HPV and Females

HPV and females

HPV EXPLAINED

Human Papillomavirus, or HPV, is a common virus that affects both females and males. There are more than 100 types of the virus. In fact, certain types of HPV cause common warts on the hands and feet. Most types of HPV are harmless, don’t cause any symptoms, and go away on their own.

About 40 types of HPV are known as genital HPV, as they affect the genital area. Up to 80% of females and males will be infected with at least one genital type of HPV at some time in their lives.1

Genital HPV types may be “high-risk” types (such as HPV types 16, 18, 31, 33, 45, 52 and 58) that have been shown to cause some forms of cancer, or “low-risk” types (such as HPV types 6 and 11) that can cause genital warts and usually benign (abnormal but non-cancerous) changes in the cervix. Both “high-risk” and “low-risk” types of HPV can cause abnormal changes.

HPV is easily spread through direct skin-to-skin contact. Anyone who has any kind of sexual activity involving genital contact could get genital HPV. That

HOW WILL I KNOW IF I HAVE HPV?

Because HPV infection doesn’t usually show any signs, you probably won’t know you have it. Most people can therefore get HPV and pass it on without even knowing it.

CONSEQUENCES OF HPV INFECTION

In most people, HPV is harmless and has no symptoms, but in some people the virus may persist and lead to disease of the genital area, including genital warts and cancers of the cervix, vagina, vulva and anus.

ABOUT CERVICAL CANCER

Cervical cancer is cancer of the cervix (which is the lower part of the uterus, or womb, situated at the top of the vagina). Cervical cancer develops when abnormal cells in the lining of the cervix begin to multiply out of control and form pre-cancerous abnormalities. If undetected, these abnormalities can develop into tumours and spread into surrounding tissue.

While factors such as the oral contraceptive pill, smoking, a woman’s immune system and the presence of other infections seem to play a part, a woman has to have been infected with certain "high-risk" HPV types for cervical cancer to develop. "High-risk" types 16, 18, 31, 33, 45, 52 and 58 are responsible for up to 90% of all cervical cancers.

DOES EVERYONE WITH HPV GET CERVICAL CANCER?

Fortunately, no. For the majority of people who have HPV, the body’s defences are enough to clear the virus. For women who don’t clear certain “high-risk” types of the virus, abnormal changes can occur in the cells lining the cervix that can lead to pre-cancers and even develop into cervical cancer later in life.

Most often, the development of pre-cancer to cervical cancer takes a number of years, although in rare cases it happens more quickly. That’s why early detection is so important. Talk to your doctor about cervical screening.

HOW IS CERVICAL CANCER DETECTED?

Cervical cancer can be detected in two ways. A woman may present to her doctor with symptoms due to the cancer, or the cancer may be detected in its early stages through cervical screening.

HOW ARE ABNORMAL CERVICAL CELLS AND PRE-CANCERS TREATED?

Abnormal cervical cells can be divided into low-grade and high-grade abnormalities. Most low-grade abnormalities will clear without causing any lasting effects.

Occasionally, high-grade changes will progress to cervical cancer if left untreated. This usually takes a number of years, although in rare cases it can happen sooner.

If a woman has high-grade pre-cancerous changes detected through cervical screening, she will be referred for colposcopy.

In many cases, during the colposcopy a small piece of tissue (a biopsy) will be taken from the cervix. If the biopsy confirms the woman has a high-grade cervical abnormality (referred to as CIN 2 or 3), she will most likely be offered surgery to remove the affected part of the cervix. This can be done using a variety of ways including, amongst other techniques, surgical excision and laser removal. This usually requires a day stay in hospital.

HOW IS CERVICAL CANCER TREATED?

If detected early, cervical cancer can be treated, but as with any medical condition, prevention or early detection is always best. When, after colposcopy and biopsy, a woman is found to have cancer of the cervix (rather than a pre-cancer), she will usually be referred to a specialist cancer gynaecologist for further assessment and management.

Treatment for cervical cancer usually involves surgery to remove the cancer (including local excision, hysterectomy) and/or radiotherapy with or without additional chemotherapy depending on the size or stage of the tumour.

ABOUT GENITAL WARTS

Genital warts are benign, flesh-coloured growths that are most often caused by certain "low-risk" types of HPV (types 6 and 11).

Genital warts most often appear on the external genitals or near the anus of males and females. Genital warts may cause symptoms such as burning, itching and pain. The types of HPV that cause genital warts are different from the "high-risk" types that can cause cancer.

After sexual contact with an infected person, genital warts may appear within weeks, months, or not at all.

HOW ARE GENITAL WARTS DIAGNOSED?

A doctor can usually recognise genital warts just by seeing them.

HOW ARE GENITAL WARTS TREATED?

Genital warts can disappear on their own without treatment; however, there’s no way of actually knowing if they will disappear or grow larger. Depending on size and location, there are several treatment options. A special cream or solution may be applied to the warts. Some genital warts can be removed by either freezing, burning, or using laser treatment. However, no matter the treatment, there’s a chance that genital warts will reappear after treatment, since the types of HPV that cause them may still be present.

ABOUT VAGINAL AND VULVAL CANCERS

Vaginal and vulval cancer are uncommon cancers. Infection with certain “high-risk” HPV types is a risk factor for vaginal and vulval cancers. Other factors include cigarette smoking and a previous history of genital cancer.

HOW ARE VAGINAL AND VULVAL CANCERS TREATED?

For patients diagnosed with vaginal and vulval cancers, the main treatment options are surgery, radiation therapy and chemotherapy.

ABOUT ANAL CANCERS

Anal cancer is an uncommon cancer that affects both males and females. Infection with certain types of "high-risk" HPV is a risk factor for anal cancers as well as other risk factors, including cigarette smoking and immunodeficiency syndromes.

HOW ARE ANAL CANCERS DIAGNOSED?

Anal cancer sometimes has no symptoms at first. Common symptoms can include bleeding and discomfort in the area. Other symptoms can include pain, itching, straining during a bowel movement, change in bowel habits, change in the diameter of the stool, discharge from the anus and swollen lymph nodes in the anal or groin area. A doctor may diagnose anal cancer using a number of tests such as a physical exam and history, digital rectal examination (DRE), anoscopy, proctoscopy, biopsy or ultrasound.

HOW ARE ANAL CANCERS TREATED?

For patients diagnosed with anal cancers, the main treatment options are surgery, radiation therapy and chemotherapy.

1. The Australian Immunization Handbook 10th Edition, 2013.