Find out more: HPV and males

HPV and Females

Q. What is cervical cancer?

Cervical cancer is cancer of the cervix. The cervix is the lower part of the uterus, or womb, and is 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 abormalities. If undetected, these abnormalities can develop into tumours and spread into the surrounding tissue.

Q. What causes cervical cancer?

While factors such as the oral contraceptive pill, smoking, a woman's immune system and the presence of other infections also seem to play a part, a woman has to have been infected with certain "high-risk" HPV types before cervical cancer can develop. "High-risk" types 16 and 18 are responsible for ~70% of all cervical cancers.

Q. How common is cervical cancer?

Each year in Australia approximately 600 new cases of cervical cancer are diagnosed and approximately 130 women die from this disease. Globally, cervical cancer is the second most common women's cancer, which is why many countries, including Australia, have implemented regular cervical screening (i.e. Pap smears) programs to detect cervical abnormalities.

The incidence of invasive cervical cancer has fallen dramatically in the last decade due to the formation of the National Cervical Screening Program, which takes the form of 2-yearly Pap smears for women.

Reference: Australian Institute of Health and Welfare. Cervical Screening in Australia 2009-2010. April 2012 AIHW cat no CAN 67.

Q. What is HPV?

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, do not 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. More than 80% of females and males will be infected with at least one type of genital HPV at some time.

Genital HPV types may be "high-risk" types (such as HPV types 16 and 18) that can cause cervical pre-cancer and 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 the "high-risk" and "low-risk" types of HPV can cause abnormal Pap smears.

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 means it's possible to get the virus without having intercourse. And, because many people who have HPV may not show any signs or symptoms, they can transmit the virus without even knowing it. A person can be infected with more than one type of HPV.

It is estimated that many people get their first type of HPV infection within their first few years of becoming sexually active.

Genital HPV infection is not something to feel embarrassed or ashamed about. It is very common and for the majority of people who have HPV, the body's defences are enough to clear the virus. Up to 90% of infections are “cleared” within the first 36 months. It could almost be considered a normal part of being sexually active.

Q. How will I know if I have HPV infection?

Because HPV infection does not usually show any signs or symptoms, you probably won't know you have it. Most people can therefore get HPV and pass it on without evening knowing it.

Most women are diagnosed with HPV disease as a result of an abnormal Pap smear. A Pap smear is part of a gynaecological examination that aims to detect abnormal cervical cells (pre-cancers) in the lining of the cervix before they have the chance to become cervical cancer. In fact, invasive cervical cancer is one of the most preventable cancers. Although distressing, pre-cancers detected during a Pap smear can be treated. That's why it's important to follow your healthcare professional's recommendation about regular Pap smears.

Q. What are the consequences of HPV?

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.

In females, HPV has been shown to cause cervical cancer and some vaginal, vulval and anal cancers and genital warts.

In males, HPV has been shown to cause genital warts and some anal cancers.

Q. What is a Pap smear?

The Pap smear or 'Pap test' is a test that can detect abnormal cells in the cervix that may lead to cervical cancer. When detected early, changes to the cervix are easy to treat. That is why having a Pap smear every 2 years is so important.

A Pap smear requires the use of a vaginal speculum but it only takes a minute or two. It is performed by a doctor or nurse, who will take a sample of cervical cells by touching the cervix with a small brush and spatula. The cells are then smeared onto a glass slide, which is sent to a pathology laboratory to be examined under a microscope.

Pap smears are usually performed every 2 years, unless your GP or nurse has asked you to have them more frequently. Regular Pap smears are a very good way of picking up abnormal cells before they progress into cervical cancer. If you are, or have ever been, sexually active (with either male or female partners) you should be having 2-yearly Pap smears, starting when you are 18 to 20 years old, and continuing through until age 70.

A Pap smear only tests for abnormal cells of the cervix. It does not screen for ovarian cancer or any other gynaecological cancers.

Q. How can I help protect myself against HPV infection and disease?

Click here for more information.

Q. 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.

According to current Australian guidelines, if a woman's Pap smear shows low-grade changes, her healthcare professional may advise a repeat smear sooner than 2 years (usually after 6 or 12 months). Sometimes colposcopy (an examination of the cervix with a special microscope) may also be offered, either straight away or after the Pap test, if it shows that the low-grade changes are still present.

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's Pap smear shows high-grade precancerous changes she will be referred for a 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.

Q How is cervical cancer treated?

If, 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. The cancer may be staged according to the level of invasiveness. Usually, treatment for cervical cancer 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.

If detected early, cervical cancer can be treated, but as with any medical condition prevention or early detection is always best if it is available.

Q. How common is anal cancer?

Anal cancer affects both males and females and, although relatively rare, in 2005 there were 149 cases in males and 176 cases in females.

Infection with certain types of "high-risk" HPV types (such as HPV types 16 and 18) is a risk factor for anal cancers as well as other risk factors including cigarette smoking, immunodeficiency syndromes and a previous history of genital cancers.

Q. How are anal cancers treated?

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

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What is the main cause of cervical cancer and has been shown to cause some vaginal, vulval and anal cancers and genital warts?

Smoking
Human Papillomavirus (HPV) infection
Weakened immune system
Other infections

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 before cervical cancer can develop.

In most people HPV is harmless and has no symptoms, but in some people the virus may persist and lead to diseases of the genital area.

In females, HPV has been also been shown to cause some vaginal, vulval and anal cancers and genital warts.

In males, HPV has been shown to cause genital warts and some anal cancers.

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What areas of the body are different HPV types able to infect?

Hands
Feet
Genitals
All of the Above

Human Papillomavirus, or HPV, is a common virus that affects both males and females. There are more than 100 types of the virus. In fact, certain types of HPV cause common warts on the hands and feet

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Up to what proportion of males and females will be infected with at least one type of genital HPV at some time?

5%
15%
30%
80%

Up to 80% of people (males and females) will be infected with at least one type of genital HPV at some time

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There are over 100 types of HPV. Approximately how many infect the genital area?

40
60
80
100

About 40 types of HPV are known as genital HPV as they affect the genital area.

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What percentage of HPV infections are “cleared” by the body’s immune system within the first 36 months?

30%
60%
90%
99%

Up to 90% of HPV infections are "cleared" within 36 months.

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Which two “high-risk” HPV types have been shown to cause approximately 70% of all cervical cancers?

HPV 16 & 33
HPV 16 & 18
HPV 42 & 51
HPV 18 & 42

"High-risk" HPV types 16 & 18 are responsible for ~70% of all cervical cancers.

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Approximately how many new cases of cervical cancer are there a year in Australia?

200
400
600
1000

Each year in Australia approximately 600 new cases of cervical cancer are diagnosed and approximately 130 women die from this disease.

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Globally cervical cancer is the fourth most common cancer in women?

True
False

Globally, cervical cancer is the second most common women's cancer, which is why many countries, including Australia have implemented regular cervical screening (i.e. Pap smears) programs to detect cervical abnormalities.

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Approximately how many cases of anal cancers are there each year in Australia?

25
125
225
325

Anal cancer affects both males and females and, although relatively rare, in 2005 there were 149 cases in males and 176 cases in females.

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Which two types of “low-risk” HPV types have been shown to cause approximately 90% of genital warts?

42 & 31
42 & 52
6 & 11
11 & 45

Up to 90% of genital warts cases are due to infection with “low-risk” HPV types 6 and 11

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It is estimated that what proportion of young sexually active people have genital warts at any one time?

1/50
1/100
1/250
1/500

Genital warts are quite common. Approximately 1% of young sexually active people have them at any one time.

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How are females able to help protect themselves against cervical cancer?

Attend regular Pap smears when recommended to do so
Speak to their doctor about whether they are eligible for vaccination
Use condoms to help reduce the risk of being infected with HPV
All of the above

If used correctly, condoms can help reduce the risk of genital HPV. It is now possible to be vaccinated against cervical cancer. Vaccination does not protect against all HPV types that could cause cervical cancer therefore it is important women continue with regular Pap smears.

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How are males able to help protect themselves against genital warts and some anal cancers?

Speak to their doctor about whether they are eligible for vaccination
Use condoms to help reduce the risk of being infected with HPV
Both of the above

If used correctly, condoms can help reduce the risk of genital HPV. It is now possible to be vaccinated against some types of HPV. It is important you discuss whether you are eligible for vaccination with your doctor first.

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