital cancers;
- 1,250 men diagnosed with
penile and other male genital cancers; and
- 3,050 women and 2,020 men
diagnosed with anal cancer.
Certain populations may be at higher risk
for HPV-related cancers, such as gay and bisexual men, and individuals
with weak immune systems (including those who have HIV/AIDS).
RRP
is very rare. It is estimated that less than 2,000 children get RRP
every year.
How can people prevent HPV?
A vaccine can now protect
females from the four types of HPV that cause most cervical
cancers and genital warts. The vaccine is recommended for 11
and 12 year-old girls. It is also recommended for girls and
women age 13 through 26 who have not yet been vaccinated or
completed the vaccine series.
For those who choose to be sexually active, condoms may
lower the risk of HPV, if used all the time and the right
way. Condoms may also lower the risk of developing HPV-related
diseases, such as genital warts and cervical cancer. But HPV
can infect areas that are not covered by a condom—so condoms
may not fully protect against HPV. So the only
sure way to prevent HPV is to avoid all sexual activity.
Individuals can also lower their chances of getting HPV by
being in a mutually faithful relationship with someone who
has had no or few sex partners. However, even people with
only one lifetime sex partner can get HPV, if their partner
was infected with HPV. For those who are not in long-term
mutually monogamous relationships, limiting the number of
sex partners and choosing a partner less likely to be
infected may lower the risk of HPV. Partners less likely to
be infected include those who have had no or few prior sex
partners. But it may not be possible to determine if a
partner who has been sexually active in the past is
currently infected.
How can people prevent HPV
related diseases?
There are important steps
girls and women can take to prevent cervical cancer.
The HPV vaccine can protect against most cervical cancers
(see above). Cervical cancer can also be
prevented with routine cervical cancer screening and
follow-up of abnormal results. The Pap test can identify
abnormal or pre-cancerous changes in the cervix so that they
can be removed before cancer develops. An HPV DNA test,
which can find high-risk HPV on a woman’s cervix, may also
be used with a Pap test in certain cases. The HPV test can
help healthcare professionals decide if more tests or
treatment are needed. Even women who got the vaccine when
they were younger need regular cervical cancer screening
because the vaccine does not protect against all cervical
cancers.
There is currently no vaccine
licensed to prevent HPV-related diseases in men. Studies are
now being done to find out if the vaccine is also safe in
men, and if it can protect them against HPV and related
conditions. The FDA will consider licensing the vaccine for
boys and men if there is proof that it is safe and effective
for them. There is also no approved screening test to find
early signs of penile or anal cancer. Some
experts recommend yearly anal Pap tests for gay and bisexual
men and for HIV-positive persons because anal cancer is more
common in these populations. Scientists are still studying
how best to screen for penile and anal cancers in those who
may be at highest risk for those diseases.
Generally, cesarean delivery
is not recommended for women with genital warts to prevent
RRP in their babies. This is because it is
unclear whether cesarean delivery actually prevents RRP in
infants and children.
Is there a test for HPV?
HPV tests are available to help screen women aged 30 years
and older for cervical cancer. These HPV tests are not
recommended to screen men, adolescents, or women under the
age of 30 years. There is no general HPV test for men or
women to check one's overall "HPV status." Also, there is
not an approved HPV test to find HPV in the mouth or throat·
Genital warts are diagnosed
by visual inspection. Some health care providers may use
acetic acid, a vinegar solution, to help identify flat
warts. But this is not a sensitive test so it may wrongly
identify normal skin as a wart.
·
Cervical cell changes (early
signs of cervical cancer) can be identified
by routine Pap tests. The HPV test can identify high-risk
HPV types on a woman’s cervix, which can cause cervical cell
changes and cancer.
As noted
above, there is currently no approved test to find HPV or
related cancers in men. But HPV is very common and HPV-related
cancers are very rare in men
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Is
there a treatment for HPV?
There is no treatment
for the virus itself, but a healthy immune system can
usually fight off HPV naturally. There are
treatments for the diseases that HPV can cause:
Visible genital warts
can be removed by patient-applied medications, or by
treatments performed by a health care provider. Some
individuals choose to forego treatment to see if the warts
will disappear on their own. No one treatment is better than
another.
Cervical cancer
is most treatable when it is diagnosed and treated early.
There are new forms of surgery, radiation therapy, and
chemotherapy available for patients [see
www.cancer.org
But women who get routine Pap testing and follow up as
needed can identify problems before cancer
develops. Prevention is always better than treatment.
Other HPV-related
cancers are also more treatable when diagnosed and
treated early. There are new forms of surgery, radiation
therapy, and chemotherapy available for patients.
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