By Hazel Abinsay M.D.
What is HPV?
HPV, or the human papillomavirus, is a very common virus. HPV has many different strains or types of the virus, but the most common ones are HPV 6, 11, 14, and 18. Some strains are higher risk and can cause cancer. In both men and women, HPV can cause genital warts, oral cancer, and anal cancer later in life.
In women, HPV can cause cervical cancer. Cervical cancer screening is performed with pap smears in which samples of cells from the cervix are collected with a small brush. HPV is tested on pap smears as 9 out of 10 cases of cervical cancer are caused by HPV, which is about 11,000 yearly cases in the United States. Every year, nearly 200,000 women are diagnosed with precancerous changes of the cervix. Over 4,000 women die of cervical cancer every year. HPV is also important in prenatal testing.
In men, HPV can cause penile cancer and the other cancers as above. In the United States, over 14,000 men can get these HPV-related cancers yearly.
How is HPV transmitted?
When we think of sexually transmitted diseases (STD), we often think of chlamydia, gonorrhea, syphilis, or HIV. These diseases are treated with medications. However, HPV is actually the most common sexually transmitted infection. Both men and women can get HPV. It is spread through vaginal, anal, or oral sex. Patients who have HPV may spread HPV to their partners. It is often silent and does not cause any symptoms. About 80% of sexually active people are infected with HPV at some point in their lives. There is no real way to tell which people have HPV, who will develop cancer or other health problems in the future. If there are symptoms, the most common presentation is genital warts, but signs of infection can appear weeks, months, or even years after initial infection.
Is there a cure for HPV?
There is no scientifically proven treatment or medication to kill the HPV virus. Your body’s immune system naturally can help fight the virus and eventually clear it. Medications can help symptoms like genital warts go away. Cancers can undergo appropriate treatment. However, depending on the strain of HPV, the virus can linger in the body for years.
What is the HPV vaccine?
The HPV vaccine is one of the newest vaccines recommended for children. The HPV vaccine helps to protect a person from the most common strains – HPV-16 and -18, which account for 70% of cervical cancers, and HPV-6 and -11, which cause about 90% of genital warts.
Why is there some hesitation to receive the vaccine?
Some parents hesitate to consent for their pre-teen or teenager to receive a vaccine that is associated with sex. Many parents think that their child won’t become sexually active for a very long time so therefore won’t be at risk for HPV. However, according to the Centers for Disease Control (CDC), the average age for first sexual intercourse for both boys and girls is 17 years old. With that being said, pediatricians strongly encourage all patients to receive this vaccine as early as possible before they become sexually active or exposed.
What are the vaccine recommendations?
The CDC recommends that the HPV vaccine be given to pre-teens (both boys and girls) as part of the immunization schedule. It is routinely given as part of the 7th grade required vaccines around the age 11-12. The most common side effects associated with this vaccine are arm pain, redness, and swelling to the injection site. Some teenagers may faint after the vaccine but usually recover without issues. This vaccine is not recommended for everyone older than 26 years old, as it may not be as effective due to likely HPV exposure in adulthood.
Is the vaccine effective?
Since the introduction of the HPV vaccine in 2006, there has been a dramatic decrease in the number of cervical cancer patients diagnosed yearly. Cervical cancer was once the leading cause of cancer deaths in women in the United States. However, with cervical cancer screening and the HPV vaccine, it is now one of the most preventable cancers. Early vaccination can prevent over 90% of these HPV-related cancers.
What should we do?
We need to raise awareness that HPV-related cancers can be preventable, if we vaccinate against HPV early. If you are a parent, I strongly recommend HPV vaccination for your children, as it affects their future health. In general, men and women should seek medical care if they notice any abnormal growths in their mouths or genital areas. Women should have routine Pap smears as recommended by their doctors. High risk men, such as men with HIV or those who receive anal sex, should also inquire with their physician about anal Pap smears. Lastly, we need to appreciate that many years of testing this vaccine through proper science has made a significant impact to women’s (and men’s) health.
DR. HAZEL ABINSAY is a pediatrician practicing in Kalihi and Ewa Beach. She is a board member of the Philippine Medical Association of Hawaii.