Your HPV and cancer prevention questions answered

The human papillomavirus (HPV) causes almost all cervical cancers and is linked to five other types of cancer: anal, penile, throat, vaginal and vulvar. And while there’s much that we know about HPV and cancer prevention, there’s also much to left to be researched and a great deal of misinformation.

To clear up confusion about HPV, HPV testing and cancer prevention, we spoke with Andrea Milbourne, M.D., professor and head of general gynecology in Gynecologic Oncology and Reproductive Medicine at MD Anderson.

What are the chances I’ve been exposed to HPV?

“A majority of people in the world have been exposed to HPV,” Milbourne says.

In fact, the chance of a man or woman being infected with HPV during their lifetime is 80%. But that isn’t cause for panic. For most people, the immune system eliminates it before it becomes a problem.

When should I get HPV testing?

Even though HPV exposure rates are high, HPV testing is not recommended for everyone because it’s likely that the virus will go away on its own without causing any health problems.

• Women ages 21 to 29 should have a Pap test every three years.
• Women ages 30 to 64 should have an HPV and Pap test every five years. (MD Anderson preferred). If you choose not to get HPV testing, get a Pap test every three years. A Pap test does not test for HPV. It tests for abnormal cells that may be caused by HPV. That's why MD Anderson prefers that women get both tests.
• Women age 65 or older may not need additional exams if you’ve had no unusual Pap or HPV test results in the past 10 years. Talk with your doctor to find out what tests are right for you. 
• There is not HPV test for men.

Currently, there is no oral HPV screening.  The tests that have been developed so far have not been successful indicators of HPV in men. But some healthcare providers do offer anal pap tests in men that can detect abnormal cells that would lead to anal cancer.

Do HPV tests and Pap tests prevent HPV?

A Pap test detects abnormal cells on the cervix that may lead to cervical cancer. An HPV test detects the presence of the HPV virus. Neither test can prevent or treat HPV infection.

“Once Pap tests were introduced in the 1970s, cervical cancer rates began to decline,” Milbourne says. “But they don’t actually prevent cancer.”

“The HPV vaccine is the best way to prevent HPV and the types of cancer it causes,” Milbourne says.

All males and females ages 9–26 should get the HPV vaccine. It is most effective when given at ages 11–12. Unvaccinated men and women ages 27–45 can also get the HPV vaccine and should talk to their doctor about the benefits of the vaccine.

Can I protect my children from HPV?

The best way to protect your children from HPV is with the HPV vaccine. The vaccine is recommended for preteen boys and girls at age 11 or 12 so they can be protected before ever being exposed to the virus.

If I was not vaccinated as a child, should I get the vaccine now?

If you have not been vaccinated and are under the age of 27, MD Anderson strongly recommends getting vaccinated. If you are between 27 and 45, you should talk with your physician about the benefits of getting vaccinated.

After age 15, three shots are required for the vaccine to be effective.

What should I do if I have HPV?

“First of all, don’t panic,” Milbourne says. “Just because you have HPV doesn’t mean you will get cancer.”

Of the millions of HPV cases worldwide, 500,000 become cervical cancer each year.

You’ll want to find out if you’re positive for high risk HPV and what type of HPV you have. Certain types of HPV are more likely to develop into cancer than others.

If you’re at high risk or a Pap test shows that you have abnormal cells, the next step is to undergo a colposcopy. During this screening exam a doctor will use a colposcope, an instrument with a magnifying lens, and a weak solution of acetic acid to examine the cervix. If doctors see any potentially cancerous or pre-cancerous areas, they will perform a biopsy. The biopsy results will determine what next steps, if any, are necessary.