What you should know about the common cancer-causing virus HPV

PHOTO: The Straits Times

Q: I recently had a pap smear. The results came back normal… except that I tested as HPV positive. I asked what HPV meant, and the doctor said it stood for human papilloma virus. What is this?

HPV, as you rightly said, stands for human papilloma virus. However, it is not one virus, but more specifically, a group of more than 150 viruses.

Each HPV virus has a number, e.g. HPV 1, 2, 3 and so on.

There are certain types of HPV that are associated with certain diseases.

The word "papilloma" means a kind of wart that results from certain HPV types.

Not all HPV viruses cause warts, so this is actually a misnomer.

How often should you really get a pap smear?

  • A pap smear should be done once every three years. This is very important if you are between ages 21 to 29 years old. Once you hit your 30s, it's more advisable to combine pap smear tests with HPV tests.
  • It's only when the disease goes on for three years should one be worried as that's already an indication that your body can't handle it on it's own.
  • Sexually active people are advised to take HPV tests in order to cure its effects and since the effect can range from frequent colds to a number of different and disparate diseases.
  • Centres of Disease Control and Prevention says that there is no effective nor approved HPV test for men. Women's pap smear and HPV tests are still the most reliable for early detection and cure.
  • When it comes to the dilemma of whether you can transmit HPV orally, the answer is a big yes. Harvard Medical School's research shows that unprotected oral sex can lead to oral and throat cancer.
  • HPV lives in your body's epithelial cells. These are the cells that coat your skin's surface, and also the surfaces of the vagina, anus, vulva, cervix, penis, mouth and throat.

Is HPV common?

It is very common.

HPV lives in your body's epithelial cells. These are the cells that coat your skin's surface, and also the surfaces of the vagina, anus, vulva, cervix, penis, mouth and throat.

HPV is the most common sexually-transmitted infection.

At least 50 per cent of all people who have had sex at some point in their lives have an HPV infection.

In fact, most of the time, you don't even know you have an infection.

This is as it frequently doesn't produce any symptoms and often goes away by itself.

Also read: How often should you really get a pap smear?

You mentioned many types of HPV. What types are associated with what disease?

Sixty types of HPV can cause warts on your hands and feet.

Forty other types are sexually transmitted and like to infect your body's mucous membranes, such as your genitals.

There are high-risk types and low-risk types.

High-risk HPV types are HPV 16 and 18, which cause about 70 per cent of cervical cancers. Other high-risk types include HPV 31, 33, 45, 52 and 58.

The low-risk types such as HPV 6 and 11 cause 90 per cent of genital warts, which rarely become cancerous and are perfectly treatable.

Also read: Are pap smears enough to prevent cervical cancer?

What are genital warts?

Genital warts are soft growths that appear around your genitals.

They are sometimes painful, itchy and discomfiting. They may produce discharge and may sometimes bleed.

They can occur for both men and women.

They may be very small or large, sometimes appearing like a cauliflower.

For women, they are usually more dangerous because some of them can progress to cervical cancer.

They can appear on the penis, scrotum, anus, groin, or even thighs for men, and the vagina (inside and outside), anus (inside and outside) and cervix for women.

If you have had oral sex with an infected partner, they can also appear on the lips, tongue and throat.

Top 5 STIs in Singapore

  • With each intimate relationship, we bring with us a sexual history, and there are numerous other sexually transmitted infections out there other than HIV.
  • Here are the top five reasons why you should always insist on using a condom.
  • Chlamydial infection can cause painful urination, as well as urethral discharge in men and vaginal discharge in women.
  • Untreated cases may lead to infertility and pregnancy-related complications in women.
  • It can also infect the rectum, causing painful defecation and rectal discharge.
  • Most people infected with this STI experience no symptoms, so they may unknowingly pass it to their partners.
  • Genital warts are caused by the human papillomavirus (HPV). A number of strains of HPV specifically cause it.
  • Those who do will notice cauliflower-shaped growths appearing on the genitals and sometimes around the anus (even without anal intercourse). - See more at: http://a1admin.asiaone.com/health/body-mind/get-tested-these-top-5-stis-singapore#sthash.kk2y2LXf.dpuf
  • This is another bacterial infection, other than chlamydia, that can cause infertility.
  • Victims may experience a burning sensation when urinating or notice a creamy white, yellow or green penile, vaginal or anal discharge.
  • The throat can also be infected through oral sex. The infection can also spread through the bloodstream and infect other parts of the body, including the joint and skin.
  • Get Tested: To detect the presence of this infection, swabs are taken from suspected areas, or urine samples are collected.
  • A person can be carrying the herpes simplex virus (HSV) even if he hasn't been humping around.
  • HSV can cause either genital or oral herpes, the latter more commonly known as cold sores.
  • Herpes is contracted through direct skin-to-skin contact with an infected individual via sexual intercourse or kissing.
  • The signs, if they appear, include painful urination, and sores on the genitals, anus, thighs and buttocks (ouch!).
  • In severe outbreaks, there may also be flu-like symptoms, fever and muscle ache.
  • This can be deadly if left untreated.
  • In the early stages, an infected person may notice a painless sore in the genital region, or a widespread rash that tends to affect the palms and soles.
  • Syphilis is spread through direct contact with a syphilitic sore, which is found mainly on the genitals, anal regions, and (less commonly) around the lips and mouth.
  • Get Tested: It can be diagnosed with a blood test or a swab taken from the sore.

I have HPV. But I've always had sex with a condom. Why did I get it then?

HPV is spread through contact with the infected genital skin, mucous membranes or bodily fluids of your sexual partner.

It can be passed on during sexual intercourse or oral sex.

So, even if you use a condom, there are parts of your partner's skin that are not covered with a condom. Therefore, using a condom doesn't fully protect you from getting HPV.

Moreover, not many people realise they have HPV, hence it spreads quite easily as people who have HPV remain sexually active.

Even if you have had sex with only one person, you can get HPV.

Sometimes, you develop symptoms years after you have had sex with someone who is infected.

Therefore, you can't really tell when it was that you first got infected.

However, you are more likely to get HPV if you have sex at an early age; have many sexual partners; or have a sexual partner who has been with a lot of other sexual partners.

Also read: 9 per cent of women have HPV infections: Study

How is HPV associated with cancer?

People, especially women, are afraid of HPV because it is associated with cervical cancer.

As mentioned, there are certain strains of HPV that can transform cervical cells into cancerous ones.

That is why you have to keep on monitoring your cervix for any changes through a six-monthly or annual pap smear.

HPV can also rarely lead to penile or anal cancer.

Can I treat HPV?

There is no cure for HPV itself, but the good news is that it often goes off on its own.

Most of the treatment for HPV revolves around the symptoms that it causes.

If you have genital warts, you can certainly treat them with some antivirals and topical treatments. Large warts can also be surgically lasered off.

The best way to protect against HPV though is through vaccination.

There are three vaccines that can be given to boys and girls from ages nine to 26. They protect against certain strains of high-risk HPV.

If you have HPV, it is always wise to go for an annual or six-monthly routine pap smear and cervical check-up.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.