Health Articles-Human Papillomavirus (HPV) and Cervical Cancer

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Human Papillomavirus (HPV) and Cervical Cancer

By: Dr. Lois Ramondetta

Many women are unaware that a condition called human papillomavirus (HPV) is linked to cervical cancer. Becoming educated about HPV could help prevent cervical cancer if women follow through with recommended annual pap tests and seek treatment for the virus.

Lois Ramondetta, M.D., an assistant professor in the Department of Gynecologic Oncology at M. D. Anderson, addresses the subject below by answering common HPV questions.

What is the human papillomavirus (HPV)?

The human papillomavirus (HPV) is the name for a group of more than 100 viral subtypes, many of which can be contracted through sexual contact. HPV is one of the most common sexually transmitted diseases in the United States. According to the American Social Health Association, approximately 5.5 million new cases of sexually transmitted HPV infections are reported every year. At least 20 million Americans are already infected. Some types of HPV can cause abnormal tissue growth in the form of warts (papillomas). Some HPVs are associated with certain cancers and precancerous conditions.

What is the connection between HPV and cancer?

Most cases of HPV are low-risk and rarely develop into cancer. Certain high-risk HPVs develop into cancer.

If you have high-risk HPV, does that mean you have cancer?

A small percentage of women with HPV get cervical cancer if the precancerous ("dysplastic") cells are not removed. High-risk HPV is the main cause of cervical cancer. In fact, HPV is linked to about 95% of cervical cancer cases.

What are the risk factors for developing cancer as a result of HPV?

*Smoking
*Having numerous sexual partners without using protection
*Being infected with the human immunodeficiency virus (HIV)
*Suppression of the immune system due to some other cause, such as transplant or lack of follow-up for pap smears

What are possible symptoms of HPV?

*Most often there are no symptoms
*Warts on the genitals or anus which could appear several weeks, months or even years after sexual contact with a person with HPV
*Growths that are often flat and nearly invisible

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How is HPV detected?

HPV is detected through a woman’s annual pap test. If pap test results show high-grade abnormal cell changes, a colposcopy and biopsy are recommended.

*Colposcopy is a procedure in which a lighted magnifying instrument called a colposcope is used to examine the vagina and cervix

*Biopsy is the removal of a small piece of tissue for diagnosis There is currently no simple test to detect HPV in men, who typically do not show symptoms. That is why it is important to use a condom and limit the number of sexual partners.

How is HPV treated in women?

When doctors detect dysplasia (precancerous cells) through a pap test and confirm them by a colposcopy-directed biopsy, the HPV is treated with a procedure involving the removal of the outer portion of the cervix. This is an outpatient procedure with minimal risk. This procedure is called a Loop Electrosurgical Excision Procedure (LEEP).

Low-grade dysplasia may only need to be followed every few months, as it often goes away on its own. High-grade (moderate or severe dysplasia) is best managed by surgical removal, due to its tendency to progress to invasive disease.

What increases the chances of contracting dysplasia as a result of HPV itself?

*Beginning sexual intercourse at an early age, especially age 16 or younger, because changes to the cervix during adolescence mean more risk of exposure
*Having many sexual partners, because it increases the chance that a woman will be exposed to and develop an HPV infection in the cervix
*Smoking
*Contracting other sexually transmitted diseases
*Suppression of the immune system (from HIV or transplants)

Do condoms protect against HPV?

They do protect somewhat against HPV but they need to be used EVERY time. Also, as HPV warts can be external, exposure may not be prevented with a condom.

What research is being done to help prevent or treat HPV?

An HPV vaccine is being developed. Obstacles in vaccine development include the huge number of viral subtypes, as well as the likelihood of early exposure in young people and thus the probable need to vaccinate women and men at birth. Doctors at M. D. Anderson recommend yearly pap smears, good nutrition, condom use and avoidance of tobacco products.