The Link Between HPV and Cervical Cancer

Seventy-nine million Americans may have the human papillomavirus (HPV), yet more than 76% of women in the United States have never heard of this sexually transmitted virus which causes virtually 100% of all cervical cancers.

Scientists have discovered approximately 100 types of the human papillomavirus virus. Visible genital warts occur in only about 1% of sexually active adults infected with the HPV virus, while other types of HPV are subclinical infections. The types of HPVs that cause genital warts (HPV types 6 and 11) are not associated with increased cancer risks. HPV types 16, 18, 31, 33, and 35 are linked to cervical cancer. These high-risk HPVs may also be linked to increased risk of cancers of the vulva, anus, and bladder.

A woman receiving a cervical cancer vaccine
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Symptoms of HPV and Genital Warts

Often, unless genital warts are located in a spot where you can see or feel them, you may not know you are infected. Genital warts sometimes go undetected because they are inside the vagina, on the cervix, or in the anus.

HPV is frequently difficult to detect because genital warts are often skin-colored and painless, and rarely cause symptoms. You should consult your physician anytime you notice unusual growths, bumps, or other skin anomalies, as well as if you experience itching, pain, or abnormal bleeding.

Diagnosing HPV

Genital warts or HPV viruses are sometimes detected during your annual GYN examination; however, the Pap smear is not a screening tool for HPV or any other STD or infection, as it looks specifically for abnormal cells. HPV can be detected with co-testing while getting the Pap smear. Although most HPVs do not progress to cancer, it is especially important for women diagnosed with HPVs to have regular Pap smears.

Starting at age 30, experts recommend that women ask for co-testing for HPV with their PAP testing. The tests can be done at the same time and will not cause a difference in the exam with your healthcare provider. The difference between the two tests is that the HPV test checks for the virus and the PAP test checks for cell changes. Co-testing is the best way to detect precancerous cells and early cancers in women 30 and older.

While the Pap smear is not designed to detect HPV (only abnormal cervical changes) abnormal changes may indicate HPV infection or another vaginal infection. Your physician will order either a follow-up screening procedure such as a colposcope or follow you closely to detect any further cervical changes when abnormal Pap results are obtained.

If your Pap smear result indicates dysplasia, it's important to note that cervical dysplasia does not mean cervical cancer. However, cervical dysplasia is thought to be a precursor condition for carcinoma in situ (CIS) and invasive cancer of the cervix. Many cases of dysplasia regress over time and the factors that lead to progression to invasive cervical cancer remain unclear.

In CIS, an outer layer of normal cells is replaced by cancer cells. CIS is about 95% treatable and curable. Invasive cancer of the cervix occurs when cancer cells invade the underlying tissues of the cervix. CIS generally occurs in women between 25 and 34, while invasive cancer of the cervix primarily occurs in women over the age of fifty.

The prognosis for invasive cervical cancer is largely dependent on the extent of disease at the time of initial diagnosis. The current death rate for cervical cancer remains higher than it should be due to the approximately one-third of women who do not have regular annual Pap smears. An astonishing 90% of cervical cancer deaths could be eliminated through earlier detection with the Pap smear.


Treating HPV is often difficult and frustrating for both the patient and the physician. Treatment of visible genital warts for the average patient often requires several treatments before symptoms subside. These treatments are not cures. After treatment, the virus may remain in nearby skin and lie dormant for months or even years before becoming visible again, and in some cases, visible warts never return.

The CDC recommends treatments of visible HPV genital warts that vary from patient-applied therapies such as podofilox and imiquimod to provider-administered therapies such as cryotherapy, podophyllin resin, trichloroacetic acid (TCA), bicholoracetic acid (BCA), interferon, and surgery.


Because we know that the type of HPV virus without genital warts is the cause of cervical cancers, and there is no treatment for this type of HPV, prevention of HPV is a key factor in the prevention of cervical cancer. Preventing HPV includes the same recommendations as for the prevention of other sexually transmitted diseases (STDs), specifically meticulous condom use by all sexually active individuals who are not in long-term monogamous relationships.

Limiting the number of sexual partners you have in your life may also be a significant component in the prevention of HPV and the associated increased risk of cervical cancer (evidence suggests that people with multiple sexual partners have a much higher incidence of HPV and cervical cancer).

Needless to say, if your sexual partner tells you that they have HPV, genital warts, or any other STD, make an appointment to see your physician.

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