Human papillomavirus (HPV)
infections are recognized as the cause nearly all cervical cancers, as well as most cases of anal cancer. Additionally, HPV also causes some cancers of the vagina, vulva, and penis and oral HPV infection can cause cancers of the head and neck (e.g. throat, larynx, and mouth).
For those who choose to be sexually active, condoms may lower the risk of HPV infection, which has been linked to not only cervical cancer, but other HPV-related diseases and HPV-related cancers. One study found that when condoms are used correctly every time sex occurs, they can lower the HPV infection rate by about 70%. To be most effective, they should be used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom – so condoms may not fully protect against HPV.
Anal dysplasia and anal cancer
Anal cancer is a cancer that forms in tissues of the anus. Estimated new cases and deaths from anal cancer in the United States in 2012 will include more than 6,000 new cases and approximately 780 deaths of which approximately 2,700 will be women and 1,500 will be men. Gay and bisexual men (who have sex with other men) are about 17 times more likely to develop anal cancer than men who only have sex with women.
One type of HPV, HPV-16, has been associated as a risk factor for anal cancer. The vaccine Gardasil® can help protect against infection with both HPV subtypes 16 and 18 (as well as 6 and 11). Gardasil® was originally only approved for use in women to prevent cervical cancer, but it is now also approved to prevent anal cancers and pre-cancers in both men and women as well as vulvar and vaginal cancers and pre-cancers (in women).
Risk factors for anal cancer
- Infection with HPV-16: In a 2004 study of 6,000 anal cancer patients, the majority of whom were women, 73% had tested positive for HPV-16.
- Unprotected sex: Having unprotected sex, either anal or vaginally, raises your risk of becoming infected with HPV.
- Number of sex partners: For women, having many sex factors has been identified as a risk factor.
- Receptive anal intercourse: This has been identified as a strong risk factor, but is not required.
- Smoking: Current smoking is a known risk factor.
- History of fissures, fistulas, hemorrhoids.
- Other HPV-related cancers (cervix and/or vulva)
- Immunosuppression (e.g. HIV infection, anti-rejection drugs associated with organ transplants)
- Sometimes there are no signs or symptoms.
- Anal bleeding, pain, itching, or discharge.
- Swollen lymph nodes in the anal or groin area.
- Changes in bowel habits or the shape of your stool.
Head and neck cancer
Sex+ Health Podcast:
Part 1: Head and neck cancers are increasing in number and one type – oropharyngeal cancers found in the area of the throat just behind the oral cavity, the base of the tongue, soft palate, the tonsils and the walls of the throat – is primarily caused by HPV. In this episode we’re talking with Mr. Bob Cupps, who very recently underwent treatment for oropharyngeal cancer talks with us about his experiences, what the patient journey is like, and why HPV vaccines are crucial in preventing these diseases.
Head and neck cancers arise in the head or neck region (in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx [voice box]). The Centers for Disease Control and Prevention (CDC) estimates that more than 1,700 new cases of HPV-associated head and neck cancers are diagnosed in women and nearly 5,700 are diagnosed in men each year in the United States, but many of these cancers are related to tobacco and alcohol use, not HPV. These numbers are based on cancers in specific areas of the head and neck (oral cavity and oropharynx) and do not include cancers in all areas of the head and neck. African Americans get these cancers more often than people of other races and ethnicities. Non-Hispanics and men get these cancers more often than Hispanics and women.
- A study published in October in the Journal of Clinical Oncology traced more than 70% of new cases of oral cancers to HPV infection, putting it ahead of tobacco use as the leading cause of such cancers.
- Experts are working to understand why rates of oropharyngeal cancer — a type of head and neck cancer — have skyrocketed in recent years, increasing 225% between 1988 and 2004.
- Findings indicate that HPV is not likely to spread through kissing or casual contact and that most cases of oral HPV can be traced to oral sex.
- Sore throat or ear pain that doesn’t go away
- Constant coughing
- Pain or trouble swallowing or breathing
- Weight loss
- Hoarseness or voice changes that last more than 2 weeks
- Lump or mass in the neck
Penile Intraepithelial Neoplasia (PIN) and penile cancer
Penile cancer is a rare cancer that forms in the penis. Most penile cancers are squamous cell carcinomas (cancer that begins in flat cells lining the penis). The CDC estimates that each year in the U.S. there are about 400 men who get HPV-related cancer of the penis. Penile cancer is more common among Hispanic men than non-Hispanic men. While most males do not ever experience symptoms or health risks if they get one or more “high-risk” types of HPV, there are some cases of cell changes (neoplasia) on the penis, which are caused by “high-risk” types of HPV.
- First signs: changes in color, skin thickening, or a build-up of tissue on the penis.
- Later signs: a growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful and bleed.
Vaginal Intraepithelial Neoplasia (VAIN) and vaginal cancer
Vaginal cancer is a cancer that forms in the tissues of the vagina (birth canal). The vagina leads from the cervix (the opening of the uterus) to the outside of the body. The most common type of vaginal cancer is squamous cell carcinoma, which starts in the thin, flat cells lining the vagina. Another type of vaginal cancer is adenocarcinoma, cancer that begins in glandular cells in the lining of the vagina.
The CDC estimates that around 600 new cases of HPV-associated vaginal cancer are diagnosed each year in the U.S. More black and Hispanic women get vaginal cancer than women of other races and ethnicities, similar to cervical cancer.
The vaccine Gardasil® can help protect against infection with HPV subtypes 16 and 18 (as well as 6 and 11). Gardasil® was originally only approved for use in women to prevent cervical cancer, but it is now also approved to prevent vulvar and vaginal cancers and pre-cancers (in women) as well as anal cancers and pre-cancers in both men and women.
The American Cancer Society reports that risk factors include:
- Age (vaginal cancer occurs mainly in older women with 15% of cases found in women younger than 40. About half occur in women 70 or older)
- DES – a hormonal drug given to some women to prevent miscarriage between 1940 and 1971.
- Up to 90% of vaginal cancers and pre-cancers (vaginal intraepithelial neoplasia — VAIN) contain the human papilloma virus (HPV)
- Having had cervical cancer
- Vaginal irritation
- abnormal vaginal bleeding or discharge
- pelvic pain
- a lump, bump, or lesion in the vagina
- pain during sexual intercourse
Vulvar Intraepithelial Neoplasia (VIN) and vulvar cancer
Vulvar cancer is a cancer that occurs on the outer surface area of the female genitalia. The vulva is the area of skin that surrounds the urethra and vagina, including the clitoris and labia. In 2007 (the most recent year numbers are available) 1,149 women in the United States were diagnosed with vaginal cancer, of whom 376 died. Though it can occur at any age, vulvar cancer is most commonly diagnosed in older women.
The vaccine Gardasil® can help protect against infection with HPV subtypes 16 and 18 (as well as 6 and 11). Gardasil® is approved to prevent vulvar and vaginal cancers and pre-cancers (in women) and to prevent anal cancers and pre-cancers in both men and women.
The Mayo Clinic reports the following risk factors associated with vulvar cancer:
- Increasing age. The risk of vulvar cancer increases with age, though it can occur at any age. The average age at diagnosis is 65.
- Being exposed to HPV
- Being infected with HIV
- Having a history of precancerous conditions of the vulva
- Having a skin condition involving the vulva
- Itching that doesn’t go away
- Pain and tenderness
- Bleeding that isn’t from menstruation
- Skin changes, such as color changes or thickening
- A lump, wart-like bumps or an open