The most common sexually transmitted virus in the United States is genital human papillomavirus (HPV). There are over 150 strains of HPV and 20 million Americans are infected, with another 14 million becoming infected annually. Over fifty percent of sexually active men and women become infected with HPV at some point in their lives. Although most infections with HPV don’t cause symptoms, the virus can cause cervical cancer in women. Cervical cancer is the second leading cause of cancer deaths in women around the world. An estimated 10,000 women in the U.S. are diagnosed with cervical cancer annually and 3,700 die from cervical cancer. There are over forty strains of HPV that can cause cancer. Although almost 100% of cervical cancers are related to HPV, two strains, 16 and 18, have been related to approximately 70% of cases of cervical cancer.
Initially, HPV vaccine was recommended only for treatment of girls and young women, but recommendations have been expanded to include boys and young men. Although cervical cancer is the primary concern, HPV has been associated with other, less common cancers in men and women. It can also cause genital warts and warts in the upper respiratory tract. Although there is no treatment for infection with HPV, the conditions that result from infection can be treated.
Protection from HPV is available in the form of a vaccine. The HPV vaccine consists of an inactivated virus and it protects against four major types of HPV, including two types that cause over seventy percent of cervical cancer and two types that cause ninety percent of genital warts. Although HPV protects against most cases of cervical cancer, it does not confer immunity against all HPV types that cause cervical cancer, so after vaccination, women over the age of 21 should continue to be screened with Pap smears on a regular schedule, as recommended by the United States Preventive Services Task Force (USPSTF).
Almost 50% of new HPV infections occur in women between the ages of 15 and 24. The Centers for Disease Control (CDC) recommends routine HPV vaccination for girls and boys who are 11 or 12 years old, although doctors may give it to girls who are as young as 9 years of age. It’s important for girls to be immunized before their first sexual contact, since they have not yet been exposed to HPV. The CDC also recommends vaccination against HPV for men ages 22-26 that are immunocompromised or engage in sexual activity with other men, if they have not already been vaccinated. Gardisil® is a vaccine that will protect them against almost 100% of disease caused by the four types of HPV against which it protects. Gardisil 9® was approved by the FDA in 2014 and protects against 9 strains of HPV, including the original 4. Cervarix® protects against HPV strains 16 and 18 and is only approved for use in women. The CDC also recommends a catch-up vaccination for girls and women who are aged 13 through 26 years who have never received the vaccine. It is given as a three dose series, with the second dose 2 months after the first, and the third dose in 6 months after the first dose.
Pregnant women should not get the vaccine, because although it appears to be safe for both mother and unborn child, studies are ongoing. It can be given to mothers who are breastfeeding.
HPV is associated with anogenital cancers, including cervical, vaginal, vulvar, penile, and anal. It is also associated with oropharyngeal cancer and genital warts. Vaccination can significant reduce incidence of these diseases, but rates of vaccination remain unacceptably low. Although over 60 million doses of HPV vaccine have been administered, there have been no reports of severe adverse effects or adverse reactions linked to the vaccine. If you need more information in HPV vaccination, call our office for a consultation or talk to your doctor today.