Understanding the Prevalence and Complexity of HPV and Cancer
Many sexually active people get infected with HPV at some point in their lives, and some HPV types may also develop into cancers in people.
However, not all HPV infections progress into cancers. It can be treated on its own within two years of infection.
Then, what is the common factor that differentiates between non-cancerous HPV infection and rare cancerous HPV types?
The answer lies in its types. HPV is divided into low-risk and high-risk HPV types depending on their association with cancers.
This comprehensive article will elaborate on all HPV and cancer, their causes, and effective preventive strategies.
How does HPV cause cancer
Before understanding the complete mechanism of how HPV can cause cancer in people, it is necessary to get a brief understanding of the pathogen.
HPV is a group of more than 200 viruses that infect the skin and mucosal cells.
Depending on their association with cancer, they are further divided into two categories, low-risk and high-risk HPV types.
Low-risk types of HPV can be treated with the help of an active immune system, while high-risk HPV types may cause serious complications, such as cancers.
The development of cancer in people infected with HPV can be understood with an example of Cervical Cancer:
HPV infects the cells
When HPV infects the cells of the cervix, it interferes with various important processes inside a cell.
It can interfere with the cell’s replication, communication, and division processes, which may lead to changes in the cell’s function.
As an example, HPV has two proteins, i.e., E6 and E7. These proteins can turn off the tumor-suppressing genes p53 and Rb.
Thus, it can cause an abnormal growth of cells in the cervix, leading to more changes in genes and causing cancer.
Though these abnormal cells are recognized by the body’s immune system, sometimes, they may remain undetected for longer and continue to grow.
However, these abnormal cells do not cause cancer instantly.
As per the WHO, it can take 15 to 20 years for HPV-infected cells to develop into cancer.
But, this process can be faster in people who smoke and have weak immune systems.
HPV causes Dysplasia and precancers
Dysplasia is a precancerous condition in which cells grow abnormally within a tissue or organ.
HPV infection can lead to abnormal changes in the epithelial cells and, thus, causes Dysplasia of the vagina, cervix, penis, vulva, anus, and oropharynx.
Further, depending on the complexity, Dysplasia can be divided into three categories:
- Mild or low-grade Dysplasia: These types of Dysplasia usually go away on their own once the viral infection clears
- Moderate-grade Dysplasia: Persistent high-risk HPV infection can lead to this type of Dysplasia
- High-grade Dysplasia: In this type of Dysplasia, the cells have changed
It is important to remember that not all precancerous cells progress into cancers. These are abnormal cells that may turn into cancer. However, most precancerous cells do not morph into cancer cells.
What type of cancers does HPV cause
HPV may lead to six types of cancers in people.
The various types of HPV-related cancers are as follows:
Cervical Cancer
According to the WHO, high-risk HPV is linked to almost all (99%) Cervical Cancer cases.
HPV types 16 and 18 account for up to 70% of all cervical diseases.
However, as per the CDC, only 10% of women with cervical HPV infection will develop longer infection and increase their chances of Cervical Cancer.
The common symptoms of Cervical Cancer include:
- Vaginal bleeding between periods
- Painful sexual intercourse
- Pain in the lower abdomen
- Changes in your vaginal discharge, color, and smell
The Cervical Cancer screening test can be performed for the detection of changes in the female cervix’s cells.
This test includes a Pap test, also called Cervical Cytology, which identifies the HPV infection in the region.
Penile Cancer
Persistent high-risk HPV-type infection can lead to cancer of the penis.
As per a review in the Translational Andrology and Urology (TAU), HPV is found in almost 48% of Penile Cancer specimens.
Penile Cancer is most common in people with Human Immunodeficiency Virus (HIV) or involved in sexual relationships with other men.
However, there is no standard screening test for its early detection, as the majority of Penile Cancer starts under the male foreskin.
Some common symptoms of Penile Cancer are sores, bleeding, and penile discharge.
Vulvar Cancer
Vulvar Cancer occurs in the outer side of the female genital region.
Generally, this cancer forms a sore or a lump that may get itchy.
According to NCBI, the percentage of HPV-positive Vulvar Squamous Cell Carcinoma (VSCC) ranges between 18% and 75%, depending on geographical location.
HPV is involved in at least one of the two pathways leading to VSCC.
Vaginal Cancer
Vaginal Cancer is not a common cancer. It occurs at the lining of the female vagina.
Cancer that starts from the other body part, such as Uterine or Cervical Cancer can spread to your vagina and may lead to Vaginal Cancer.
Anal Cancer
HPV can cause cancer in the anus and is common in men and women.
It is seen more in people with HIV or who are involved in sex with an infected person.
Routine screening tests are not recommended for people with Anal Cancer.
Some physicians may recommend Anal Cytology Testing for screening of the disease.
Oropharyngeal Cancer
These types of cancers are also common in men and women and can infect the mouth and throat parts of the body.
Also, there is no screening test for the detection of Mouth and Throat Cancer. Still, many cancers can be detected with regular check-ups.
How to prevent HPV and cancer
HPV and cancer are preventable with effective strategies.
People can follow the given methods to decrease their chances of getting HPV infection:
Vaccinations
HPV vaccines are approved for both men and women and can effectively prevent infection.
Vaccines can prevent HPV and cancer, and other HPV types linked with genital and anal warts.
The vaccination must be given between the ages of 9 and 12.
Avoid sex with multiple barriers
Sexually active people should avoid having sex with many partners.
It can decrease the infection transmission from one infected person to a healthy individual.
Avoid having sex without barriers
Using condoms may be beneficial in limiting the transmission of infection-causing pathogens.
It cannot provide complete protection against HPV, as it cannot cover every possible infected area, such as genital or anal area.
Still, it can provide some protection against HPV and other STDs.
Conclusion
High-risk HPV types are the cause of HPV and cancer in people.
The mechanism of cancer starts when HPV infects the cells of the body, such as the cervix, and starts abnormal growth of cervical cells.
This can induce changes in the epithelial cells and may turn into cancers. However, this takes up to 20 years for abnormal cells to turn into cancer.
After inducing changes in the epithelial cells, HPV can cause cancers of the penis, vagina, cervix, anus, oropharynx, and vulva.
Fortunately, there are certain preventive strategies to decrease the chances of getting an HPV infection that can lead to cancer.
People can get vaccinated, avoid sex with multiple sexual partners, and use barrier methods to prevent HPV infection.
Further, on noticing any serious symptoms, it is important to consult a healthcare practitioner, perform screening tests, and seek treatment.
Frequently Asked Questions
What kind of cancer does HPV cause?
The high-risk Human Papillomavirus (HPV) type can cause cancers of the penis, cervix, vagina, anus, mouth and throat, and vulva in people. Thus, it is important to consult a healthcare practitioner and seek prompt medical attention to avoid serious complications.
Can you live with HPV without getting cancer?
Yes, you can live with HPV without getting cancer. Though HPV can cause a wide range of cancers in men and women, not all HPV infections turn into cancers. Almost 90% of HPV infections can be treated within two years. Only high-risk types of HPV infection can turn into cancers.
What percentage of high-risk HPV turns into Cervical Cancer?
When the body’s immune system cannot treat HPV infection and remains persistent for longer, it can lead to cancer. As per the CDC, only 10% of women infected with HPV in the cervix can have the risk of Cervical Cancer.
How does HPV cause cancer?
When HPV infects the cells of the body, such as the cervix, it interferes with the various cell processes. It can interfere with replication, and cell communication, which may cause abnormal growth of the cells and may increase the risk of HPV and cancers, such as Cervical Cancer.
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