Genital human papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the United States. It’s so common that, by age 50, about 4 in 5 women have been infected with HPV at some point.
More than 40 HPV strains can infect the genital areas of men and women, as well as the lining of the mouth and throat.
Most people infected with HPV don’t know they have it, as it often produces no symptoms. And the immune system can generally get rid of the infection within about two years.
At the OB/GYN office of Dr. Hany H Ahmed in Houston, Texas, Dr. Ahmed usually tests for HPV infection during a routine Pap smear. Results that come back positive can take two forms: low-risk or high-risk. Here’s what you need to know about the difference.
What’s the difference between low-risk and high-risk HPV?
HPV is usually classified into non-oncogenic (wart-causing) or oncogenic (cancer-causing), based on the strain’s ability to increase a person’s risk for cancer. The types that cause genital warts aren’t the same as those that cause cancer.
Low-risk HPVs mostly cause no disease, though a few types can cause warts on or around the genitals, anus, mouth, and/or throat.
HPV infections unsuccessfully controlled by your immune system are more likely to become high-risk. They can persist for years and lead to cell changes that, untreated, may turn cancerous. In the US, high-risk HPVs cause 3% of all cancers in women and 2% in men.
Long-lasting, high-risk HPV infections can cause cancer in areas of the body where HPV infects cells: the cervix, oropharynx (back of the throat, tongue, tonsils), anus, penis, vagina, and vulva.
The virus infects the squamous cells that line these organs’ inner surfaces. That makes most HPV-related cancers a form of squamous cell carcinoma. Some cervical cancers that derive from HPV infection of gland cells in the cervix are called adenocarcinomas.
Most HPV infections, even high-risk ones, rarely cause symptoms in the cervix, which is why it’s so important to get regular cervical cancer screenings with Dr. Ahmed.
Precancerous lesions at other body sites may cause symptoms like itching or bleeding. And if the infection develops into cancer, the cancer itself may cause symptoms like bleeding, pain, or swollen glands.
If Dr. Ahmed finds high-risk HPV, he can take a number of steps to control any abnormal cells before they can form a cancerous mass. He might:
- Schedule a repeat HPV test or HPV/Pap test in 1 or 3 years
- Conduct a colposcopy (examines cells at high magnification) to check for abnormalities
- Obtain a biopsy (a sample of cells) to check for abnormalities
- Recommend treatment
The goal of treating abnormal cells is to remove or destroy their chance to turn cancerous. The most common treatment for high-grade cell changes is conization, in which Dr. Ahmed removes a cone-shaped piece of tissue from the cervix and cervical canal.
There are two types of procedures:
Loop electrosurgical excision procedure (LEEP)
Dr. Ahmed passes a current through a thin wire loop to remove abnormal tissue; done in-office.
Cold knife conization
He removes the abnormal tissue with a scalpel; done at the hospital under general anesthesia.
Two other treatments commonly used are laser therapy to remove or destroy abnormal cells and cryotherapy, which uses a cold probe to freeze and destroy the abnormal tissue.
The HPV vaccine
In 2006, the FDA approved a vaccine against HPV. Children ages 11–12 should get two doses, given 6 to 12 months apart, before they’re exposed to the virus. Since the vaccine’s introduction, HPV infections and cervical precancerous lesions have dropped.
- Among teen girls, HPV infections with strains that cause most HPV cancers and genital warts dropped 88%
- Among young adult women, HPV infections with strains that cause most HPV cancers and genital warts dropped 81%
- Among vaccinated women, cervical precancerous lesions caused by HPV dropped 40%
If you’re diagnosed with high-risk HPV, it’s not a death sentence. It simply means Dr. Ahmed needs to take a closer look at infected areas and treat any abnormal cells. To learn more about the process, or to schedule a consultation with Dr. Ahmed, call our office or book online today.