Massachusetts Medical Society's Physician Focus

October 2014

HPV: Human Papillomavirus

PROGRAM HIGHLIGHTS:

  • Human Papillomavirus is the most common, sexually-transmitted infection and, with the exception of flu and pneumonia, hurts and kills more people than all other vaccine-preventable diseases combined.

  • HPV is easily transmitted by any skin-to-skin contact, and approximately 80 percent of people – men and women alike – will be exposed to HPV at some time in their lives.

  • HPV can lead to cervical cancer, head-and-neck cancers, anal cancer, and genital warts.

  • Vaccination is the best prevention, and the full regimen of three shots should be given to both girls and boys beginning at 11–12 years of age for maximum protection.

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Human Papillomavirus, or HPV, is the most common sexually transmitted infection. It can be passed along by any skin-to-skin contact, usually by sexual contact, and is a human carcinogen that can lead to cancer.

While in most cases HPV goes away on its own, it can also be insidious, staying in the body for years, unbeknownst to the individual. “Most HPV infections are asymptomatic [without symptoms],” says Rebecca Perkins, M.D., “until someone develops an advanced disease.”

Dr. Perkins, a board-certified obstetrician-gynecologist at Boston Medical Center and an Assistant Professor at Boston University School of Medicine, is the featured guest on the October edition of Physician Focus with the Massachusetts Medical Society. In conversation with program host Mavis Jaworski, M.D., a family medicine physician, she discussed the basics of HPV, its prevalence, the risks of disease associated with the virus, and the benefits of vaccination.

“Eighty percent of people will be exposed to HPV at least once,” says Dr. Perkins. “It is incredibly easily transmitted, and one hundred times more infectious than HIV and herpes. And it can stay hidden in the body for decades. An infection that someone got in their twenties can pop out in their forties or fifties.”

That delayed reaction, she notes, can result in cancer of the cervix, head and neck (most commonly the tongue and tonsils), the anus, and genital organs. An HPV test is done for women as part of their screening for cervical cancer, but no individual screening test exists for HPV. “We’re looking for it [in women],” Dr. Perkins says, “because it’s a marker as a high risk of cervical cancer.” She adds that no test for men outside of research studies exists at this time.

Human Papillomavirus is ubiquitous. According to the U.S. Centers for Disease Control and Prevention, approximately 79 million Americans are currently infected with HPV, and 14 million become newly infected every year. And the toll from HPV-related cancers is significant: nearly 12, 000 women in the U.S. get cervical cancer every year, and nearly 4,000 of them die from the disease. Some 11,000 men and women contract head and neck cancers, with 75 percent of those caused by HPV. Head-and-neck cancers are more common in men, and they are rapidly increasing: the incidence of head-and-neck cancers has doubled in the last 20 years.

The best prevention against HPV is vaccination, which should be given to girls and boys beginning at age 11or 12. The regimen consists of three shots, which should be taken within a six-month period, and patients need all three doses to benefit from the full effectiveness of the vaccine. Studies show that complete vaccination before age 14 is twice as effective as after age 15. The vaccine, proven highly safe and effective, is designed to protect against cervical and anal pre-cancers, head-and-neck cancers, and genital warts, also caused by HPV. While 40 different types of HPV exist, the vaccine protects against the most important four types that lead to cancers and genital warts.

Dr. Perkins’ message to both boys and girls – and especially their parents – about taking advantage of the vaccine is clear: get vaccinated. “People are not getting it as reliably as they ought to be,” she says. “People are not realizing how important it is; people are not realizing how many cancers are caused by HPV every year.”

Watch the video above for additional discussion about the timeline of cervical cancer, how many cancer cases could be prevented if everyone were immunized, details on the schedule for vaccination, and why vaccinating 11- and 12-year-olds provides the most effective protection.

Text:
MMS/Richard Gulla

ADDITIONAL RESOURCES
About the Virus - Centers for Disease Control

About HPV Vaccines - Centers for Disease Control

About Preteen and Teen Vaccines

American Congress of Obstetricians and Gynecologists

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"hpv" PSA


From left, Mavis Jaworksi, M.D., Rebecca Perkins, M.D.
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