HPV and Cancer in Women: Symptoms, Treatments, and Prevention

HPV, with its many subtypes, causes numerous diseases in humans, from warts to cancer, and is a virus. HPV causes a very common infection that usually has no symptoms; nearly 80% of the population has some form of HPV infection. However, high-risk HPV types persisting in the body for a long time may cause infected cells to change and divide uncontrollably, contributing to cancer development. Prevention through vaccination is therefore very important.

HPV infections are generally cleared from the body by our immune system within 2 years. However, if certain HPV strains persist for several years, they may cause cellular changes that lead to cancer.

This article will summarize the different symptoms of HPV, some treatment options, and some prevention methods.

Pictures of HPV Symptoms

Human papillomavirus (HPV) infection may cause warts on the genitals and in the throat.

An HPV-related oropharyngeal wart can be seen above on the right side of the uvula (when viewed from the front).

HPV-related cervical lesions can be seen above. 

How Does HPV Spread?

HPV spreads through sexual and intimate skin contact.

There are more than 200 different HPV types; more than 40 infect humans. Different HPV types carry different risks.

Low-risk HPV rarely turns into cancer but may cause symptoms such as genital warts around the genitals and anus. These symptoms are not always visible, however. For example, they may occur inside the anus, vagina, or cervix.

High-risk HPV may cause no symptoms. However, if it persists in the body for a long time, it may cause several cancers, including:

• cervical
• vaginal and vulvar
• oropharyngeal (head and neck)
• anal

Whether HPV causes symptoms is unrelated to whether it is high- or low-risk. The only way to determine cancer risk or its presence is through microscopic examination and laboratory testing.

Related Topic: HPV – A Cancer-Causing Virus's Journey of Evading the Immune System

Cervix: HPV and Cancer Symptoms

A woman may show different symptoms depending on the type of HPV she has.

If HPV is low-risk, warts may develop on the cervix, causing irritation and pain. These warts may cause bleeding in some people.

High-risk HPV usually causes no initial symptoms. However, if the virus remains in the body for many years, infected cells may change and begin dividing uncontrollably. This process may lead to cancer.

Related Topic: What Does an Abnormal Pap Smear Test Result Mean? 

Early cervical cancer or the presence of precancerous cells may cause no symptoms. It is therefore important for women, depending on their age and other risk factors, to have screening every 3-5 years using a Pap or HPV DNA test.

Some symptoms of advanced cervical cancer include:

• pain during sex
• pain in the pelvic (groin) region
• unusual vaginal discharge
• unusual bleeding, such as after sex

Some symptoms of more advanced cervical cancer include:

• weight loss
• difficulty urinating and having bowel movements
• blood in the urine

Vagina and Vulva: HPV and Cancer Symptoms

HPV may infect cells in the vagina and around the vulva. If a woman's HPV is low-risk, she may notice warts on the vulva.

These warts may appear as:

• clustered skin lesions resembling cauliflower
• a scattered area of skin darker than unaffected skin
• a growth that may be raised, flat, smooth, or rough

Warts generally indicate low-risk HPV. A type of vulvar cancer may appear as a cauliflower-like growth, so a person should speak with a doctor if they notice an unusual growth around the vulva.

If untreated, high-risk HVP may cause vaginal or vulvar cancer. Women may have no symptoms when they have precancerous cells or are in the early stages of vaginal or vulvar cancer.

A Pap test can determine whether cells are precancerous, so it is important for women to have regular Pap tests approximately every 3-5 years. A doctor will examine the vulva while checking the vagina and cervix for precancerous cells. They will look for specific skin changes such as discoloration, sores, and lumps.

How often a person needs a Pap test depends on their age and other risk factors.

Some symptoms of vaginal cancer include:

• bleeding after sex
• unusual discharge
• a lump in the vagina
• pain during sex

Some symptoms of vulvar cancer include:

• a lighter or darker patch of skin
• a colorless bump or lump
• thickening of the skin
• itching
• pain
• bleeding
• an open sore that does not heal within a month

Mouth and Throat: HPV and Cancer Symptoms

Someone with low-risk HPV may notice warts at the back of the throat near the tonsils and at the base of the tongue. HPV may spread to these areas through oral sex.

However, a person with high-risk HPV may develop oropharyngeal (mouth and throat) cancer.

Some symptoms of oropharyngeal cancer:

• persistent sore throat
• ear pain
• hoarseness
• swollen lymph nodes
• pain on swallowing
• unexplained weight loss

What Are HPV's Effects on Women's Health?

HPV is very common. In fact, almost everyone who becomes sexually active contracts the virus, and approximately half of these infections are high-risk types.

A person's immune system usually controls or completely eliminates HPV infection. According to the World Health Organization (WHO), approximately 90% of HPV infections clear within 2 years.

Sometimes, however, a high-risk HPV type may persist for years and lead to cancer.

High-risk HPV causes 3% of all cancers in women. HPV also causes 99% of cervical cancers. HPV 16 and 18 in particular cause 70% of cervical cancers and precancerous lesions.

HPV Treatment

There is no treatment for HPV. Doctors can only treat the conditions caused by HPV and remove cells that appear cancerous or precancerous.

A doctor may treat genital warts with:

• prescription medicines
• cryosurgery (destruction by freezing)
• lasers or electric currents
• surgery

Doctors usually treat precancerous changes in the cervix using a loop electrosurgical excision procedure (LEEP), in which a thin wire loop carrying an electric current removes abnormal tissue.

Related Topic: What Is Conization, and How Is It Performed?

They may treat precancerous changes in other tissues with:

• medicines applied to the affected area
• LEEP
• surgery
• cryosurgery

If a person develops cancer as a result of HPV, they will receive treatment for that cancer, including surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy.

Protection Against HPV Through HPV Vaccination

Preventing HPV is very important globally. According to the WHO, cervical cancer is the fourth most common cancer in women worldwide.

The WHO strongly recommends vaccination against HPV strains that cause cervical cancer. It also recommends vaccinating girls aged 9-14 and cervical screening for women aged 30 and over. Some countries now also vaccinate boys.

HPV vaccines are available in several types: bivalent, quadrivalent, and nonavalent. Gardasil and Cervarix are widely used HPV vaccine brands. All 3 vaccines are available in Turkey.

When and How Often Should the HPV Vaccine Be Given?

The US CDC (Centers for Disease Control and Prevention) recommends:

• All girls and boys aged 11 - 12 should receive 2 doses of HPV vaccine. The first dose is routinely recommended at ages 11-12. Vaccination may begin at age 9. There may be 6-12 months between the first and second doses.
• Adolescents and young adults aged 15 to 26 who begin vaccination should receive three doses within six months.
• The bivalent and quadrivalent vaccines were suitable up to age 26. The nonavalent vaccine may be given up to age 45.

What Are HPV's Effects on Men's Health?

HPV is also a common infection in men, with both low- and high-risk types. HPV infections in men generally cause no symptoms and may be controlled and eventually eliminated by the immune system. In some cases, however, HPV may also lead to serious health problems in men.

1. Genital warts: Low-risk HPV types may cause genital warts in men. These warts may appear on the penis, scrotum, anus, or groin.

2. Cancer: High-risk HPV types may cause cancer in men. The most common HPV-related cancers include anal, penile, and oropharyngeal (head and neck) cancers. High-risk HPV types remaining in the body for a long time may cause infected cells to change and divide uncontrollably, contributing to cancer development.

   • Oropharyngeal cancer: High-risk HPV types increase the risk of oropharyngeal (mouth and throat) cancer in men. Symptoms include a persistent sore throat, ear pain, hoarseness, swollen lymph nodes, pain on swallowing, and unexplained weight loss.

Vaccination is important for reducing and preventing HPV's effects in men. The HPV vaccine strengthens men's immunity against high-risk HPV types and reduces the risk of cancer development.