Hidden infection

Human papillomavirus (HPV) is a sexually transmitted virus that nearly everyone has been exposed to by the time they reach adulthood.

For some, the infection will be asymptomatic, while others may go on to develop warts or even cancer.

According to the Centers for Disease Control and Prevention (CDC), 90% of HPV infections in both men and women will resolve on their own within two years, as the immune system fights off and clears the virus from the body.

Women routinely undergo a Pap test, a non-invasive procedure to look for changes in the cervical cells. The test can also detect early cancers in the cervix as well as potentially precancerous conditions.

Doctors may perform an anal Pap test in men and women at increased risk for cancer caused by HPV, but there is no approved test for HPV in the throat like there is for the cervix.

Throat threat

Historically, cervical has been the most common HPV-related cancer, but over the past decade, cancer of the oropharynx (the tonsils and base of the tongue) has taken the top spot.

Researchers believe the rise is due to new and changing sexual behavior, including oral sex.

The good news is HPV-related oropharyngeal cancers, which are more common in but not exclusive to men, are highly treatable if caught early.

“Most men and women have had been exposed to HPV in their lifetime, but not all have had a high-risk exposure that is more likely to grow into cancer over time,” said Russell Smith, MD, section chief of head and neck surgical oncology at Baptist MD Anderson Cancer Center.

Early detection

“Unfortunately, there is no way to screen for HPV-mediated cancers in the oropharynx before a person starts showing clinical symptoms,” Dr. Smith explained. “An asymptomatic neck mass is far and away the most common presenting symptom we see. The second is persistent throat soreness. Once there’s a visible mass in the throat or a lymph node in the neck, the HPV has turned cancerous and the patient will require therapy.”

Though they can be subtle, early symptoms of oropharyngeal cancer may include:

• Earaches
• Voice changes
• Pain or difficulty swallowing

Reduce your risk

So, can you lower your chance of getting HPV? Here are Dr. Smith’s recommendations:

• Get vaccinated. The CDC recommends HPV vaccination as early as 11 years old, as it is most effective when given prior to any sexual activity. Those who have high-risk behaviors or haven't yet had sexual activity are candidates for the vaccine until age 45.
• Avoid sexual contact with a partner if genital warts are present.
• Use condoms correctly every time you have sex.

“Being vaccinated doesn’t mean you won’t still be exposed to HPV. It means you are less likely to have a chronic infection and it won’t turn your normal cells into cancer cells,” Dr. Smith said.

Researchers recently found about 75.1% of teens in the United States had received at least one dose of the HPV vaccine, up from 71.5% in 2020. That increase is crucial to lowering the rate of HPV-attributable cancers.

“We are anticipating over the next 10-15 years to see a drop in the number of men and women who have these cancers,” Dr. Smith said. “It’s such an important health issue because we really could eliminate a form of cancer if everyone got the HPV vaccine.”

Your primary care physician can administer the HPV vaccine and can either perform or help set up preventive care, like Pap tests. To schedule an appointment with a Baptist MD Anderson Cancer Center specialist, call 904.202.7300.