You Should Know This About Human Papilloma Virus (HPV)

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Americans are more aware that there is a test for human papillomavirus (HPV) than their counterparts in the UK and Australia, according to a new study, but few people know much more than that.

“Awareness of HPV has tended to be low but has been rising since the introduction of testing and vaccination,” said Jo Waller, the study’s senior author.

Background: HPV is a virus that you may not know much about, but you should. There are about 30 to 40 types of HPV that can affect the genital areas. The US Centers for Disease Control and Prevention (CDC) offers that there are about 6 million new cases of genital HPV infections in the USA annually. About 74% are among 15 to 24 year olds. Exposure can occur with any genital contact (not just intercourse), and the virus itself causes no symptoms. F9r many people, HPV is transmitted during their first 2 to 3 years of sexual contact.

  • HPV typically clears on its own. But for those who don’t clear certain subtypes, HPV can cause cervix, vaginal, and vulvar cancer among females. Other types can result in genital warts and anal cancer among both women and men.
  • HPV is now the leading cause (above even tobacco and alcohol) of cancers of the oropharynx (including the base of tongue and tonsils).
  • There is now a vaccine that can help protect against high-risk types of HPV. In the USA, Gardasil may be offered to girls and young women ages 9 to 26. Boys and young men may be offered it, too. Still, only a doctor or health professional can decide (with you) if the vaccine is appropriate for you. The vaccine is not used for treatment.

People seem to be more aware of HPV vaccination than testing, however, which is not surprising given the publicity around the vaccine, added Waller, a public health researcher at University College London.

  • The Pap test used to look for abnormal cell changes in the cervix is much older and generally familiar to most people, but the newer HPV test looks for the virus that causes those changes, Waller said. The HPV test was only introduced in the 1990s and it’s used a little differently in each of the countries that were included in the new study, Waller pointed out.

Worldwide Variation: In the U.S., HPV testing is used as a screening tool in women over the age of 30. In both the U.S. and the UK, HPV testing is also used along with the Pap test to determine the next steps in treatment – for instance, biopsy. In the UK and Australia, the HPV test is also used to monitor treatment results.

Waller said that many studies have attempted to assess the public’s knowledge about HPV and HPV testing, but they all used different methods and asked questions in different ways, so it’s hard to compare the findings. “We wanted to use the same questionnaire to look at knowledge across three countries where HPV testing is used in different ways,” she told Reuters Health in an email.

The Study: The researchers used an online survey to find out if participants in the the U.S., UK and Australia were aware of HPV testing and HPV in general.

  • The first question asked was ‘Before today, had you ever heard of HPV?’ Participants who responded ‘yes’ were then directed to 15 general questions about HPV.
  • Participants were then asked ‘Have you ever heard of HPV testing?’ Those who responded ‘yes’ were asked six more questions about the test.

Of the 2,409 men and women who answered the survey, about 61% had heard of HPV. Among those who had heard of the virus, only half were aware of the HPV test. Awareness of the HPV test was higher in the U.S. than in the UK and Australia.

The participants who had heard of HPV testing, on average, answered less than half of questions about details of testing correctly. Overall, women knew more than men.

  • Most of the survey participants did know, for example, that the HPV test can be done at the same time as the Pap test, and that a positive HPV test doesn’t mean a woman will definitely get cervical cancer.
  • But they didn’t know a negative HPV test indicates a low risk of cervical cancer. Few also knew that the HPV test is not an indicator of whether the HPV vaccine is needed.

“It’s important for people to understand that although the HPV vaccine protects against HPV, it’s still really important for women to have screening, to check for (virus) types not covered by the vaccine,” Waller said. Women who are screened and found not to have the HPV virus should be reassured that their risk of developing cervical cancer over the next five years is extremely low, Waller added.

And now you know a bit more about HPV (Human Papilloma Virus). I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

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Reference: Sex Transm Infect doi:10.1136/sextrans-2013-051402; http://gardasil.com/hpv-and-your-child/who-gets-hpv/

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understandcancerin60minutes

Harvard AB Yale MD UPenn Radiation Oncology Radiation Oncologist, Seattle area

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