People with HPV are at risk of developing genital warts and some cancers, says Debbie Saslow, the American Cancer Society’s managing director of HPV and gynecological cancers.
Saslow has spent nearly 25 years studying HPV and is working to raise awareness for the HPV vaccine.
This conversation has been edited and summarized for clarity.
CNN: What causes HPV?
Debbie Saslow: Almost everyone will get HPV at some point, and most people will get no symptoms. Some types of HPV can cause skin warts, 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, thus mostly through sexual activities. Cervical cancer is the most common HPV cancer in women. Although some women are unfamiliar with their cervix, many go to a gynecologist to get tested with a Pap test or HPV test for cervical cancer. 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 tonsils. The other four cancers are anal cancer in men and women, penis cancer in men, and vulva and vaginal cancer in women.
Not as many people are at the point where they are symptomatic, as screenings 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 HPV?
Saslow: Being vaccinated can prevent more than 90% of HPV cancer and more than 90% of genital warts. It is recommended for boys and girls from 9 to 12 years, but people up to 26 years can still get the vaccine.
Secondary prevention for women between 25 and 65 with a cervix is a cervical cancer examination. By finding it and treating or removing cancer or cervix, you can prevent cancer.
The preferred screening method is an HPV test every five years. Unlike a Pap test, HPV testing 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 may progress to precancerous cancer.
If someone undergoes a negative HPV test, the chances of them getting cervical cancer in the next five or ten years are almost nil.
There are no recommended HPV screenings for men because there is no HPV test for them. The only exception is for anal cancer. This is not a national recommendation, but anal screening 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 it 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 are at a higher risk of getting HPV, but they are not at a higher risk if they get HPV, get cancer faster or cancer than someone who has HPV from a mutually monogamous mate.
The risk is higher, but it does not change the screening interval. The timing of HPV infection to precancerous cancer is a decade, and therefore five years between shows is really safe. The time from HPV cancer exposure is closer to 20 years, so we have a lot of time to find it.
CNN: What do you tell parents that their children will become sexually active sooner if they get the vaccine?
Saslow: There are many studies that show that this is not true at all. There are studies where researchers have asked, was there a difference in the number of sexually transmitted diseases, the age when people started having sex or had unintended pregnancies, and the answer is generally no.
For parents who think this is true, tell your children if you teach them how to drive so as not to wear a seat belt, as this will cause them to move quickly? You do not, and this is the exact same logic with the HPV vaccine.
We recently changed the wording of the guideline to strengthen the recommendation for vaccination at the age of 9. Before it is said that you have to vaccinate at 11 or 12 years of age, or that you can start at 9 years of age. Now we say only 9 to 12. offer the vaccine to a 9- or 10-year-old, parents do not think about their sexuality. When the children are 11 or 12, this is where the parents’ minds tend to go.
CNN: Should university students get the HPV vaccine?
Saslow: Remember that if the vaccine is not given by 12 years, it is still recommended until the age of 26. Adults up to 45 can ask their provider about it, but the effectiveness drops drastically during the study years, about 18 years.
College is a good time to find people who are missing or people whose parents have chosen not to give their child the vaccine, because then the person can make a choice themselves.
By the time you leave the university, the effectiveness of the vaccine is low. Mostly it is because people are already exposed to HPV and the vaccine only works before you are exposed.