July 20, 2007

Women’s Health:

What Women Should Know About HPV

By Kenneth L. Noller, MD

Human papilloma-virus (HPV) is the most common sexually transmitted infection and affects both men and women. HPV causes genital warts and cervical cancer. Most sexually active individuals will have an HPV infection in their lifetime, and 80% of women will have had one by the age 50.

Genital warts are growths that can appear inside or outside the vagina or on the penis and can spread to nearby skin. Warts are usually treatable and are not typically associated with cancer.

HPV infection can cause the growth of abnormal cells on or around the cervix. The cells often go away without treatment, but in some cases they will continue to grow and eventually turn into cancer.

There are simple ways to lower your risk of HPV infection and ensure that any abnormal cell changes are found before they can become cancerous.

Get Vaccinated. Gardasil, the first FDA-approved vaccine for HPV, protects against the four HPV types responsible for 90% of genital warts and 70% of cervical cancers. It is approved for girls and women ages 9 to 26. The vaccine is most effective when given before the onset of sexual activity and any exposure to HPV. It is currently being studied in women older than 26 and in men and boys. The HPV vaccine is not recommended for pregnant women.

Get Routine Pap Screenings. There are more than 40 strains of genital HPV. Routine Pap testing can detect abnormal cervical cells caused by all HPV types. Women are urged to continue with Pap screenings, even if they have already been vaccinated.

ACOG recommends that women have their first Pap test within three years of sexual activity or by the age of 21, then annually until age 30. Women older than 30 who have had three normal tests in a row can get a Pap test every two to three years, but should still see their doctor annually for other routine screenings and preventive care.

In addition to Pap testing, women 30 and older can also have an HPV test, which screens for the presence of cancer-causing HPV strains. When taken together, these tests increase the odds of finding abnormal cell changes. HPV testing is not advised for women under 30 because it may lead to unnecessary treatment of abnormal cells that would likely resolve if left alone.

Be Safe. To lower your risk of contracting HPV, limit your number of sex partners. Because HPV can be transmitted through skin-to-skin contact, condoms do not offer complete protection. However, with regular and proper use, condoms may lower the risk of infection.

Dr. Noller is President of the American College of Obstetricians and Gynecologists.

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