hpv

Human papillomavirus (HPV) is a group of related viruses. They can cause warts on different parts of your body. There are more than 200 types. About 40 of them are spread through direct sexual contact with someone who has the virus. They can also spread through other intimate, skin-to-skin contact. Some of these types can cause cancer.

There are two categories of sexually transmitted HPV. Low-risk HPV can cause warts on or around your genitals, anus, mouth, or throat. High-risk HPV can cause various cancers:

• Cervical cancer
• Anal cancer
• Some types of oral and throat cancer
• Vulvar cancer
• Vaginal cancer
• Penile cancer

Most HPV infections go away on their own and don't cause cancer. But sometimes the infections last longer. When a high-risk HPV infection lasts for many years, it can lead to cell changes. If these changes are not treated, they may get worse over time and become cancer.

HPV infections are very common. Nearly all sexually active people are infected with HPV soon after they become sexually active.

Some people develop warts from certain low-risk HPV infections, but the other types (including the high-risk types) have no symptoms.

If a high-risk HPV infection lasts for many years and causes cell changes, you may have symptoms. You may also have symptoms if those cell changes develop into cancer. Which symptoms you have depends on which part of the body is affected.

Health care providers can usually diagnose warts by looking at them.

For women, there are cervical cancer screening tests which can find changes in the cervix that might lead to cancer. As part of the screening, women may have Pap tests, HPV tests , or both.

An HPV infection itself cannot be treated. There are medicines that you can apply to a wart. If they don't work, your health care provide could freeze, burn, or surgically remove it.

There are treatments for the cell changes caused by infection with high-risk HPV. They include medicines that you apply to the area that is affected and various surgical procedures.

People who have HPV-related cancers usually get the same types of treatment as people who have cancers that are not caused by HPV. An exception to this is for people who have certain oral and throat cancers. They may have different treatment options.

Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading HPV. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

Vaccines can protect against several types of HPV, including some that can cause cancer. The vaccines provide the most protection when people get them before they are exposed to the virus. This means that it is best for people to get them before they become sexually active.

NIH: National Cancer Institute

Genital warts are a sexually transmitted infection (STI) caused by the human papillomavirus (HPV). The warts usually appear as a small bump or group of bumps in the genital area. They are flesh-colored and can be flat or look bumpy like cauliflower. Some genital warts are so small you cannot see them. In women, the warts usually occur in or around the vagina, on the cervix, or around the anus. In men, genital warts are less common. They may have warts on the tip of the penis, around the anus, or on the scrotum, thigh, or groin.

You can get genital warts during oral, vaginal, or anal sex with an infected partner. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading HPV. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex. HPV vaccines may help prevent some of the HPV infections that cause genital warts.

Your health care provider usually diagnoses genital warts by seeing them. The warts might disappear on their own. If not, your health care provider can treat or remove them. HPV stays in your body even after treatment, so warts can come back.

Dept. of Health and Human Services Office on Women's Health

The cervix is the lower part of the uterus, the place where a baby grows during pregnancy. Cervical cancer is caused by a virus called HPV. The virus spreads through sexual contact. Most women's bodies are able to fight HPV infection. But sometimes the virus leads to cancer. You're at higher risk if you smoke, have had many children, use birth control pills for a long time, or have HIV infection.

Cervical cancer may not cause any symptoms at first. Later, you may have pelvic pain or bleeding from the vagina. It usually takes several years for normal cells in the cervix to turn into cancer cells. Your health care provider can find abnormal cells by doing a Pap test to examine cells from the cervix. You may also have an HPV test. If your results are abnormal, you may need a biopsy or other tests. By getting regular screenings, you can find and treat any problems before they turn into cancer.

Treatment may include surgery, radiation therapy, chemotherapy, or a combination. The choice of treatment depends on the size of the tumor, whether the cancer has spread and whether you would like to become pregnant someday.

Vaccines can protect against several types of HPV, including some that can cause cancer.

NIH: National Cancer Institute

The cervix is the lower part of the uterus, the place where a baby grows during pregnancy. Cancer screening is looking for cancer before you have any symptoms. Cancer found early may be easier to treat.

Cervical cancer screening is usually part of a woman's health checkup. There are two types of tests: the Pap test and the HPV test. For both, the doctor or nurse collects cells from the surface of the cervix. With the Pap test, the lab checks the sample for cancer cells or abnormal cells that could become cancer later. With the HPV test, the lab checks for HPV infection. HPV is a virus that spreads through sexual contact. It can sometimes lead to cancer. If your screening tests are abnormal, your doctor may do more tests, such as a biopsy.

Cervical cancer screening has risks. The results can sometimes be wrong, and you may have unnecessary follow-up tests. There are also benefits. Screening has been shown to decrease the number of deaths from cervical cancer. You and your doctor should discuss your risk for cervical cancer, the pros and cons of the screening tests, at what age to start being screened, and how often to be screened.

Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body. The anus is formed partly from your outer layers of skin and partly from your intestine. Anal cancer is a type of cancer that forms in the tissues of your anus.

Anyone can get anal cancer, but you are more likely to develop it if you:

• You have an infection with high-risk HPV, especially if you have certain types. Most anal cancers are related to HPV infection.
• Have a weakened immune system, from conditions such as HIV or because of medicines you need to take after an organ transplant.
• Have had vulvar, vaginal, or cervical cancer.
• Have many sexual partners.
• Have anal sex.
• Smoke cigarettes.

The signs and symptoms of anal cancer may include:

• Bleeding from the anus or rectum
• A lump near the anus
• Pain or pressure in the area around the anus
• Itching or discharge from the anus
• A change in bowel habits, such as narrower stools, having to go more often, or bowel incontinence

To find out if you have anal cancer, your provider:

• Will take your medical history, which includes asking about your symptoms.
• Will ask about your family health history.
• May do a digital rectal examination (DRE). A DRE is an exam of the anus and rectum. For the exam, your provider will insert a lubricated, gloved finger into the lower part of your rectum to feel for lumps or anything else that seems unusual.
• May order tests that examine the anus and rectum, such as:
  • An anoscopy, an exam of the anus and lower rectum using a short, lighted tube called an anoscope. There is also a type of anoscopy called a high-resolution anoscopy. It uses a special magnifying device called a colposcope along with the anoscope to view these areas.
  • A proctoscopy, a procedure to look inside the rectum and anus using a thin, tube-like instrument with a light and a lens.
  • An endo-anal or endorectal ultrasound, a procedure in which an ultrasound probe is inserted into the rectum.
• May do a biopsy during an anoscopy or proctoscopy.

The treatments for anal cancer include radiation therapy, chemotherapy, and surgery. Which treatment you get will depend on how advanced the cancer is, your overall health, and your preferences.

You may be able to lower your risk of getting anal cancer by getting an HPV vaccine and not smoking. Contact your provider if you need help quitting smoking.

It is currently not known if using condoms can prevent anal HPV infections. But using latex condoms every time you have sex can help prevent HIV, a risk factor for anal cancer. And they also help prevent other sexually transmitted infections (STIs). If your or your partner is allergic to latex, you can use polyurethane condoms.

If you are an adult with HIV, it's important to get an anal cancer screening every year. The screening checks for anything that seems unusual, such as lumps, burning, and precancer cells (cells that could turn into cancer). The screening will include a digital rectal exam. If anything unusual is found, you will have an anoscopy or high resolution anoscopy.

Regular checkups with your health care provider are different from appointments for sickness or injury. Your checkups, which are also called well-woman exams, include physical exams as well as preventive care. They can help find health problems early, when they may be easier to treat.

Your checkup will include screenings for chronic diseases. As a woman, you may also get special exams and screenings, such as:

• A pelvic exam to check the health of your reproductive organs. The provider will look at your vulva, vagina, and cervix. They will also do an internal exam to feel the size and shape of your internal organs such as the uterus and ovaries.
• A cervical cancer screening, which uses a Pap test, an HPV test, or both. The tests can help prevent cervical cancer. A Pap test checks for cervical cancer and for abnormal cells that could turn into cancer. An HPV test looks for the types of HPV which can cause cervical cancer. For both tests, your provider will take a sample of cells from the surface of your cervix and send them to a lab to be examined under a microscope.
• A clinical breast exam to check for breast cancer. The provider will feel and look at your breasts and armpit area for lumps or other changes.

Which tests you get and how often you need them will depend on your age, overall health, and family health history. In some cases, your provider may also recommend other tests as well. For example, if you have a family history of certain cancers, your provider may recommend genetic testing.

During your checkup, you and your provider may also talk about other issues, such as:

• Birth control or family planning
• Menopause
• Menstrual concerns
• Sexually transmitted infections (STIs)
• Vaccines
• Your overall health, including suggestions on how to have a healthy lifestyle

To make the most of your next checkup, bring a list of any questions or concerns you have, so you can talk about them with your provider.

Head and neck cancer is the name for cancers that develop in the mouth, nose and sinuses, salivary glands, and throat and voice box (larynx). Most head and neck cancers are squamous cell cancers. They begin in the moist tissues that line the head and neck. The cancer cells may spread into deeper tissue as the cancer grows.

There are other cancers that develop in the head and neck, such as brain cancer, eye cancer, and esophageal cancer. But they are usually not considered to be head and neck cancers, because those types of cancer and their treatments are different.

Anyone can get head and neck cancer, but you are more likely to develop it if you:

• Use tobacco or drink lots of alcohol. Your risk of developing head and neck cancer is even higher if you do both.
• Are male.
• Are over age 50.
• Have a history of head or neck cancer.
• Have HPV (for cancers in the tonsils and base of the tongue).
• Are exposed to wood dusts or certain other toxic substances at work (for upper throat, nose, and sinus cancers).
• Have had radiation exposure to the head and neck (for salivary gland cancer).
• Have Epstein-Barr virus (EBV) infection (for upper throat and salivary gland cancers).
• Are Asian (for upper throat cancer).

The symptoms of head and neck cancer may include:

• A lump in the neck
• A sore in the mouth or the throat that does not heal and may be painful
• A sore throat that does not go away
• Trouble swallowing
• A change or hoarseness in the voice

Other possible symptoms can depend on the specific type of head and neck cancer.

Which exams and tests used to diagnose head and neck cancer can depend on the specific type of cancer. Possible exams and tests may include:

• A physical exam of the area that might have cancer.
• Blood and/or urine tests.
• An endoscopy.
• A biopsy or other procedure to collect cells from the area that might have cancer. The cells are viewed under a microscope to find out if they are abnormal.
• Imaging tests.

The treatment for head and neck cancer will depend on the specific type of cancer, the stage (how advanced the cancer is), your overall health, and other factors. The treatment options might include:

• Surgery
• Radiation therapy
• Chemotherapy
• Cancer immunotherapy
• Targeted therapy, which uses drugs or other substances that mainly attack specific cancer cells and cause less harm to normal cells

In some cases, you may need a combination of treatments. Sometimes surgery can affect how well you can chew, swallow, or talk. Rehabilitation, such as physical therapy, dietary counseling, and speech therapy, may help.

There are steps you can take to help prevent head and neck cancer:

• Not smoking
• Limiting alcohol use or not drinking at all
• Getting regular dental exams
• Talking to your provider about HPV vaccination

NIH: National Cancer Institute

Sexually transmitted infections (STIs), or sexually transmitted diseases (STDs), are infections that are passed from one person to another through sexual contact. They are usually spread during vaginal, oral, or anal sex. But sometimes they can spread through other sexual contact involving the penis, vagina, mouth, or anus. This is because some STIs, like herpes and HPV, are spread by skin-to-skin contact.

Some STIs can be passed from a pregnant person to the baby, either during pregnancy or when giving birth. Other ways that some STIs may be spread include during breastfeeding, through blood transfusions, or by sharing needles.

There are more than 20 types of STIs, including:

• Chlamydia
• Genital herpes
• Gonorrhea
• HIV
• HPV
• Pubic lice
• Syphilis
• Trichomoniasis

STIs can be caused by bacteria, viruses, and parasites.

Most STIs affect both men and women, but in many cases the health problems they cause can be more severe for women. If an STI is passed to a baby, it can cause serious health problems.

STIs don't always cause symptoms or may only cause mild symptoms. So it is possible to have an infection and not know it. And even without symptoms, STIs can still be harmful and may be passed on during sex.

If there are symptoms, they could include:

• Unusual discharge from the penis or vagina
• Sores or warts on the genital area
• Painful or frequent urination (peeing)
• Itching and redness in the genital area
• Blisters or sores in or around the mouth
• Abnormal vaginal odor
• Anal itching, soreness, or bleeding
• Abdominal (belly) pain
• Fever

If you are sexually active, you should talk to your health care provider about your risk for STIs and whether you need to be tested. This is especially important since many STIs do not usually cause symptoms.

Some STIs may be diagnosed during a physical exam or through STI testing. Some tests involve a microscopic examination of a sore or fluid swabbed from the vagina, penis, or anus. Blood tests can diagnose other types of STIs.

Antibiotics can treat STIs that are caused by bacteria or parasites. There is no cure for STIs caused by viruses, but antiviral medicines can often help with the symptoms and lower your risk of spreading the infection.

It's important to get treatment if you have an STI. Some types of STIs can cause serious health problems if they are not treated.

The surest way to protect yourself against STIs is to not have sex.

If you do decide to have sex, you can lower your risk of getting an STI by:

• Having you and your partner tested for STIs before having sex.
• Using a condom every time you have sex. Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STIs. If your or your partner is allergic to latex, you can use polyurethane condoms.
• Reducing your number of sex partners. You might even consider "mutual monogamy" with just one partner. This means that you agree to be sexually active only with them, and they agree to be sexually active only with you. But first you should both get tested to make sure that you don't already have an STI.
• Getting vaccinated against HPV and hepatitis B.

Oral cancer is cancer of the mouth. It is a type of head and neck cancer. Most oral cancers are squamous cell cancers. They begin in the flat cells that cover the surfaces of your mouth, tongue, and lips. The cancer cells may spread into deeper tissue as the cancer grows.

Most oral cancers are related to tobacco use, heavy alcohol use, or an HPV infection.

Anyone can get oral cancer, but you are more likely to develop it if you:

• Use tobacco or drink lots of alcohol. Your risk of developing oral cancer is even higher if you do both.
• Are male.
• Are over ago 40.
• Have HPV.
• Have a history of head or neck cancer.
• Get frequent sun exposure (for lip cancer).

The symptoms of oral cancer may include:

• A white or red patch in your mouth
• A lip or mouth sore that won't heal
• Bleeding, pain, or numbness in the lip or mouth
• Loose teeth or dentures that no longer fit well
• Problems or pain with swallowing
• A lump in your neck
• Ear pain
• Trouble moving your mouth or jaw
• Swelling of the jaw
• A sore throat or feeling that something is caught in the throat

If you have any of these symptoms for more than two weeks, see your health care provider or dentist. Oral cancer can spread quickly, so it's important to find it early.

To find out if you have oral cancer, your provider may use:

• A physical exam of the lips and mouth.
• An endoscopy.
• A biopsy or other procedure to collect cells from the lip or oral cavity. The cells are viewed under a microscope to find out if they are abnormal.
• Imaging tests.

The treatments for oral cancer include surgery, radiation therapy, or both. After surgery, some people also need chemotherapy to kill any cancer cells that are left.

There are steps you can take to help prevent oral cancer:

• Not smoking
• Limiting alcohol use or not drinking at all
• Getting regular dental exams

NIH: National Cancer Institute

Teen sexual health is about how sex affects your physical and emotional health. It means knowing how to form healthy relationships and making decisions about sex that are right for you.

As your body changes during puberty, how you think, feel, and interact with others also changes. You may have new feelings and thoughts about sex. Understanding who you're becoming as a sexual young adult is also part of teen sexual health. For some teens, that includes understanding gender identity, gender expression, and sexual orientation.

For all teens, taking responsibility for sexual health is part of growing up. Whether you choose to have sex or wait, responsibility includes knowing about:

• Sexually transmitted infections (STIs)
• Birth control
• What a healthy relationship is

Sexually transmitted infections (STIs), or sexually transmitted diseases (STDs), are caused by bacteria, viruses, and parasites that spread from person to person, usually during vaginal, oral, or anal sex. Some STIs are spread by skin-to-skin contact. Without treatment, some STIs can cause long-term health problems.

There are more than 20 types of STIs, including:

• Chlamydia
• Genital herpes
• Gonorrhea
• HIV
• HPV (human papillomavirus)
• Pubic lice
• Syphilis
• Trichomoniasis

STIs don't always cause symptoms. So it is possible to have an infection without knowing it and then pass it on to someone else. The only way to know for sure whether you have an STI is to get tested.

The most reliable way to avoid infection is to not have vaginal, oral, or anal sex. Saying "no" to sex is the right choice for many teens.

If you decide to have sex, "safer sex" practices will lower your chance of getting an STI. They include:

• Talking with your partner about preventing STIs and getting tested before having sex. If you can't talk about STIs, you aren't ready to have sex.
• Getting the HPV vaccine. You can be vaccinated between ages 9 and 26.
• Using condoms correctly every time you have vaginal, oral, or anal sex:
  • External (male) latex condoms provide the best protection against STIs. If you or your partner is allergic to latex, you can use polyurethane condoms.
  • Internal (female) condoms, made of nitrile, are placed inside the body (vagina or anus). They may be less effective against STIs than latex external condoms.
  • Don't use both type of condoms together because that increases the chance they'll rip
  • Use a dental dam (a square piece of latex, polyurethane, or nitrile) to protect the mouth during oral sex
• Having sex with only one person who has sex only with you (mutual monogamy). But first, both of you should get tested for STIs.
• Not mixing alcohol or drugs with sex. You need to think clearly to make safer choices about sex.

The only sure way to avoid pregnancy is not to have vaginal sex.

If you decide to have vaginal sex, birth control can help prevent pregnancy. There are many types of birth control that work in different ways. Your health care provider can help you choose birth control that's best for you.

Condoms are the only birth control method that protects against STIs. But condoms alone aren't the most effective form of birth control. It's safest to use condoms with another form of birth control to prevent both STIs and pregnancy.

Healthy sex starts with a healthy relationship, so it's important to take an honest look at how you and your partner treat each other. Your relationship may be healthy if it includes:

• Respect. You and your partner value each other's feelings. Neither of you pressure the other to do things they don't want to do.
• Trust and honesty. You always tell the truth and trust your partner to do the same.
• Good communication. You feel safe talking openly about your feelings, STIs, and other relationships. And you both listen.

Your relationship may be unhealthy if it includes:

• Jealousy and control. One of you wants to make all the decisions and tries to keep the other from spending time with their friends and family.
• Disrespect. One of you makes fun of the other person's ideas and feelings.
• Pressure. One of you tries to bully the other into doing sexual things they don't want to do.
• Violence. Hitting, shoving, grabbing, and sexual assault should never be part of a relationship. If you don't know how to end a violent relationship, get help.

Your decisions about sex can affect your future health. Make sure that you know the facts so you can decide what is right for you.