Medically reviewed on April 26, 2023 by Morgan Spicer, Medical Communications Manager. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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Human papillomavirus, or HPV, is a virus that commonly leads to growth or warts on the skin or the body’s mucous membranes. There are more than 150 varieties of HPV, and although many result in no symptoms or warts on the body or genitals, there are some kinds of HPV that can result in cancer.
HPV infections can be acquired by skin-to-skin contact or by sexual intercourse. In fact, HPV is estimated to be the most common sexually transmitted infection, or STI. Most infections are asymptomatic, and around 90% of HPV infections are cleared by the body within two years, but there is no cure for HPV, and the infections that persist can result in developing cancer . Nearly all cervical cancers are associated with HPV infections–with around 94% of cervical cancers being linked to HPV subtypes 16, 18, and 45–-but HPV infections are also associated with certain oropharyngeal (throat), rectal, anal, vaginal, vulvar, and penile cancers. [1, 4].
Most cases of HPV infection have no symptoms at all, and are naturally cleared by the body in two years. In those who do show symptoms, HPV normally manifests as papillomas, or warts, on the body. These can include common or plantar warts on the hands, feet, or other areas of the body, or genital warts. Warts often appear as hard, raised or bumpy lesions on the skin. HPV can be spread by skin-to-skin contact, or by contact with contaminated surfaces.
HPV is divided into low-risk and high-risk strains. The strains that are responsible for causing warts on the body and genitals are usually considered low-risk and can be diagnosed visually, so testing is not required. To test for the high-risk kinds of HPV that can result in cervical cancer, there are a few common testing methods [5-6]:
Sometimes, both types of tests are performed together. This is referred to as co-testing. HPV tests and Pap smears are often done during pelvic exams, but not always included. Be sure to ask your healthcare provider about which HPV testing method, if any, they are including as part of your pelvic exam.
The American Cancer Society (ACS) has recently updated their guidelines for HPV testing. Currently, the guidelines include :
The ACS advises that those who are vaccinated against HPV should still comply with the above screening guidelines. Additionally, there are some groups who no longer need screening, such as some women over the age 65, as well as those who have had hysterectomies for certain medical reasons.
The first step, and one of the most effective, to reducing the risks associated with HPV is to get vaccinated against the high-risk strains. The vaccines work best before you are exposed to HPV, so the CDC recommends vaccination in all people starting at the age of 11 or 12, and the vaccinations are FDA-approved. For those who are sexually active, using barrier methods such as condoms during sexual intercourse can help prevent HPV transmission.
HPV infection is exceedingly common, and one of the most effective ways to handle any risks that may arise with infection is regular screening. Because it takes years for HPV to develop into cancer, pre-cancerous or abnormal cells can often be treated before they progress to cancer.
There are many potential roadblocks and barriers to HPV testing, especially in the traditional setting. Studies have shown that many people find the traditional clinic setting to have a number of barriers to HPV screening. Some of the top reasons include:
There are numerous issues associated with following HPV screening guidelines. In many studies, HPV test self-collection has been shown to reduce or remove a number of barriers associated with traditional in-person care.[10, 11]. At-home self-sampling has been shown to be clinically effective, and has the added benefits of reducing or removing many of the top-reported reasons for avoiding screening. In the comfort and privacy of home, patients report feeling less embarrassed or uncomfortable, and more likely to comply with the ACS screening guidelines. [10,11]. For those who struggle with cost, self-collection methods can be lower cost than in-clinic visits. [10, 11].
Although most infections of HPV are harmless, there are still a number of cases that progress to serious conditions such as cancer. For this reason, taking measures to protect yourself against infection, like getting vaccinated and practicing safe sex, are important to consider. Regardless of whether you are vaccinated, or think you have contracted an infection, it’s important for people with cervixes to follow regular screening guidelines. Though there are a lot of people who report avoiding traditional in-person screening for a variety of reasons, at-home lab testing shows a promising option to help make HPV screening accessible to a larger number of people.
HPV test vs. pap smear: what's the difference?