January is cervical cancer awareness month. Nearly 13,000 women in the United States are diagnosed with cervical cancer each year.

This month, Sharon West, a guest columnist of The Citizen Times of USA, invited Dr. Amy Vance, board certified gynecologist, to address a few questions. The focus is on Human Papilloma Virus (HPV). HPV can lead to cervical cancer. We are sharing the article giving them the due credit.

What is HPV?

HPV stands for Human Papilloma Virus.

It is a virus that is a small and transmitted through contact of skin and mucosa.

What are the symptoms of an HPV infection?

Unfortunately, there are often no symptoms of HPV. While some patients might develop warts from being in contact with the virus, the changes caused by the more aggressive strains of the virus can be difficult to detect as the symptoms are initially evident only by evaluating cells under a microscope. This is why it is very important to report unusual coughs, hoarseness, and difficulty swallowing to your primary care provider and to have routine gynecological screening if you are a female.

How does one contract HPV?

The HPV virus is transmitted by sexual contact orally or at the genitals or both. It is such a common virus that the Centers for Disease Control (CDC) has recently commented that everyone who is sexually active should be considered to either already have been or sure to be in contact with the infection during their lifetime.

How serious is HPV?

It is very serious, first, because it is affects so many people. 79 million Americans are estimated to be currently infected with the virus and there are 14 million new cases each year.

Secondly, because it is associated with six different cancers.

There are different strains of the virus. While mild strains cause warty growths and do not appear to be associated with progression to cancer, more aggressive strains are more likely to be associated with cervical, head and neck, penile, vaginal, anal and rectal cancers.

HPV is thought to cause, each year:

• 10,751 cervical cancers.
• 635 vaginal cancers.
• 2707 vulvar cancers.
• 803 penile cancers.
• 5,957 anal cancers.
• 12,885 head and neck cancers.

How does a woman get tested for HPV?

Of all the cancers associated with HPV, only cervical cancer screenings have a well-established screening protocol so all women should take advantage of this. The American College of OB/Gyn currently recommends that screening begin at 21 years old. Currently, they recommend screening by a Pap smear (evaluating cells under the microscope after they have been collected by a gynecologist or other provider) and by checking for the presence of HPV (which can be tested on the same cells collected at the time of a pap smear) based on age and other risk factors. There is currently no blood or urine test for HPV.

Does HPV cause cervical cancer?

Yes. HPV is the main cause of cervical cancer. It is estimated that HPV is the cause of cervical cancer in 91% -100% of the cases.

Can men get HPV?

Yes. In fact, HPV is responsible for 18,280 HPV-related cancers in males every year.

Does having your male partner wear a condom prevent HPV?

Wearing a condom can decrease the spread of HPV and the risks of getting cancer from HPV when used consistently and correctly. It is still not able to prevent all oral transmission and is not able to eliminate the spread entirely.

How does HPV affect males?

Males can get genital warts, head and neck cancers, penile cancer, and anal-rectal cancers.

I understand there is a HPV vaccine. Who should get this and how often?

Because HPV is so common and is associated with so many cancers … most of which have no screening protocols so that they are caught at an early and easily treatable state, it is extremely important for everyone to receive a vaccine. The FDA has approved the HPV vaccine for all people 45 years old and younger.

Does HPV affect fertility or pregnancy?

HPV can affect fertility and pregnancy because some of the procedures needed to treat HPV can make it impossible or difficult to carry a pregnancy or for egg and sperm to unite in fertilization.

Is there a cure?

The HPV vaccine is currently the most likely way to “cure” the HPV virus with the aim to be a focus on prevention. Current data in women aged 27-45 years of age suggests there is an 88% reduction in persistent HPV infection, genital warts, vaginal and cervical pre-cancer or cancerous lesions. It is likely to be a much greater reduction if the vaccine is given at an earlier age when prior exposure has been lower.

Who tends to get HPV positive results?

• Have multiple sexual partners or partner who has multiple sexual partners.
• Engage in sexual activity at an early age.
• Have been pregnant many times.
• Have HIV.
• Are immunocompromised.
• Smoke.
• Have a history of other sexually transmitted infections.
• Have a history of contraception use.
• Have a low socioeconomic status.
• Have a poor diet.
• Are affected by alcoholism.
• Blacks have the greatest prevalence of HPV, followed by Hispanics.

Any closing thoughts or messages?

Yes, get your cervical screening (Pap smear) done without fail. Strongly consider receiving the HPV vaccine.

This is the opinion of Sharon West, a registered nurse in Asheville. Contact her at sharonkellywest@gmail.com.