Understanding HPV, cancer and vaccination

January is cervical cancer awareness month. Understanding this cancer requires an examination of HPV, the human papillomavirus.

Every year, nearly 14,000 cervical cancer cases are diagnosed, and even more cervical pre-cancers are found. Almost all of these cases are caused by HPV. Fortunately, these cases can be prevented in the future, thanks to HPV vaccination.

"HPV is very prevalent. We assume that everyone who is sexually active has been exposed because it affects such a massive portion of the population. It's the reason that we do testing and screening," said John Wallbillich, M.D., member of the Gynecologic Oncology Multidisciplinary Team at the Barbara Ann Karmanos Cancer Institute.

HPV is a group of more than 150 related viruses and the most commonly sexually transmitted infection globally. The Centers for Disease Control and Prevention (CDC) estimates that 79 million Americans — one out of every four people — are infected with HPV. Because it is so common, nearly every person who is sexually active will get HPV at some time in their life if they don't get the HPV vaccine. Most people with the virus do not develop symptoms and may never know they are infected. For others, the virus can lead to cervical and other gynecologic cancers or oropharyngeal (middle throat) cancers. Despite these figures, HPV vaccination rates remain low in the United States — just 49.5 percent of girls and 37.5 percent of boys have completed the HPV vaccine series.

The CDC estimates that vaccination can reduce more than 90 percent of the cancers caused by HPV every year. Vaccination is recommended for females and males at age 11 or 12 years but can be started as early as age nine and is recommended for everyone through 26 years of age, if not previously vaccinated.

As a National Cancer Institute-designated cancer center, Karmanos is among a group of elite, specialized centers from across the nation that shares the goal of sending a powerful message to parents, adolescents and health care providers about the importance of HPV vaccination for the elimination of HPV-related cancers.

Because vaccination rates are low, HPV and pap testing are crucial in providing favorable outcomes for patients and cervical cancer prevention. HPV testing can be completed alongside a pap test, which examines cells for irregularities that may indicate cancer or pre-cancer. Both tests require that a medical professional collect and analyze cells from the cervix. A health care provider can determine when and how often a woman should be tested based on age and health history.

"HPV gets into the DNA of the cell and causes an infection," said Dr. Wallbillich. "Many times, the body can clear the infection on its own. However, in some cases, the virus can stay in the cells. This causes irregularities which can turn into pre-cancer and even cancer... It would be impossible to prevent absolutely every single case of cervical cancer. Still, with routine testing, we can look for pre-cancerous or cancerous cells and test for the cancer-causing strains of HPV," said Dr. Wallbillich.

Karmanos Cancer Institute recommends that women talk to their gynecologist or primary care provider about HPV and pap testing. Those who do not have a gynecologist or primary care provider and would like to be screened may be seen by a specialist through Karmanos' Cancer Screening and Prevention Program. Women diagnosed with cervical cancer should also visit Karmanos to speak with a dedicated oncologist and design a treatment plan.