Updated March 2014
HPV is a very common virus. Most people (up to 80%) will have HPV at some time in their lives. There are over 100 different types. About 40 types infect the genital area. These are divided into “high-risk” and “low-risk” types. Low-risk types can cause genital warts. Approximately 13 high-risk types can cause cervical (neck of the uterus) or anal cancer. Most HPV infections do not cause any symptoms and go away on their own with a good immune system. There is no way to know who will clear the infection and who will develop cancer or other health problems.
The most common way to get HPV is during sexual activity with skin-to-skin contact. Most people do not know they have HPV or that they are passing it on to someone else. HPV may be passed on through oral sex. It is not clear if HPV can be spread through contact with fingers or objects that have been in contact with the virus.
Signs and Symptoms
Warts: If a person is infected with the wart-causing type of HPV, they may not have any symptoms or warts may appear weeks or months later. Warts do not all look the same: some may be fleshy or cauliflower-like while others may be small hard spots or tags. Warts can appear in the genital, vaginal or anal area and rarely, on or in the mouth. They can cause itching and sometimes they can bleed. Warts will not turn into cancer.
No symptoms: Most commonly, a person with HPV on their genitals and/or anus will have no symptoms, but they can still pass HPV to a partner.
Diagnosis and Tests
A health care provider can usually diagnose warts by examining the genital area.
A Pap test is used to screen for cervical cancer. A Pap test takes a sample of cells from the cervix and can detect changes in these cells that are usually caused by HPV. Most of the time, these changes return to normal on their own. However, some abnormal cells do not get better or are considered more serious. These require a test called a colposcopy. A colposcopy uses a special magnifying microscope to "see" the cells of the cervix and upper vagina. Cell changes that do not get better on their own may need treatment.
At the moment, there is no blood test to screen for HPV. There is a test available to screen for high-risk HPV strains on the cervix, but it is not covered by OHIP. In the future, screening for cervical cancer may routinely be done with this test. If you have more questions, you should talk with your health care provider.
In women, high-risk types of HPV can cause cervical cell changes that may lead to cervical cancer. Ninety percent of cervical cancers are preventable by having regular Pap tests and treating the abnormal cells when necessary.
In men, high-risk types of HPV may lead to cancer of the penis but this is rare. In men and women HPV infection can put you at risk for anal and/or throat cancer.
There is no cure for HPV. A person’s immune system usually clears the virus from the body. If warts or pre-cancerous changes occur there are treatments available.
The most common way to remove genital warts is with chemical preparations, freezing, lasers or surgery. Some treatments are applied by your health care provider while others can be self applied at home. However, the warts can come back until your body clears the infection naturally. Some people choose not to treat the warts and see if they disappear on their own.
Pre-cancerous cells on the cervix can be treated with laser, freezing or surgical removal
Male condoms used consistently from beginning to end of sexual contact give some protection against HPV for the parts that are covered. If warts are visible in the genital area of a new partner, avoid all genital skin-to-skin contact. However, most HPV infections have no signs or symptoms so vaccination is your best protection.
Once sexually active, a woman should have a Pap test at the age of 21 and then every three years if results are normal. Women who have had an abnormal Pap test result may need to test more frequently.
Vaccination: There are two HPV vaccines available in Canada: Gardasil and Cervarix. Both vaccines are very effective in preventing infection from certain types of HPV. Both Gardasil and Cervarix protect against infection from the two "high-risk" types of HPV (16 and 18) which cause about 70% of all cervical cancers. Gardasil also protects against the two "low-risk" types of HPV (6 and 11) which cause about 90% of all genital warts. Women who have been vaccinated still need to have regular Pap tests. See HPV Vaccine Information.
Information for Sexual Partners
In most cases your current partner will already be infected with the HPV virus at the time of your diagnosis. Most HPV-infected partners will not have nor will they develop any signs or symptoms. It is only necessary for them to see a health care provider if they have suspicious bumps.
Remember, you may still be able to pass on the virus after treatment for warts. The time it takes for your body to clear the HPV virus is difficult to predict but nearly everyone with the virus will clear it within a maximum of two years.