People with HPV are at risk for developing genital warts and some cancers, said Debbie Saslow, managing director of HPV and gynecologic cancers at the American Cancer Society.
Saslow has spent nearly 25 years studying HPV and works to raise awareness about the HPV vaccine.
This conversation has been edited and condensed for clarity.
CNN: What Causes HPV?
Debbie Saslow: Almost everyone will get HPV at some point, and most people will not have any symptoms. Some types of HPV can cause warts on the skin, some can cause genital warts, and some can cause cancer.
The types of HPV that cause cancer are transmitted through intimate skin-to-skin contact, so it is primarily through sexual activities. The most common HPV cancer in women is cervical cancer. While some women may not be familiar with their cervix, many go to a gynecologist for cervical cancer screening with a Pap test or HPV test. The most common HPV cancer in men is throat cancer, although women can get it too. It is in the oropharynx, which is the back of the throat and the tonsils. The other four cancers are anal cancer in men and women, penile cancer in men, and cancers of the vulva and vagina in women.
Not that many people get to the point of having symptoms because screening tests are fairly common in the United States, but pain after sex and abnormal bleeding are two symptoms of cervical cancer.
CNN: How can people reduce their chances of getting HPV?
Saslow: Getting vaccinated can prevent more than 90% of HPV cancers and more than 90% of genital warts. It is recommended for boys and girls ages 9 to 12, but people up to age 26 can still get the vaccine.
Secondary prevention for women ages 25 to 65 with a cervix is a cervical cancer screening test. By finding it and treating or removing the cancer or cervix, you can actually prevent cancer.
The preferred screening method is an HPV test every five years. Unlike a Pap test, the HPV test predicts the future. For example, if someone is HPV positive for two years in a row, even if the cervical cells are normal, it is a sign that the infection could progress to precancer.
If someone has a negative HPV test, their chances of getting cervical cancer in the next five to 10 years are close to zero.
HPV testing is not recommended for men because there is no HPV test for men. The only exception is anal cancer. It is not a national recommendation, but the anal exam can be used for men who have sex with men. Condoms can slightly reduce the risk of HPV transmission. It is a good idea to use them anyway to reduce the risk of other viruses.
CNN: If someone has sex with multiple partners, should that person be tested more often?
Saslow: People who are sexually active with more than one partner at a time have a higher risk of getting HPV, but are not at higher risk if they get HPV, of getting pre-cancer or cancer faster than someone who got HPV from one partner. mutually monogamous partner.
The risk is higher but the detection interval does not change. The time from HPV infection to pre-cancer is a decade, so five years between screenings is really safe. The time from exposure to HPV infection to cancer is approaching 20 years, so we have a long time to find it.
CNN: What do you say to parents worried that their children will become sexually active sooner if they get vaccinated?
Saslow: There are many studies that show that it is not true at all. There have been studies in which researchers asked if there was a difference in the number of sexually transmitted diseases, the age that people started having sex, or unwanted pregnancies, and the general answer is no.
For parents who think this is true, do you tell your children when you are teaching them to drive not to fasten their seat belt because it will make them go faster? You don’t do that, and it’s exactly the same logic with the HPV vaccine.
We recently changed the wording of the guide to strengthen the recommendation to vaccinate at 9 years of age. It used to say to vaccinate at 11 or 12 years, or it can start at 9 years. Now we only say 9 to 12 years. Studies have shown that Offer the vaccine to a 9 or 10 year old child, parents are not thinking about their sexuality. When children are 11 or 12 years old, that is where parents’ minds tend to go.
CNN: Should College Students Get the HPV Vaccine?
Saslow: Remember that if the vaccine is not given before age 12, it is still recommended until age 26. Adults up to age 45 can ask their provider, but effectiveness drops dramatically around the college years, around age 18.
College is a good time to look for people who were lost or people whose parents chose not to vaccinate their children because then the person can make a decision for themselves.
By the time you get out of college, the effectiveness of this vaccine is low. Mainly, that’s because people are already exposed to HPV, and the vaccine only works before you’re exposed.