HPV: A growing problem among sexually active women

By: By Chaz Kyser

Posted: 9/12/07

While most sexually active American women know the importance of getting tested for HIV, far too many are unaware of the need to also be screened for human papillomavirus (HPV), a virus that has the potential to also be life threatening.

According to the Centers for Disease Control and Prevention (CDC), HPV is a common virus that affects both males and females. There are more than 100 distinct strains of HPV and most types are relatively harmless, such as ones that cause warts on the hands and feet. However, about 30 types can be transmitted sexually; these are called genital HPV types. It is estimated that at least 50 percent of sexually active people will get genital HPV at some point in their lives, and 80 percent of women will have acquired it by age 50.

Doctors urge women to be screened for HPV because some of the types that are contracted sexually can cause cervical cancer. These are referred to as "high risk" types. The American Cancer Society estimates that in 2007, about 11,150 cases of invasive cervical cancer will be diagnosed in the US, and about 3,670 women will die from the disease.

HPV is easily transmitted and anyone who has had sexual activity involving genital contact can become infected-even with regular condom usage. Most people who have HPV do not show any signs or symptoms, unless they have genital warts, which is deemed a "low risk" HPV type.

Although men are just as likely to have HPV as women-and spread it-there is currently not a test for men. However, it rarely causes serious health complications in heterosexual males. Women can get screened for the virus along with their pap smear, which they are supposed to have annually.

"Annual exams allow the opportunity to educate women about their health care risks, as well as advantages of new health care technology," said Dr. Jeffrey Smith, a gynecologist in Oklahoma City who specializes in gynecologic oncology.

Some doctors automatically test for the virus; others just look for tell-tales signs that a woman may have it by looking for abnormalities on the pap smear. Smith says he routinely tests for it because it gives patients a better understanding of their risk. Between 20 to 25 percent of the 200 patients he has screened this year for HPV have tested positive. Approximately 15 percent of those had high-risk HPV.

If a woman tests positive for high-risk HPV she will most likely be given a colposcopy. During this painless, 10 to 15 minute procedure, the doctor uses a device called a colposcope-abinocular microscope through which a magnified view of the cervix can be seen under a bright light-to check for any abnormalities of the cervix, such as lesions, which may represent warts or per-cancerous conditions.

The majority of women who test positive for high-risk HPV don't have any abnormalities. This may be because their bodies have fought off the virus, or the virus simply has just not caused any detectable problems yet.

"Your immune system has the potential to fight off infection," Smith explained. "But if you become immunocompromised through smoking, being infected with HIV or taking steroids, or are chronically exposed to high-risk HPV types, you may not overcome the HPV infection."

However, Smith still stresses the need to be checked because one can't be sure the virus has not affected the cervix.

Women who test positive but have a clean colposcopy are normally asked to return back to the doctor within six months for another pap smear and test, instead of waiting a year for their next exam.

If lesions or abnormal looking cells are spotted, the doctor may remove a small sample of tissue for further analysis. Generally, doctors will set an appointment later to remove lesions and abnormal cells if they are pre-cancerous. If a woman already has invasive cancer she must work with her doctor to find the appropriate therapy to combat the disease. If it is detected early, cervical cancer is one of the most successfully treatable cancers.

Even though HPV is widespread among sexually active men and women, the number of people contracting it can be curtailed through being involved in monogamous relationships. Even if two people having sex both have HPV, it can go away because of the body's ability to fight the virus. Having partners outside of the relationship, or having sex with a new partner in a new relationship, may put one at risk for getting the virus again because of the significant risk of HPV infection associated with promiscuity or multiple sexual partners.

For girls and women who don't already have the virus there is good news. In June 2006, the FDA approved a vaccine called Gardasil that protects women from contracting four HPV types, which together cause 70 percent of cervical cancers and 90 percent of genital warts. According to the CDC, the vaccine can be given to girls as young as 9, and most insurance companies cover the vaccine for females age 9 to 26. Some doctors suggest that women who have already tested positive for genital HPV should still get the vaccine since they may not have been infected with all four types.

"This vaccine is a significant advance in the protection of women's health in that it strikes at the infections that are the root cause of many cervical cancers," said Andrew C. von Eschenbach, acting commissioner of the FDA.

For more information on HPV and cervical cancer, visit The National Cancer Institute at www.cancer.org, the Center's for Disease Control at www.cdc.gov, or The National Women's Health Resource Center at www.healthywomen.org.