HPV Vaccine in Bayside, NY
General frequently asked questions and answers about HPV.
HPV is the most common sexually transmitted disease in the world. HPV is a different virus than HIV and HSV (herpes). Most sexually active adults are exposed to the HPV virus during their lifetime. There are many different strains of HPV, which can cause health problems like genital warts and cancers. But there are vaccines that can stop these health problems from happening. If you’re looking for trusted HPV care in Bayside, NY, or exploring HPV prevention options, consider visiting a specialized clinic for more information.
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms. Anyone who is sexually active can get HPV, even if they have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected, which makes it hard to know when you first became infected.
In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause genital warts and cancer and is contagious. Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, flat or raised, and shaped like cauliflower. An experienced healthcare provider can usually diagnose warts by visual examination.
HPV is the cause of cancers of the cervix and anus. oropharynx (tonsils and tongue), penis, vulva and vagina. These cancers develop decades after a person first gets the HPV infection. The strains of HPV that cause genital warts are generally not the same as the strains of HPV that cause cancers.
There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems may be less able to fight off HPV and more likely to develop health problems from the infection.
Use condoms, stay in monogamous relationships stop smoking, get vaccinated, and get screened to make sure that you do not have a growth that is precancerous or cancerous.
The HPV vaccine is recommended for most individuals, especially those who are sexually active or have a higher risk of exposure. Adolescents and adults up to the age of 26 should consider vaccination, while older adults may discuss their risk factors with their healthcare provider to determine if vaccination is right for them.
Go to your physician and ask for an examination for this condition. The diagnosis of external genital warts in men and women is made by a visual examination which can be confirmed with a biopsy. The woman can get a Pap smear to determine whether there is cervical involvement. There is no approved screening test for HPV to tell whether it is in the throat or tongue.
Over 80 million Americans are currently infected with HPV and 14 million new people become infected every year. Most sexually active adults in the United States will have been exposed to an HPV infection during their lifetime.
HPV can be treated by cryotherapy (freezing), cauterization (burning), and surgical removal. Self-administered medications can be prescribed for external growth.
At Skin First Dermatology, we offer comprehensive HPV vaccination and treatment options in Bayside, NY. The HPV vaccine is an effective way to protect yourself against HPV-related health issues, including genital warts and certain cancers. Our experienced team is dedicated to providing personalized care to ensure your health and well-being. Ready to take the next step in prevention? Schedule your appointment with us today and safeguard your future health.
HPV Frequently Asked Questions and Answers
- There are several methods available to treat genital warts. The types of treatment approaches are divided into two categories: medical and surgical.
- Certain medical treatments are prescribed and self-administered, meaning the patient themselves has control of their own treatment.
- These treatments include: imiquimod (Aldara, Zyclara) sinecatechins (Veregen), and podophyllotoxin (Condylox).
- Chemical treatments that are applied by the physician in the office include trichloroacetic acid (TCA) and podophyllin.
- Surgical treatments include removal by electrodessication, curettage, surgical excision, laser removal and cryotherapy (freezing).
- The LEEP (loop electric excision procedure) is commonly used to treat internal growths in women. Ablative infrared coagulation has been used to treat HPV growths in the anal and rectal canal in men and in women.
- The choice of the treatment approach depends on the patient’s clinical presentation and the treatment preferences of the physician. There are advantages and disadvantages to each treatment method.
- A specific course of treatment will be recommended by the doctor depending upon the patient’s clinical presentation. Genital warts can be successfully treated with an excellent healing result when a methodical and comprehensive approach is used. HPV is a containable condition and when correctly treated patients with HPV can realistically look forward to a life free of daily stresses from this condition.
- There are several methods available to treat genital warts. The types of treatment approaches are divided into two categories: medical and surgical.
- Certain medical treatments are prescribed and self-administered, meaning the patient themselves has control of their own treatment.
- These treatments include: imiquimod (Aldara, Zyclara) sinecatechins (Veregen), and podophyllotoxin (Condylox).
- Chemical treatments that are applied by the physician in the office include trichloroacetic acid (TCA) and podophyllin.
- Surgical treatments include removal by electrodessication, curettage, surgical excision, laser removal and cryotherapy (freezing).
- The LEEP (loop electric excision procedure) is commonly used to treat internal growths in women. Ablative infrared coagulation has been used to treat HPV growths in the anal and rectal canal in men and in women.
- The choice of the treatment approach depends on the patient’s clinical presentation and the treatment preferences of the physician. There are advantages and disadvantages to each treatment method.
- A specific course of treatment will be recommended by the doctor depending upon the patient’s clinical presentation. Genital warts can be successfully treated with an excellent healing result when a methodical and comprehensive approach is used. HPV is a containable condition and when correctly treated patients with HPV can realistically look forward to a life free of daily stresses from this condition.
If one person has an HPV infection there is a significantly increased chance that their partner also has an HPV infection. The partner should be evaluated by a qualified professional so that the infection can be identified and treated before it has the chance to further progress. The incubation period for an HPV infection has been observed to range from months to over a year. The previously uninfected partner should have periodic evaluations w with their physician in order to ensure the early identification and treatment of a potential infection.
Genital warts often recur after treatment. Recurrences occur in the areas that were treated as well as in the normal appearing surrounding skin which may already be infected and where the virus is still incubating. Genital warts can grow out in areas that are completely different from the original infection site. The patient should be evaluated by their physician at periodic intervals in order to identify potential recurrences or new growths. Genital warts are highly contagious.
Many cases of genital warts spontaneously resolve on their own but there are risks to waiting to see if they do. First, although most cases of genital warts are caused by the low risk 6/11 strains, the high risk 16/18 strains can also present as genital warts. There is no definitive way to tell for certain visually which strains are in the genital warts. All parties would benefit if the growths containing high risk strains were removed.
Second, until the genital warts are removed, there is a high risk of infecting a partner. The infection may also spread on the body of an already infected individual to new previously uninfected areas on the same person. The infected individual can then be left with a more extensive infection that may eventually require more treatment than if the growths were removed at an earlier stage.
A person infected with genital warts must be especially mindful to practice safe sex until the warts are treated as well as for a certain period of time after treatment in order to ensure the early detection of an infection and to minimize the possibility of infecting a partner. A person with an HPV infection must be ever vigilant to take all possible precautions to not infect their partner.
Many cases of genital warts spontaneously resolve on their own but there are risks to waiting to see if they do. First, although most cases of genital warts are caused by the low risk 6/11 strains, the high risk 16/18 strains can also present as genital warts. There is no definitive way to tell for certain visually which strains are in the genital warts. All parties would benefit if the growths containing high risk strains were removed.
Second, until the genital warts are removed, there is a high risk of infecting a partner. The infection may also spread on the body of an already infected individual to new previously uninfected areas on the same person. The infected individual can then be left with a more extensive infection that may eventually require more treatment than if the growths were removed at an earlier stage.
A person infected with genital warts must be especially mindful to practice safe sex until the warts are treated as well as for a certain period of time after treatment in order to ensure the early detection of an infection and to minimize the possibility of infecting a partner. A person with an HPV infection must be ever vigilant to take all possible precautions to not infect their partner.
There is no cure for HPV. However, HPV is manageable and can be contained. Once a person has the infection, they always have the chance of getting a recurrence. Patients are advised to schedule periodic follow-up appointments to make sure that they do not get a recurrence. HPV can be successfully managed. The chances of HPV recurring, progressing, or infecting a partner can be effectively minimized. Safe sex and the use of condoms are critically important.
Patients should stay in good health, manage stress, and keep their immune system strong. HPV outbreaks are far more likely when the immune system becomes compromised and when they are severely stressed.
Condyloma acuminata
Genital warts (condyloma or condyloma acuminata) are flesh-colored or brown growths that may appear on the penis, anus, rectum, vulva, vagina, in the perianal area, pubic area, on the groin or on the thighs. They can present in many ways and look remarkably different although they are caused by the same virus. Genital warts may present as large or small growths that are distributed either singly or in clusters. They can have a rough, uneven surface and look like pieces of cauliflower or can present as small growths with a smooth surface. Genital warts can range from being flesh-colored to light, medium or dark brown. They are all very contagious. They can be large and noticeable or small, inconspicuous and hardly noticeable at all.
The term “papilloma” refers to a projecting finger-like growth. This is one of the more common ways that genital warts can present.
Genital warts are a dense collection of the HPV virus which grows in the external genital area
HPV infections and genital warts are usually not associated with symptoms. A person may occasionally have localized itching or irritation, but this is not common. Even when a person does see a small growth in the genital area, it usually is asymptomatic. Large genital warts can get irritated and itchy, but this is more the exception.
Many people who have genital warts are not aware that a growth is present or if they did see a growth, they may have thought that it was normal and nothing to worry about. The presentation of warts that have enlarged and rub up against clothing or folds of the skin and cause symptoms of irritation or itch is relatively infrequent.
Most people who have an HPV infection are not aware of the fact that they have an infection at all and are unintentionally infecting their partners.
Acetic acid (5%) in a vinegar-type of solution that is applied on moistened gauze to the genital areas. Genital warts my absorb the vinegar and turn white, making them easier to see and identify. The application of acetic acid is a screening test and is not firmly diagnostic. Factors that can make an area turn more white include any type of rubbing, irritation, allergies, and benign skin rashes. The only way to know for certain what a certain growth or skin change is would be to do a diagnostic biopsy.
Genital warts that present an extensive number of growths are more likely to be associated with the low-risk strains. The low-risk strains are extremely contagious but have an extremely low chance of progressing into cancerous or precancerous conditions.
Genital warts that present an extensive number of growths are more likely to be associated with the low-risk strains. The low-risk strains are extremely contagious but have an extremely low chance of progressing into cancerous or precancerous conditions.
Genital warts that present an extensive number of growths are more likely to be associated with the low-risk strains. The low-risk strains are extremely contagious but have an extremely low chance of progressing into cancerous or precancerous conditions.
Genital warts (also referred to as venereal warts or condylomata) are the most recognized form of genital HPV infection. Approximately 1% of sexually active people in the United States have genital warts at any one time.
Nearly 1 million new cases of genital warts occur each year in the United States. 90% of all genital warts are caused by the low-risk HPV6 and 11 strains.
Many people with genital warts frequently do not have symptoms and are unaware that they have any growth at all. A person may realize in retrospect after the genital warts have been identified that these growths had been present for a long time although they thought that they were normal and nothing to worry about.
Genital warts can cause symptoms if they enlarge, rub against clothing, and get irritated or infected. They rarely bleed.
Genital warts are generally not dangerous. The vast majority of genital warts are caused by low-risk strains of HPV. 90% of these strains are specifically associated with the low risk HPV 6/11 strains. Genital warts can on occasion be caused by the high-risk HPV 16/18 strains, which do have the potential to progress into precancerous or cancerous growths.
A very small percentage of growths presenting as genital warts are caused by high-risk strains. In addition, 10% -20% of genital warts are caused by mixed infections which are caused by high and low risk strains.
Genital warts are usually highly contagious.
The genital growths associated with the high-risk strains are called Bowenoid papulosis. Bowenoid papulosis lesions are usually smaller and fewer in number compared to genital warts caused by the low-risk strains. The genital growths associated with the low-risk strains tend to be greater in number, larger in size, and are highly contagious. The only way to document with certainty whether the growth contains high or low risk strains is to do a biopsy and to get HPV DNA typing.
A study was performed where several thousand cases of genital warts in men whose female partners had an HPV infection were biopsied. 6% of the biopsies showed microscopic signs consistent with squamous cell carcinoma (Bowenoid papulosis). The vast majority of these biopsies contained high-risk strains.
You need to be evaluated by your doctor, have them treated and use protection at all times. You need to be mindful of the fact that condoms do not protect against those areas not covered by the condom. In addition, condoms can break, can ride up against the shaft of the penis and leave the base of the penis exposed. Nonetheless, condoms represent the best barrier method of protection currently available.
Most genital warts go away on their own without treatment. Although you can always wait and see what happens, you need to be mindful that there are potential downsides associated with doing nothing.
Genital warts are highly contagious. There is a chance that they will spread to new previously uninfected areas on the patient, resulting in an even more extensive infection covering a larger surface area. The infected patient will now have a greater chance of infecting their partner, require more treatment sessions and may experience more recurrences of the infection.
You may infect your current and/or future partner(s) during the time that you are waiting to see if the warts will go away on their own. The greater the number of growths and the larger the area involved will result in a greater risk of infecting a partner. The new locations where the infection spread will become additional future sources of asymptomatic infection even if the visible growths go away or the infection may progress into larger genital warts.
The only way to know whether you have high or low risk strains is to have the growth(s) biopsied and to have your doctor request that HPV DNA typing be done on the specimen
The more common locations where genital warts can occur include the penis, vulva, vagina, anus, rectum, buttocks, groin, pubic area, thighs and on the lower abdomen.
The strains of HPV are referred to by number rather than by a name. The two most common strains of low-risk HPV are 6 and 11 (6/11). These two strains represent 90% of the all the low-risk genital strains which exist.
Low risk strains cannot change their chemical structure and turn into high-risk strains. The chances of a low-risk strain turning into cancer are very low. 10% -20% of genital warts are mixed infections which include both high and low risk strains. The high-risk strains in mixed infection can cause cancerous or precancerous growth.
1% of HPV infections result in genital warts.
Cancer of the penis is rare in the United States. When cancer of the penis does occur, it almost invariably occurs on an uncircumcised man.
Genital warts generally do not lead to cervical cancer. 90% of genital warts are caused by the low risk HPV strains 6 and 11, which have a very low risk of progressing into a cancer of the cervix.
Up to 20% of infections are “mixed infections” which may contain both high and low risk strains of HPV. Although some of the growths detected may look like classical genital warts, they may also be harboring the high risk 16 and 18 strains.
High risk strains in genital warts can grow into cancers of the anus, rectum, oropharynx, penis, cervix, vulva, and vagina.
A classic genital wart that is a mixed infection containing both high and low risk strains of HPV can progress into cancer or pre-cancer. Women and men with mixed infections need to continue to be monitored.
High risk strains in genital warts can grow into cancers of the anus, rectum, oropharynx, penis, cervix, vulva, and vagina.
The incubation period refers to the period of time between when a person is first exposed to the infection nil the time the infection can be detected. The incubation period is usually 3-6 months after exposure but can range anywhere from two weeks to eight months and can sometimes be even longer.
Genital warts are very contagious. A person who already has warts can spread the infection to previously uninfected areas on themselves in multiple ways, including in areas where they wear tight clothing, from abrasion during exercise or sports, drying themselves with a towel vigorously after taking a shower and even by cleaning themselves very thoroughly but perhaps too hard after a bowel movement.
Yes, you can be contagious during the incubation period. The incubation period averages 3-6 months, but an HPV infection can be established in as little as 2 weeks and as late as 8 months later, or longer. Small and barely noticeable lesions may be less contagious than dozens of large barnacles, but they are contagious nonetheless and they can serve as a source of infection to your partner.
You can be contagious even if you do not see any growths. Many people shed infectious viral particles even though they do not have any readily identifiable signs or symptoms of HPV. In addition, small growths are not infrequently present, although they can be difficult to see.
Anybody of any age who has sex or physical contact with a person who has an HPV infection can contract an infection. Up to 80% of people who are sexually active will get HPV by the time they are 50 years old.
People of any age, gender, or sexual orientation can get an HPV infection. The greatest frequency of HPV infections is seen in young adults and teenagers.
Teenager and young adults are in the years of experimentation when people are more likely to have a greater number of sexual contacts and are less likely to use condoms. 50% – 75% of all people who have HPV infections are between 15-25 years old.
Sexual intercourse is the most common form of transmission of HPV, but it can also spread from genital rubbing that may occur with foreplay or any type of skin contact. Virgins have ben observed to develop genital warts as well as abnormal Pap smears.
Most HPV infections are transient and go away on their own. If and until they do go away on their own, the person with the HPV infection may be highly contagious. Sexual contact should be minimized during this time and safe sex should be practiced. Many people opt to seek treatment rather than go through a period of abstinence and uncertainty concerning whether the infection will actually go away.
A number of people have HPV infections that persist and do not spontaneously resolve. These people have active infections which continue to be contagious and their partners may be infected after sexual contact.
If you choose to not get evaluated and treated after exposure you need to take full precautions in order to minimize the chance of transmitting the infection to somebody else. You may be highly contagious during this time.
The average HPV infection lasts for several months. The average low risk HPV infection lasts for 6 months and the average high risk HPV infection lasts for 12 months.
Many people do not have a good natural immunity to HPV infections and have active infections that can persist for years. People who choose not to get treated need to take maximum precautions in order to minimize the chances of transmitting the infection to their sexual partner(s).
Any new or old growths in the genital area should be checked out. Just because a bump has been present for a while does not necessarily mean that it is harmless.
You should go to your doctor to be evaluated. If your partner has an HPV infection you in turn have a much greater chance of also being infected.
HPV infection s can be highly contagious If a woman has a positive Pap test her male partners needs to be evaluated because he now has an increased chance of developing genital warts. A woman whose male partner has genital warts has a higher chance of getting an HPV from him.
Two people who have been monogamous for a long period of time can develop an HPV infection. HPV can lay dormant for years and then get reactivated when a person may be tired, worn-down, stressed-out o have other conditions that predispose to reactivation. The partner with the old, reactivated infection is now at risk of giving it to their partner.
Factors which can reactivate a latent infection include tiredness, fatigue, illness, stress, certain medications or an immunocompromised state.
Everybody who has the high-risk strains does not develop cancerous or precancerous growths. Only a small percentage of high-risk HPV strains actually progress and cause a cancer.
An abnormal Pap smear is not necessarily caused by high-risk strains. Most Pap smears go back to normal on their own and do not require immediate treatment. The doctor may obtain a new Pap smear several weeks or months later in order to evaluate whether abnormalities are still present. Treatment may be necessary if an abnormal Pap test persists over time.
The infections which are of greatest concern are those that continue to persist over time and do not resolve. These infections need to be carefully monitored because they have been associated with an increased chance of evolving into cancerous or precancerous growths.
It can take several decades between the time the person is first was exposed to the infection and the time that it takes for a cancer to develop. The most common age range in which women are diagnosed to have cervical cancer, for example, is when they are 35-50 years old. This indicates that these women most likely contracted the infection when they were young adults or even during their teenage years. Anal, rectal and oropharyngeal cancers also develop several decades after the patient first contracts the HPV infection.
Women or men who are immunocompromised are at increased risk of developing infections, which tend to require more treatments and be associated with a greater number of recurrences. People who are immunocompromised and have high risk strains of HPV are also more likely to develop more aggressive cancers.
Genital warts in women or men who are immunocompromised are associated with a greater number of growths, more extensive involvement, more frequent recurrences, and a more aggressive natural history. Nonetheless, with proper treatment and monitoring, these infections can be managed and contained.
You need to go to your physician so that you can be properly evaluated and treated. Early diagnosis and treatment are important. Like many things in life, the most important thing is just showing up.
Low risk strains like 6/11 have an average duration of approximately 6 months.
High-risk strains like HPV16/18 have an average duration of 12 months. This means that 50% of patients are positive for the high-risk strains of HPV for one year or more before and if they resolve. Many patients are contagious for even longer periods of time. Their partners continue to be at risk of contracting the infection during this time and safe sex should be practiced.
All HPV infections do not eventually go away on their own. The infected partner may have a persistent infection that does not re- solve on its own and this person continues to be contagious to others. Other people have only a partial spontaneous resolution of the infection and also continue to be contagious. The person who has the genital warts can infect their partner(s) as long as the infection is active.
The person who has the genital warts can continue to spread the infection from the localized area(s) originally infected to the normal uninfected skin surrounding the warts. This will result in an even more extensive infection. Treatment will the be even more challenging and the infection even more contagious if the infection spreads to new locations.
You cannot accurately predict whether an infection will or will not go away on its own. You have to consider yourself contagious during this time if you decide to wait it, safe sex practices need to be taken with your partner in order to minimize the chance of infecting them.
More extensive infections which involve a greater number of growths over a large surface area are more likely to recur and less likely to spontaneously resolve. HPV infections in men who are uncircumcised tend to be more persistent and associated with higher recurrence rates after treatment than in men who are circumcised. Growths which contain the high risk HPV infections are also more likely to persist in uncircumcised men compared to circumcised men.
You should see your doctor and have them monitor your progress. Many HPV infections are difficult to detect with the naked eye. Physicians are able to examine the area carefully with magnifiers, are able to get closer to the areas that need to be examined than you are and also have more experience differentiating the normal from the not normal. In addition, there are areas that are out of your sight line which you cannot see during self-examination.
Many people with HPV infections don’t have readily apparent signs or symptoms of infection may nonetheless be asymptomatically shedding the virus which can still cause an infection in their partner(s). There are various tests that can accurately evaluate the presence of infection. You need to discuss this at length with your doctor.
The median time for HPV infection to grow into a genital wart is 3-6 months. This is called the incubation period. The incubation period ranges from 1-8 months but in some cases growth can be detected as early as 2 weeks after contact while in other cases growths are not detected until over a year after contact.
There are a number of different screening tests available for women which will result in the early detection of HPV infections. These screening tests include Pap smears and HPV DNA tests. Cancers and/or infections can be detected early and a treatment plan can be initiated before the infection has the chance to further progress.
The average HPV infection lasts at least 6 months. Low risk HPV infections have an average duration of 6 months. High risk HPV infection have an average duration of 12 months.
HPV infection are frequently transient and can resolve on their own without being treated but may be highly contagious during this time. The genital warts may decrease substantially in size but still be contagious. Maximum precautions should always be taken in order to protect your partner.
Anal warts are growths that occur on the skin outside the anus, on the anus, and/or extend into the anal canal. They are caused by an HPV infection, the same infection which causes genital warts.
People may notice or feel a bump or growth on the anus or inside their anal canal. Anal warts usually do not cause discomfort or pain. Patients may experience symptoms of itching, bleeding, discharge, or a sensation of pressure around the anus. The growths may go away on their own, get larger or stay the same. They are frequently highly contagious and may infect the normal surrounding skin. The actual sites of infection are usually more than can be visually identified because they may have already infected the nor- mal surrounding skin and are still incubating.
Anal warts are predominantly caused by anal sex. More women than men get anal warts because a greater number of women have receptive anal sex than gay and bisexual men, who constitute a much smaller percentage of the population (CDC).
Anal intercourse is the most common cause of anal warts. People can also develop anal warts from being touched with fingers, whether during sexual foreplay or when cleaning or bathing. The HPV virus has been identified to be present beneath the finger- nails. Good hand hygiene is especially important for a person with a genital HPV infection because they may inadvertently spread the infection to a partner or to other sites on their own bodies.
According to the CDC, 20% – 40% of heterosexual couples have engaged in anal sex at least once. 10% of heterosexual couples practice anal intercourse on a regular basis. Women have receptive anal sex in greater numbers than men who have sex with men, because gay men represent a much smaller percentage of the population. The incidence of anal warts continues to increase in both women and men.
The anatomic proximity of the vaginal opening to the anus in women facilities non-sexual ways of transmission. Leakage of infected vaginal secretions may infect the anus in this manner. The use of sex toys can also cause anal HPV infections.
HPV DNA in heterosexual men has been detected in the anal canal 16% of the time and in the perianal area 21% of the time. One-third of patients with anal HPV have the high-risk strains.
There is a baseline prevalence of 27% anal HPV infection in HIV negative women. 70% of these women were noted on follow up to develop an anal HPV infection.
Natural history studies show that the median duration for infection with a high-risk strain was 150 days (5 months). Anal infection cleared without treatment in 87% of women within one year. This is a shorter time than the clearance rate for the cervix, where 90% of HPV infections take 2 years to clear.
Both oncogenic and non-oncogenic anal HPV infections cleared on average in about 7.5 months. HPV 16, the strain most prominent in cervical cancer as well as in several other cancers, lasts just over 12 months. Men with a higher number of female sex partners took longer to clear both high risk and low risk HPV stains. Men who are older are able to clear high risk HPV infections more quickly than their younger counterparts
The average latency period of the virus ranges from one to eight months. There are reported instances of HPV which had a latency period of over one year.
Infection of the anal region with HPV in both heterosexual men and non- HIV infected women is relatively common and is increasing.
Most cases of anal warts are consist of low risk HPV strains (6/11), which can grow large, are very contagious but are benign and do not cause cancer. If a person has a mixed infection that consists of both low and high-risk strains, however, the high risk strains still have the potential to progress into cancer.
A person who is infected with the high-risk strains of HPV is at increased risk of the infection progressing into a cancer of the anus or rectum. 90% of anal cancers are caused by the high-risk strains (16/18). HPV 16 is responsible for most cases of anal cancer. Treatment of anal cancer is over 80% successful if the growths are treated early.
HPV can be transmitted through any sexual activity that involves skin-to-skin or skin-to-mucosa contact including vaginal, anal, and oral sex. Both symptomatic and asymptomatic individuals can transmit HPV to their sexual partner.
More than 50% of sexually active women in the U.S, are estimated to have been infected by one or more genital HPV types at some point in their lifetime. Heterosexual HIV negative adult men have been shown to have an overall HPV prevalence of approximately 50%. Concordance of HPV between sexual partners is variable and ranges from 40% – 60%, which may be affected by length of sexual relationship, frequency of intercourse, condom use and number of lifetime sexual partners.
HPV infection s can be highly contagious If a woman has a positive Pap test her male partners needs to be evaluated because he now has an increased chance of developing genital warts. A woman whose male partner has genital warts has a higher chance of getting an HPV from him.
HIV negative women, including those with both low and high-risk HPV strains, have a greater incidence of anal HPV infection than cervical HPV infection. The prevalence of anal HPV infection in HIV positive women has also been demonstrated to be even higher than the prevalence of cervical HPV infection.
HPV in the anal canal of women is not uncommon. Women have higher rates of anal HPV than cervical HPV. Most of the anal infections are probably due to anal intercourse. These women should continue to be screen in order to ensure the early identification of disease.
The presence of high-risk HPV significantly increases the chance of developing anal warts. A synergistic relationship between the high risk and low risk HPV infections may be present. Woman with multiple types of anal HPV infections are more likely to con- tract additional infections as well as more likely to clear HPV infections faster than women infected with only one HPV type.
Treatment – Anal Warts
There are several methods available to treat genital warts. The types of treatment approaches are divided into two categories: medical and surgical.
Certain medical treatments are prescribed and self-administered, meaning the patient themselves has control of their own treatment.
These treatments include: imiquimod (Aldara, Zyclara) sinecatechins (Veregen), and podophyllotoxin (Condylox).
Chemical treatments that are applied by the physician in the office include trichloroacetic acid (TCA) and podophyllin.
Surgical treatments include removal by electrodessication, curettage, surgical excision, laser removal, cryotherapy (freezing) and IRC (infrared coagulation).
Ablative infrared coagulation (IRC) is a treatment option to treat HPV growths in the anal and rectal canal in men and in women. The choice of the treatment approach depends on the patient’s clinical presentation and the treatment preferences of the physician. There are advantages and disadvantages to each treatment method.
A specific course of treatment will be recommended by the doctor depending upon the patient’s clinical presentation. Genital warts can be successfully treated with an excellent healing result when a methodical and comprehensive approach is used. HPV is a containable condition and when treated correctly patients with HPV can realistically look forward to a life free of daily stresses from this condition.
The treatment of anal warts can in almost all cases be done in the office. The patient can return to work the same day. Patients are usually in and out of the office in an hour or less. The treatment is safe and the risks are minimal.
The treatment of anal warts if covered by insurance because it is a medically necessary service.
Anal Cancer
The risk factors for anal cancer include receptive anal intercourse, sexual orientation, multiple partners, lack of condom use, being uncircumcised and having sex with men who are not circumcised, smoking, passive smoke exposure, race, ethnicity, and educational level.
The number of anal cancers have doubled in the last decade and the number is continuing to rise. MSM and HIV positive men and women have seen the most dramatic increase in anal cancers and have had the lowest survival rates.
The treatment of anal warts can in almost all cases be done in the office. The patient can return to work the same day. Patients are usually in and out of the office in an hour or less. The treatment is safe and the risks are minimal.
Specific risk factors for a women include having had receptive anal intercourse, multiple partners, lack of condom use, sex with a man/men who are uncircumcised, smoking, passive smoke inhalation, and/or if the woman has a history of having had cervical, vulvar or vaginal cancer.
HPV is responsible for 100% of cervical cancers and 90% of anal cancers. The majority of anal cancers are caused by HPV 16 or 18. HPV is a small un-enveloped, double-stranded DNA virus with over 100 different genotypes or strains identified. At least 30 of these HPV strains are sexually transmitted and infect the top layers of the skin of the genial tract.
Anal cancer like cervical cancer, is preventable and curable, especially if treated in the early stage of disease.
Pain or tenderness in the area around the anus, which can be constant or occur only with bowel movements or receptive sex Bleeding with bowel movements
Lump or hard area on the outside of the anal area that appears to be increasing in size
Itching or discharge from the anus
Pain or a sense of fullness and a constant need to go to the bathroom which may occur as tumors grow and begin to invade the sphincter muscle
The Anal Cancer Foundation published the numbers that appear below:
HPV-associated anal cancer | 3,286 women and 1,916 men every year.
|
Cervical cancer | 10,976 women/year
|
Oropharyngeal cancer | 8,586 cases/year in men of HPV associated. 1,881 cases/year in women of HPV associated
|
HPV-associated penile cancer
| 749 men/year
|
HPV-associated vaginal cancer
| 830 women HPV associated each year
|
HPV associated vulvar cancer
| 2,840 women/year |
Anal HPV Infections and Cancer in the Gay Population
Men who had sex with men (MSM) have a higher risk of getting anal warts. HIV positive gay men are at the highest risk of having persistent HPV throughout their lives. Gay, bisexual and HIV positive men have a higher risk of getting anal cancer than women or heterosexual men diagnosed with anal HPV infections.
Men who have sex with men (MSM) have the highest risk of developing anal cancers. The risk of anal cancer in MSM who HIV are negative and have a history of receptive anal intercourse is similar to the incidence of cervical cancer prior to the introduction of the Pap smear which allowed early detection and treatment of the condition.
HIV positive men have a significantly increased risk of developing anal cancers compared to MSM who are HIV negative.
HIV+ individuals now have the benefit of more effective medications which have allowed HIV status to become a chronic disease because of increased survival rates. Most MSM have anal HPV infections. Almost all HIV positive men have HPV infections. Anal cancers have an incubation period that can be 20 years or longer. HPV positive men used to die before anal cancers could develop be- fore effective anti-HIV medications were developed. HIV positive men now live longer and during the additional time in these men’s lives more anal cancers will develop. These individuals need to be diagnosed early so that proper treatment can be initiated.
HPV is responsible for 100% of cervical cancers and 90% of anal cancers. The majority of anal cancers are caused by HPV 16 or 18. HPV is a small un-enveloped, double-stranded DNA virus with over 100 different genotypes or strains identified. At least 30 of these HPV strains are sexually transmitted and infect the top layers of the skin of the genial tract.
There are approximately 37 million people worldwide living with HIV at the end of 2014. There are 1.2 million HIV infected individuals in the United States. Approximately 1% of women and 28% of men with anal caner also have an HIV infection. Cancer is estimated to be responsible for over one-third of all deaths in HIV infected individuals The immunosuppression associated with HIV infection reduces the ability to control the oncogenic viral process, which explains the greater risk of infection-related cancer.
Prior to the availability of high actively antiretroviral therapy (HAART), the estimated incidence of anal cancer amongst HIV infected MSM was 60-fold higher than men in the general population. The incidence of anal cancer in HIV infected MSM is now estimated to be 80x higher than men in the general population. This increase in incidence of anal cancer has been shown to be associated with the HIV epidemic in men. The incidence of HPV associated anal cancer has increased in the HAART era because more HIV positive men are living with HIV because they are not dying from opportunistic infections and other conditions.
Anal cancer is a relatively uncommon cancer. In the HIV positive MSM and HIV positive woman, however, it is a not uncommon cancer. HIV positive MSM (men who have sex with men) have an incidence of anal cancer that is 10x the incidence of cervical cancer in the general population of women who are not HIV positive.
Now that we are in the antiretroviral therapy (ART) era, the focus has shifted to get chronic complications of HIV infection under control. It takes many years for an HPV infection to progress to cancer. This progression was not a pressing issue in the past because people who were HIV positive did not live long enough for this to become a concern. The introduction of highly efficacious anti- retroviral medications have enabled HIV positive individuals to live a relatively normal lifespan. The attentive evaluation and treatment of patients for chronic complications of HIV is now more pressing.
Anal cancers are preventable. The incidence of anal cancer went up in the HAART (highly active anti-retroviral therapy) era rather than down because as more patients lived the high-risk HPV growths had the opportunity to progress into anal cancer.
HIV positive men are more likely to have high risk HPV strains than men who are not HIV positive. 93% of HIV-positive men have been found to have at least one HPV type compared to 64% of HIV-negative gay men. 74% of HIV positive men had at least one high risk HPV type, compared to 37% of HIV-negative men.
HIV infection increases the risk of HPV infection. It has also been observed that HPV increases susceptibility to HIV infection. Successful treatment of HIV may reduce the risk of anal cancer for men living with HIV
The incidence and prevalence of genital warts in men decreases with age. Nonetheless, older MSM still remains at risk for genital warts. Recurrence, defined as reappearance of genital warts within 12 months after complete clearance, ranges from 4% – 50%, de- pending on the treatment used and the immune competence of the patient. Older MSM are more likely to have been exposed to HPV in the past and over 50% are noted to be positive for oncogenic (high risk) HPV. A large study of HIV-negative MSM found 26% prevalence of non-oncogenic (low risk) HPV types and 26% prevalence of oncogenic (high risk) HPV types within the anal canal across all age groups.
In MSM who are HIV negative, 45% of those with anal HPV infections were infected with more than one HPV types, with both high and risk types present in lesions.
Category
| Approximate prevalence rate
|
Prevalence in HIV-negative gay men
| 60%-75%
|
Prevalence in HIV-positive men
| 80% – 100%
|
Prevalence in men with multiple types of HPV, including high-risk types in HIV-negative gay men.
| 25%
|
Prevalence in men with multiple types of HPV including high risk types in HIV Positive men.
| 60%
|
Incidence of anal cancer in HIV-negative gay men
| 35/100,000 men
|
Incidence of anal cancer in HIV-positive Gay men
| 70/100,000 men
|
Incidence of anal cancer in general population
| 1-1.5/100,000 men
|
Anal cancer occurs 20x more frequently in gay men than heterosexual men.
Anal cancer occurs over 60x more frequently in HIV gay men than in heterosexual men.
Many genital warts as well as cervical cancer precursors resolve on their own without treatment. There is an ongoing debate about whether anal -precancers should be monitored or treated.
There is a higher prevalence of high-risk strains in the anus than in cervical lesions or genital warts. The lesions which are observed have a considerably greater chance of progressing into anal cancer. The most conservative approach is to treat the patient who has an anal precancer because patients often get lost to follow up and by that time the lesion may have advanced considerably or patients do not come for follow up until the lesions are considerably larger, more pronounced and a later stage of development.
Vaccination
The HPV vaccine is preventive but is not therapeutic. The HPV vaccine offers protection against those strains of the virus to which a person was not previously exposed. The best hope for future generations is that young people get vaccinated at an early, age, before they have had many sexual contacts.
The vaccine provides close to 100% protection against genital warts and pre-cancers. The HPV vaccine contains seven high risk strains of HVP that protect against over 80% of the strains that cause HPV-related cancers. The vaccine includes the high risk strains 16 and 18. People who get vaccinated will be protected from both high and low risk anal HPV infections. 90% of anal cancers are made up of HPV 16/18. HPV 16 is the strain involved in the majority of cases of anal cancer.
The vaccine is the most hopeful solution for the next generation.
The FDA (Food and Drug Administration) approved the HPV vaccine to prevent initial infection against HPV 6, 11, 16, and 18 in women in 2006. The FDA approved the vaccine for men in 2009. The vaccine has been demonstrated to be highly efficacious in pre- venting genital warts as well as the precursor stage to anal cancer. Additional high-risk strains have since been added to the vaccine in order to give an individual an even greater immunity and protection against strains that can cause cancer.
The benefits of the HPV vaccine in males include the reduction of HPV-associated disease (genital warts and cancer) in boys and men and the prevention of the transmission of the HPV virus to women.
HPV vaccine demonstrates 70% efficacy against external anogenital condyloma and 57% against intra-anal condyloma amongst MSM 26 y/o and younger.
The HPV vaccine was demonstrated to decrease the risk of anal genital warts in older MSM. The lifetime risk for developing anal cancer was reduced by 60%. The HPV vaccine in men is currently FDA approved only for men 9-26 y/o but in light of this data should be considered for off label use.
A 47% decrease in recurrence of genital condyloma related to HPV types found in the vaccine was seen in women who received the HPV vaccine. The study did not reach statistical significance.
Oropharyngeal cancers include cancers of the tonsils, the base of the tongue, the palate and the back of the throat. HPV is the cause of 70% of the new cases of oropharyngeal cancers. The frequency of HPV-related oropharyngeal cancers is increasing. Most oropharyngeal cancers are associated with high risk 16/18 strains. HPV 16 is the most common strain associated with oropharyngeal cancers. In the past, most people who developed oropharyngeal cancer were elderly, had a history of tobacco and alcohol use and had a form of oropharyngeal cancer not related to HPV. Most people diagnosed with oropharyngeal cancers related to HPV are younger and do not have a history of heavy tobacco or alcohol use.
The vast increase in oropharyngeal cancer incidence rates is due to increased frequency of oral sex over the years. The oropharyngeal cavity is an area in which the HPV virus can thrive. Men are several times more likely to develop this condition than women and also develop a more aggressive form of oropharyngeal cancer than women.
The incidence of oral cancers in men is now greater than the incidence of cervical cancer in women. This is in large part due to the success of screening tests like the Pap smear which allow for the early detection and prevention of cervical cancer in women. There is no effective screening for oropharyngeal cancer at this time.
The HPV vaccine is expected to have a protective effect against oropharyngeal cancers caused by the same high-risk strains that have been demonstrated to effectively decrease the incidence of precancerous cervical lesions in women. The effectiveness of the HPV vaccine against oropharyngeal cancer continues to be studied
The HPV vaccine protects against contraction of the HPV virus and is specifically targeted towards the HPV strains most likely to cause genital warts and cancer.
Clinical studies have documented that the vaccine provides close to 100% protection against genital warts and pre-cancers. HPV-related cancers take 20+ years to incubate within the body.
The vaccine is effective in preventing genital warts and pre-cancers in almost all cases. However, the vaccine offers varying degrees of prevention. The two low-risk strains of HPV in the vaccine which cause genital warts offer protection against 90% of the low risk strains
The seven high risk strains of HPV in the vaccine protect against 80% of the strains that cause cervical cancer and an higher percent- age of protection against certain other cancers. The high-risk HPV strains in the vaccine represent the most aggressive high-risk strains that exist so the individual who is vaccinated is protected against the most dangerous strains.
The vaccine is preventive but is not therapeutic. The vaccine will not help decrease the infection from strains that the patient had before being vaccinated. The vaccine will protect only against those strains to which a patient has not been exposed to previously.
The HPV vaccine is most effective for those people who have not yet been exposed to the HPV strains in the vaccine. People are encouraged to get the vaccine before they are sexually active or before they have had many sexual contacts.
Adolescents ages 9-14 are advised to get two vaccines over a 6-12-month period. Teens and young adults ages 15-26 need to get three vaccines over a 6-month period.
The vaccine will only give a person protection against those strains in the vaccine to which they have not been previously ex- posed. The older that a person is the greater the chances are that they had already been exposed to at least one if not several of the strains of HPV. The vaccine will be more effective against more strains of the virus in a person who has had fewer partners. This explains why the vaccine is most effective in people who are younger and/or have had less sexual experience.
The man who is vaccinated will be able to avoid any one of many negative psychological aspects of having a sexually transmitted disease. He will avoid the embarrassment and discomfort of informing his current or future partner(s) that has an infection. The man who is vaccinated and protected from HPV infection will be able to avoid the time, hassle and cost of visiting doctors in order to be treated.
The vaccine is not inexpensive but is covered by insurance for men up to the age of 21-26 years of age. The advantages of getting the HPV vaccine far exceed the disadvantages of the long-term expense, time, and the emotional and psychological hassles associated with having an HPV infection
Men can get genital warts as well as cancers of the anus, rectum oropharynx and penis.
The most frequently seen HPV-related condition that men can get are genital warts. Genital warts are usually caused by low-risk HPV strains. HPV strains 6 and 11 are the most common HPV strains and represent 90% of the causes of genital warts.
In men, HPV causes cancers of the penis, anus and rectum that are associated with the high-risk strains of HPV. HPV 16 and 18 rep- resent about 70% of the HPV strains that cause these cancers. Cancers of the oropharyngeal region are also seen more frequently in men than in women, and those cancers are caused almost exclusively by HPV 16 alone.
The vaccine is strongly recommended for gay and bisexual men and men through the age of 26. The vaccine is most effective when given at a younger age and before a person has had many sexual contacts.
The protection against HPV infection is the same in the gay and heterosexual men. Both heterosexual and gay men who will bene- fit most from the vaccine are those people who have not been exposed to those strains in the vaccine to which they have not been previously exposed.
Gay men on average have a greater number of risk factors that can predispose them to increased chances of HPV infection, which includes both genital warts caused by the low-risk strains and HPV-related cancers related to the high-risk strains. The cancers of the anus and rectum which occur in gay men are more aggressive and resistant to treatment than those observed in the heterosexual population.
Gay men have a greater number of sexual partners and practice high-risk sex more frequently than in the heterosexual community.
Genital warts are extremely common in the gay community and occur more frequently in gay men than in heterosexual men.
Gay men who have been vaccinated have a statistically significantly decreased chance of getting genital warts as well as precursors to anal cancer. The social and psychological advantages of getting the vaccine are similar to those for straight men.
Genital warts occur much more frequently in gay men than in heterosexual men.
The risk of anal and rectal cancers is 30x greater in gay HIV negative men compared to heterosexual men. The incidence of anal and rectal cancers in the HIV+ population is 80x greater than in heterosexual men.
Yes. Gays are a high-risk group for getting HPV infections.
The prevalence of both high risk and low risk HPV strains is significantly lower in circumcised men when compared to uncircumcised men. Circumcised men do not develop genital warts or condyloma as frequently as uncircumcised men.
The partners of circumcised men have a lower chance of contracting an HPV infection than the partners of uncircumcised men. Genital warts recur more frequently in uncircumcised men compared to circumcised men. Both high risk and low risk HPV types occur 20% – 70% less frequently in circumcised men compared to uncircumcised men.
Women will have a higher chance of contracting high risk HPV strains and cancer of the cervix after having sexual contact with a man who is uncircumcised. Uncircumcised men are more likely to harbor high risk strains of HPV than men who are circumcised.
The foreskin in an uncircumcised man provides a large surface area that is exposed to potential infection. The foreskin is also easily traumatized, resulting in multiple small breaks and micro-cuts through which the HPV virus can infect the skin.
Circumcised men have a lower chance of being carriers for HPV compared to uncircumcised men. Women who are exposed to men who are carriers of high-risk HPV viruses are less likely to acquire an infection if their male partner is circumcised.
HPV infections in uncircumcised men are more difficult to treat, have higher recurrence rates and are more likely to infect a part- ner than are infections in circumcised men. The increasing use of the HPV vaccine should decrease the incidence of infection in both circumcised and uncircumcised men.
The number of uncircumcised men in the United States is increasing as the years go by. The trend in hospitals throughout the United States after World War 2 was to circumcise males shortly after birth because it would result in better hygiene and a lower incidence of a number of different genitourinary infections.
This guideline has not been adhered to adamantly in recent years. In addition, over the last several decades there has been increase immigration to the United States from Asian and Hispanic countries. In such regions, circumcision is not part of the culture and is not routinely practiced. These groups tend to carry on the tradition of not getting their sons circumcised. The Department of Health had historically issued health care guidelines encouraging parents to circumcise their sons but has more recently taken a more neutral position.
The increased prevalence of uncircumcised men in the United States would be expected to be associated with an increased incidence of HPV in the population. The use of the HPV vaccine to decrease the incidence of HPV would be expected to be associated with a decreased incidence of HPV in the population.
The end result of how these competing factors will balance out remains to be seen.
HPV the most common sexually transmitted disease in the United States. It has been estimated that 80 million people in the United States have the infection and that 14 million new people are exposed every year. Sexually active adults in the United States have a 50% – 70% chance of having been exposed to HPV at some time In their lifetime by the time they are 50 years old.
However, the highest incidence of HPV infections occurs in younger age groups. This is due to the fact that sexual experimentation and having multiple sexual partners is more frequent amongst younger people. As people age they tend to enter into more monogamous relationships and their exposure to HPV then declines.
HPV strains are categorized by the number they were assigned rather than by name. The vast majority of strains of HPV are low risk. The term low risk strain indicates the likelihood of such a strain leading to cancer is low. The most common low risk strains are 6 and 11.
Similarly, the term high risk strain indicates that these HPV strains have a higher-than-normal risk of causing a cancer. The most common high-risk strains are 16 and 18.
Most genital warts are made up of low-risk strains. Genital warts are extremely contagious and are associated with a high recurrence rate. Genital warts that contain low risk strains have a negligible chance of progressing into a cancer.
Patients with HPV need to be monitored after treatment. Recurrences are common. In addition, 10%-15% of genital warts are “mixed” infections where more than one strain of HPV is involved. There are many
Risk factors for acquiring an HPV include:
- A history of multiple sexual partners
- Unprotected sex
- Being uncircumcised
- Cigarette smoking
- Secondhand smoke exposure
- Chronic disease
- Immunocompromised conditions
- Immunosuppressive medications
There are many psychological impacts of having an HPV infection. Individuals who are diagnosed with an HPV infection frequently experience social isolation, shame, embarrassment, anger and resentment. They may be more mistrustful of their present and future partners.
HPV infections are the cause of cancer in the cervix 99% of cases.
There is usually a 20-year period of time between the time that a person was first infected with HPV and the time when an invasive cancer of the cervix is detected.
Most cases of HPV infection which eventually progress into cancer of the cervix were first contracted when the woman was a teenager or young adult.
A woman who wants to minimize her chances of getting an HPV infection and cervical cancer would need to decrease the risk fac- tors for acquiring an infection, which include minimizing the number of sexual partners, using condoms, not smoking, and avoiding passive smoke exposure.
The prognosis depends on the stage at which the diagnosis of cervical cancer is made. The stage refers to how far along the infection has progressed. The earlier the stage the better the survival rate.
The five-year survival rate of cervical cancer in the early stages of the disease is 96%-99%. The five-year survival rate for the late stages of the disease is 15%-20%.
The prognosis is always more favorable for any cancer when it is diagnosed at an early stage, so that the appropriate therapeutic interventions can be initiated as the soonest possible time. Diagnostic screening tests and effective treatments for HPV infections, precancers and cancers are available to those women who are screened appropriately and regularly on their health care providers
Most cases of cervical cancer are detected at an early stage when a woman gets cervical cancer screening on a regular basis. An infection that evolves and progresses from an early infection to an invasive cancer despite screenings at regular intervals would be extremely rare.
Cervical cancer is preventable in the vast majority of cases. Most cases of cervical cancer can be detected at an early stage of development in women who are properly screened at regular intervals. Cervical cancer usually occurs in instances where the women did not get her screening tests at the appropriate regularly prescribed intervals.
The fact that a women has an HPV infection does not automatically mean that she is going to get cancer of the cervix. The vast majority of women who have an HPV infection have the low risk (benign) strains that have zero potential to progress into any type of cancer. Only high-risk strains of HPV have the potential to progress into cancer of the cervix, and only a small percentage of the high risk strains evolve into cervical cancer.
10% of the people infected with HPV have the high-risk strains. Only a small percentage of high-risk strains will progress and evolve into cancer of the cervix.
A women will not necessarily get cervical cancer if high risk strains of HPV are identified. Nonetheless, she needs to be closely monitored by her doctor because she will have a higher risk for developing an abnormal Pap smear (cervical dysplasia) or a cervical cancer.
Over 11,000 women in the United States develop cervical cancer each year.
4,000 women/year die from cervical cancer in the United States.
Most of the deaths from cervical cancer are preventable if the women had gone to their physicians or health care providers and gotten checkups. Many of the people who develop cervical cancer fell between the cracks of the health care system. Cervical cancer is a preventable disease in developed countries – and hopefully one day also in developing countries – and does not need to happen.
Although 4,000 deaths per year from cervical cancer is a far greater number than is acceptable, it remains a relatively small number considered in the context of the fact that the United States has a population of over 300 million people.
Cervical cancer is the third most common cancer in women worldwide. An estimated 533,000 women worldwide were diagnosed with cervical cancer in 2008, according to Cancer Research UK. The developing countries have the largest burden of cervical cancer and account for 86% of all cases diagnosed worldwide in 2008.
The mortality rate from cervical cancer is 5x higher in Latin American and the Caribbean compared to North America. The main reason is lack of resources in the developing world to do adequate screening and to deliver quality health care.
There are over 200 different strains of HPV and they are site (or location) specific. There are certain strains that grow on the hands (hand warts), others that grow on the feet (plantar wart) or on the face (face warts). The strains that grow in the genital area are called genital warts.
The term site specific means that each of the different many strains of HPV grows better in certain areas of the body compared to others.
The only way that you can know for certain what strains are in the genital wart is if a sample is forwarded to the lab for a DNA test.
Although there is a very small chance that a hand wart can grow in the genital area, the chances of that wart going into a cancer are zero. The strains that most frequently cause hand warts cannot evolve into a cancer.
Yes they can, but this is not common and it is unlikely. The different strains of the virus are site (location) specific, so it would be unusual for an infection from hand or foot warts, for example, to spread to the genital area. The strains of HPV that cause hand warts do not grow well in the genital area.
HPV infections have been associated with cancers of the cervix, vulva, vagina, penis, anus, rectum, and the oropharyngeal area (tonsils, tongue, roof of the mouth, back of the throat).
The only way that you can know for certain what strains are in the genital wart is if a sample is forwarded to the lab for a DNA test.
A biopsy first needs to be obtained and forwarded to a laboratory in order to confirm whether an HPV infection is present. The physician can then request that the laboratory do typing to tell which strains of the infection are present.
A biopsy is the definitive test in both a man and a woman. Women can get a Pap smear as a screening test and can then get typing done on swabs from the cervix in order to tell whether high or low risk strains are present. Men at risk can get swabs from the rectal area. Blood and urine tests for HPV are not effective.
Genital warts associated with the low-risk strains are more likely to be large, more numerous, rapidly spreading and are highly contagious. High risk strains are more likely to present in few numbers and as small, sometimes inconspicuous-appearing growths.. The only accurate way to tell whether they are high or low risk is to do an HPV DNA test.
The most common high-risk strains are 16 and 18 (16/18), which together represent approximately 70% of the high-risk strains which occur in the general population.
Genital HPV infections are referred to as being either high risk or low risk strains. The presence of high-risk strains places a person at a higher risk of developing a cancer or precancerous condition. The presence of low-risk strains is associated with annoying and highly contagious conditions like genital warts but is not associated with an increased chance of getting cancer.
The high-risk strains of HPV have been associated with cancers or precancers of the cervix, vulva, vagina, anus, rectum, penis and the oropharyngeal area.
The low-risk stains are associated with genital warts and do not have any potential to progress into a cancer.
Mixed infections are areas or growths that contain both high and low risk strains. Approximately 10%-20% of genital warts are so- called “mixed infections.” The high-risk strains in these mixed infections can progress into more aggressive cancerous and precancerous conditions. An HPV infection that is made up of predominantly low risk strains can still contain the potentially more aggressive high-risk strains.
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