Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Nearly 80% of sexually active people will be infected with at least one type of HPV at some point in their lives. While most HPV infections clear on their own without causing problems, certain high-risk strains can lead to cervical cancer and other serious conditions if left undetected.
The good news is that with vaccination and regular screening, cervical cancer is one of the most preventable cancers.
What Is HPV?
HPV is a group of more than 200 related viruses, of which about 40 types are spread through direct sexual contact. These are divided into two categories:
- Low-risk types (such as HPV 6 and 11) can cause genital warts but do not lead to cancer.
- High-risk types (such as HPV 16 and 18) can cause changes in cervical cells that, over time, may develop into cervical cancer. These strains are also linked to cancers of the throat, anus, vulva, vagina, and penis.
HPV is transmitted through skin-to-skin contact during vaginal, anal, or oral sex. Condoms reduce but do not eliminate the risk of transmission since HPV can infect areas not covered by a condom.
The HPV Vaccine
The HPV vaccine (Gardasil 9) is one of the most effective tools we have for cancer prevention. It protects against nine HPV types, including the strains responsible for the vast majority of HPV-related cancers and genital warts.
- Recommended ages: The CDC recommends routine HPV vaccination at age 11 or 12, though it can be given as early as age 9.
- Catch-up vaccination: The vaccine is recommended for everyone through age 26 who was not adequately vaccinated earlier.
- Ages 27-45: Shared clinical decision-making is recommended. The vaccine may still be beneficial depending on your risk factors and exposure history.
The vaccine is most effective when given before any exposure to HPV, which is why early vaccination is emphasized. However, even if you have already been exposed to one strain, the vaccine can still protect against the others.
Screening: Pap Smears and HPV Tests
Regular screening catches cervical changes early, long before they have a chance to become cancer. Current guidelines recommend:
- Ages 21-29: Pap smear every 3 years. HPV testing is not routinely recommended in this age group because HPV infections are extremely common and usually resolve on their own.
- Ages 30-65: Pap smear plus HPV co-testing every 5 years (preferred), or a Pap smear alone every 3 years.
- Over 65: Screening may be discontinued if you have had adequate prior screening with normal results.
What Do Abnormal Results Mean?
An abnormal Pap smear does not mean you have cancer. It means that some cervical cells look different from normal, and further evaluation is needed. Depending on the results, your provider may recommend:
- Repeat testing: Mild changes often resolve on their own and may just require more frequent monitoring.
- Colposcopy: A closer examination of the cervix using a magnifying instrument, often with a small biopsy to evaluate the abnormal cells.
- Treatment: If precancerous cells are found, procedures like LEEP (loop electrosurgical excision) can remove them before they progress. These treatments are highly effective and preserve fertility in most cases.
At Garden OB/GYN, we provide comprehensive HPV screening, vaccination counseling, colposcopy, and treatment for cervical abnormalities. If you are due for a screening or have questions about HPV, reach out to our team to schedule an appointment.
