What is HPV Cancer? Symptoms, Causes & Treatment

On this page we explain which types of cancers are associated with HPV, how HPV works to cause cancer, and how many of these cancers occur in the US and UK every year. We also discuss steps that you can take to protect yourself and your loved ones from HPV-associated cancer. Finally, we provide a timeline of HPV and cancer to show you how far we have come, and how far we still have to go.

What is HPV?

HPV stands for human papillomavirus (HPV). It is the most common sexually transmitted disease in the United States with about 80 million people currently infected and nearly every person becomes infected at some point in their lifetime.

What types of cancer are caused by hpv?

Infection with HPV causes 5% of all cancers worldwide. Many people know about the link between HPV and cervical cancer, but did you know that HPV also causes at least five other cancers?

The majority of HPV-associated cancers are linked to just two types of HPV: types 16 and 18. There are about 16 high-risk types that have been identified, and there are over 100 different types of HPV overall. 40 HPV strains are sexually transmitted. The term ‘high-risk’ means that these types of HPV are more likely than other types to cause cancer.

Both low-risk and high-risk HPV infections can disappear on their own without causing any damage to the body. The symptoms are abnormal changes in cells and are usually very mild. They often go away even if left untreated. The immune system is often able to attack the virus before it has a chance to cause long-term infection. In fact, people can be totally unaware that they even had symptoms or HPV.

Some high-risk HPV infections can remain in the body for years, however. These longer-lasting infections can lead to more serious changes in cells that may progress to cancer if they are not found and treated. Please see our Anal Precancer information page for more details about the various types of anal precancer specifically. 

What types of Cancers are Associated with HPV?

HPV causes a majority of anal cancer (91%), cervical cancer (91%), oropharyngeal cancer (70%), vaginal cancer (75%) and vulvar cancer (69%), as well as some penile cancer (63%). Studies have also found HPV DNA in tumors of the oral cavity and larynx. Emerging studies also have found HPV DNA in lung tumors.

HPV-related cancers are on the rise in general. The National Cancer Institute (NCI) reports that incidences (new cases) of both anal and oropharyngeal cancers are increasing. It is estimated that by 2020 there will be more HPV-associated oropharyngeal cancer diagnoses than cervical cancer in high-income countries like the US and UK.

According to the Centers for Disease Control and Prevention (CDC) every year in the US, 4$,000 people are diagnosed with a cancer caused by HPV.

A study from 2015 [Saraiya et al. (2015). US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. Journal of the National Cancer Institute; 107(6)] gave the following HPV-associated cancer estimations based on a review of US Cancer Registries from 2008-2010:

In the US:

• HPV-associated anal cancer affects around 5,900 women and 2,690 men every year.
• The most common cancer attributed to HPV in US women is cervical cancer, with 10,900 HPV-attributable cases being diagnosed every year.
• The most common HPV-attributed cancer in men is oropharyngeal cancer with roughly 13,500 HPV-attributable cases diagnosed in men and women every year. Oropharyngeal cancer is sometimes called head and neck cancer. Some oral cavity and larynx cancers may also be connected to HPV.
• HPV-associated penile cancer affects around 800 men every year.
• There are about 600 HPV-associated vaginal cancer diagnoses every year.
• There are 2,800 HPV-associated vulvar cancer diagnoses every year.

Note that these numbers do not reflect the overall numbers of these specific cancers diagnosed every year, simply the HPV-related ones. Over the last few decades, scientists have discovered that more cancers in these sites are related to HPV.

In the UK, the following number of HPV-associated cancer cases were diagnosed every year from 2014-2016:

• • • 1,310 men and women were diagnosed with HPV-associated anal cancer.
    • 3,160 women were diagnosed with HPV-associated cervical cancer.
    • 9,556 men and women were diagnosed with HPV-associated head and neck cancer.
    • 401 men were diagnosed with HPV-associated penile cancer.
    • 189 women were diagnosed with HPV-associated vaginal cancer.
    • 909 women were diagnosed with HPV-associated vulvar cancer.

How do high-risk HPV types cause cancer?

All types of HPV infect squamous epithelial cells, which are the cells that cover the skin and mucous membranes. Once the infection has occurred, the virus is able to enter the cell and make proteins. Two of the proteins made by high-risk types interfere with normal cell functioning that prevents excessive growth. This interference causes the cell to grow uncontrollably.

In many cases, the infected cell is recognised by the body’s immune system, which will prevent the virus from doing serious harm. If the immune system does not kick in, however, the infected cells will continue to mutate and divide, causing more abnormal cells. This can lead to even more uncontrolled growth.

If growth continues, lesions (damaged tissue) develop which can eventually turn into tumors (cancer). Researchers believe that it can take from 10 to 20 years or longer for a new infection with high-risk HPV to develop into cancer.

HPV types that cause cancer include 16, 18, 31, 33, 34, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 and 70. Types 16 and 18 are the most common.

How many cancers worldwide are linked to the most common HPV types, HPV 16 and 18?

HPV 16 and 18 are the most common and most high-risk types of the virus. Of all cancers probably caused by HPV worldwide, the following are linked to these two specific types:

• • • 70% of cervical cancer
    • 92% of anal cancer
    • 89% of oropharyngeal cancer
    • 63% of penile cancer
    • 80% of vaginal cancer
    • 80% of vulvar cancer

How can HPV be prevented?

HPV Vaccination

Three vaccines are approved to protect people from the high-risk HPV strains that cause the most cancers. Two of these vaccines are approved for use in all males and females while one is approved only for females.

All male and female children in the US under 26 are recommended to receive the HPV vaccine. Routine vaccination is recommended at the ages of 11 or 12 during their pre-teen check-up, but the vaccination series can begin as young as 9.

In the UK, all male and female children are offered the vaccine at 12 and 13. Please see our Vaccination page to learn more about these vaccines and how they are effective in the fight against cancer.

Understand HPV transmission – How do people get hpv?

HPV is transmitted through skin-to-skin contact. In addition to immunization against various strains of the virus, staying safe from HPV-associated cancers involves protecting yourself from HPV infection. To do so means avoiding all intimate manual and genital contact with another person for an entire lifetime.

HPV is transmitted through multiple forms of sexual contact. HPV has even been found in young women and men who report no-to-limited penetrative sexual activity, reaffirming the importance of vaccination prior to any form of sexual activity. HPV transmission is also possible through all forms of sex, including oral sex. Emerging studies show that there may also be oral-to-oral transmission of HPV, but more studies are needed to show whether this transmission is possible through kissing.

Since most people will have at least one intimate partner at some point in their lives, nearly every person will be exposed to HPV. Someone with one life partner can still get HPV. However, a sexually monogamous relationship with an uninfected partner will likely reduce your chance of exposure to the virus. Most people are unaware that they are – or were ever – infected.

Even latex condoms, though helpful at reducing exposure, are not 100% reliable at preventing infection. Areas of skin not covered by the condom can still transmit the virus to a sexual partner.

Screening and Testing for HPV

Cancers can also be prevented with routine screening and follow up. The only routine screening method, and the most commonly known, is the cervical pap smear. However, if you feel or see abnormal changes in other parts of your anogenital or oral region, see your medical provider for further advice.

Cervical pap tests are recommended to look for abnormal cells on the cervix caused by HPV. Any abnormalities found can then be removed before they have a chance to get worse. In addition to the cervical pap test, the FDA has also recently approved HPV DNA tests for women over 25. These are not blood tests but look for HPV DNA in cervical cells. These can help determine whether a woman has any of the high-risk strains. Her physician can then recommend an appropriate course of action to prevent cancer.

Unfortunately, there is no routine standard test or screening process to detect HPV in men. There are also no standard screening protocols to detect HPV in locations in women other than the cervix. However, individuals who feel they may be at risk may want to consult their providers regarding screening options that exist but are not administered routinely.

Efforts are underway to study the best prevention and treatment methods for precancer in other parts of the anogenital area and the head and neck as the cervix is the only location routinely screened for abnormal changes related to HPV.

We are helping to lead the effort to establish better prevention options for anal precancer for men and women. There are tools available to detect anal precancer such as the anal pap, high-resolution anoscopy and DREs, but these are not yet included in official screening guidelines. We are working to advocate for expanded guidelines to other HPV-affected sites as quickly as we can to augment the already approved cervical precancer screening guidelines. Updating HPV-associated precancer screening guidelines will help to catch cancer early in thousands of people.

Please visit our Anal Precancer page for more information about methods that have been used effectively in screening for anal cancer.

Know Your HPV risk factors

It is important to remember that infection with HPV does NOT mean that a cancer diagnosis is inevitable.

However, certain risk factors, such as smoking or a compromised immune system, can increase the chance that an HPV infection will develop into cancer. You are also more likely to be diagnosed with an HPV-associated cancer if you have already had one. For example, a risk factor for HPV-associated vulvar cancer is a previous diagnosis of HPV-associated cervical cancer.

Please make sure to discuss your risk factors with your doctor, and ensure that you receive timely and adequate screening and medical care when necessary.

Why are we only learning about the link between HPV and cancer now?

Researchers have actually suspected that cervical cancer is linked to a sexually transmitted mechanism since the 19th century. They only discovered the specific connection between HPV and cervical cancer in the 1980s, however, when researchers in Germany found HPV in the majority of cervical tumors.

Still, not many people know about HPV or its association with cancer. This is partially due to lack of education about this issue and poor communication about it to the public. It is very common to only find out about HPV after a person has received an abnormal pap test or even a cancer diagnosis.

This is something that the Anal Cancer Foundation is working to change. We need to spread the word about the link between HPV and cancer to help prevent future tragedies. Now that we have a vaccination to prevent infection with the main cancer-causing types of HPV, we can put an end to these cancers!

Timeline of HPV and Cancer

1928:

Dr. George Papanicolaou discovers that cervical cancer cells can be detected with a vaginal smear test. This paves the way for him to produce the world’s first cervical cancer screening test, now known as the ‘pap’ smear, which swipes cells from the cervix, not the vagina.

1943:

The pap is introduced to physicians’ offices. It helps doctors detect and treat cervical cancer and precancer before it can spread to other organs. Over the next few decades, the pap test helps prevents thousands of deaths in high-income countries. Since its initial introduction, the pap smear has resulted in an approximately 70% decrease in cervical cancer rates in the US. 

1983-1985:

German researchers discover that most cervical pre-cancers and cancers contain HPV. They specifically find HPV types 16 or 18. Other types of HPV are later linked to cervical cancer, but 16 and 18 are considered the most risky. In the 1980’s, HPV’s link to anal, penile, vaginal and vulvar cancers is also discovered.

1990:

Some of the first studies linking HPV types 16 and 18 to cancers of the oropharyngeal region are published.

1999:

Widespread, Medicare-subsidized screening for cervical cancer in women over the age of 65 leads to a 19% reduction in diagnoses of this cancer from 1990. Screening has allowed greater detection of precancerous lesions, leading to earlier treatment, halting the development of cancer.

1999:

An HPV DNA test is approved by the FDA. It is different than the pap smear because it is looking for the presence of high-risk HPV DNA within the DNA of the cell using a specific machine, whereas the pap smear looks for abnormal changes to the cell that can be seen through a microscope. The HPV DNA test is able to identify DNA from several high-risk HPV types. The HPV test can detect HPV infections that have the potential to cause cell abnormalities, sometimes before these abnormalities are even visible.

The HPV test is currently approved for use in women over 25 without needing a concurrent pap test, as well as for women of any age who have had an abnormal pap test. Used alone, the HPV test will help determine the need for additional testing or screening. The HPV DNA test is better at detecting pre-cancers than the pap test, but also gives more false positives. In combination, the DNA and pap tests are excellent tools to detect pre-cancer risk. In 2014, the FDA approved the HPV DNA test to be used alone to detect precancer and determine the need for additional testing.

2006:

The FDA approves Gardasil, the first vaccine that protects against HPV. This first version of Gardasil prevents infection with HPV 16 and 18, the two high-risk strains that cause most anal, vaginal, vulvar, oropharyngeal, penile, and cervical cancers. It is approved for use in females and males ages 9-26, however, it is only routinely recommended for girls at this time. It is permissively recommended for boys in 2009.

2008:

A second vaccine against HPV 16 and 18 called Cervarix is approved for females aged 9-25 in the UK.

2009:

Cervarix is approved for females ages 10-25 in the US. Gardasil is also approved for use in the US in males ages 9-26 to prevent genital warts.

2010:

The FDA approves Gardasil for the prevention of anal cancer. The Anal Cancer Foundation testified before the FDA regarding the importance of preventing anal cancer.

2011:

In the US, Gardasil is routinely recommended for all children – boys as well as girls – at the age of 11-12. This means it is recommended for all children at their preteen check-up alongside other pre-teen vaccines, Tdap and Meningococcal. Catch-up vaccine is recommended up to the age of 21 for boys and 26 for girls who did not already receive the vaccine. It is recommended that men who have sex with men and immunocompromised men should also be vaccinated until the age of 26. During hearings held by the CDC, the Anal Cancer Foundation led a coalition of organizations to submit multiple testimonies in support of expanding the vaccine to protect all children against HPV and the cancers it causes. Read the testimony to the CDC.

2012:

The UK Department of Health approves Gardasil and it replaces Cervarix in the national immunization program.

2013:

The President’s Cancer Panel releases a report urging an increase in vaccine uptake. The panel notes that full vaccine coverage amongst adolescent girls was only at 33.4% in 2012. Amongst boys, coverage was even worse, at only 6.8%. The Panel calls these low rates “a serious threat to progress against cancer” The Panel stated: “By supporting vaccination as an urgent national and global health priority, the US National Cancer Program has an unprecedented opportunity to contribute to preventing millions of avoidable cancers and other conditions in men and women worldwide”.

2014:

The ANCHOR study begins. This study is designed to determine whether routine screening and treatment of high-grade squamous intraepithelial lesions (HSIL for short) in HIV+ men and women is an effective method of preventing anal cancer. This study is still actively recruiting participants. The Anal Cancer Foundation hopes that one day anal pap smears will become as routine as cervical paps are today. The ANCHOR study is the first step towards that day and saving thousands of lives a year. We wrote letters to the National Cancer Institute in support of this study. Read our September 2011 letter and our September 2012 letter.

Also in 2014, the FDA approved the use of a third vaccine, Gardasil 9, for use in females ages 9-26 and males aged 9-15. The ‘9’ was added as this vaccine provides protection against nine different strains of HPV: types 6, 11, 16, 18, 31, 33, 45, 52 and 58. Like Gardasil, Gardasil 9 protects against anal, cervical, vulvar and vaginal cancers; and types 6 and 11 to protect against genital warts. Please see our Vaccination page for more information on this recent addition to the options for protection against HPV. It is expected that the recommendation will be expanded to include all girls and boys up to 26 in late 2015 or 2016.

2018:

The Joint Committee on Vaccination and Immunisation (JCVI) recommended that boys should also be included in the UK HPV vaccination program from September 2019.

2019

All 12- and 13-year-olds in school Year 8 will be offered on the the HPV vaccine on the NHS.

Video credit: survivornet

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FAQs

How fast does HPV turn into cancer?

Usually many years – often a decade or more. The process is slow and happens in stages: a persistent infection gradually causes cell changes, those cell changes may become precancerous, and only in some cases do precancerous changes progress to cancer. This slow timeline is actually good news, it gives screening tests plenty of opportunities to catch changes early, when they are most easily treated.

Most HPV infections are extremely common and often resolve on their own without causing any health problems. Most people who become infected with HPV will not develop cancer. Persistent infections with high-risk HPV types (such as HPV 16 and 18) are associated with an increased risk of developing certain types of cancer, including cervical, anal, and oropharyngeal cancers, but even then, cancer is not inevitable.

What are the chances of getting cancer from HPV?

For most people, the chances are low. Although HPV infection is extremely common, cancer is not. The body clears most infections on its own, and even persistent infections usually do not progress to cancer, especially with routine screening that catches precancerous changes early.

There are high-risk HPV types – including HPV 16, 18, 31, 33, and 45 – that have a stronger association with cancer, but the majority of people exposed to even these types do not develop cancer. Vaccination, regular check-ups, not smoking, and open conversations with your healthcare provider all reduce risk further.

How curable is HPV cancer?

Cure rates depend on the type and stage of cancer, but HPV-related cancers tend to respond well to treatment, often better than cancers caused by other factors. Cancers caught early are highly treatable, and even many advanced cases have good outcomes.

The chances of successful treatment are generally higher when HPV-related cancers are detected at an early stage, which is why regular screenings matter so much. Even after successful treatment, individuals may need regular follow-up appointments and screenings to monitor for any signs of recurrence.

Do you have HPV for life?

Usually not. Most HPV infections are cleared by the immune system within one to two years, often without the person ever knowing they had it. Some infections do persist longer, but even then, HPV can become undetectable over time. Being diagnosed with HPV today does not mean you will have it, or pass it on, forever.

Who is most likely to get cancer from HPV?

Several factors can raise the risk, though none of them guarantee cancer will develop. People at higher risk include those infected with high-risk HPV types such as HPV 16 and 18, individuals with weakened immune systems (such as those living with HIV/AIDS or on immunosuppressive medications), people who smoke, those who have not received the HPV vaccine, and those who are not keeping up with recommended screening.

Sexual activity is also a factor – HPV is primarily transmitted through sexual contact, and more partners means more opportunities for exposure, though one partner is enough. The single most protective thing anyone can do is get vaccinated and stay current on screening.

Is HPV early cancer?

No. HPV itself is not cancer, but it can lead to certain types of cancer over time. Most HPV infections are harmless and cause no symptoms. In some cases, persistent infections with high-risk HPV types can cause changes in the cells of the affected area – these are called precancerous changes, meaning they are not yet cancer but have the potential to develop into cancer over time if not treated.

The progression from precancerous changes to cancer is usually slow and can take years, which is why regular screenings such as Pap smears are so valuable – they can detect precancerous changes at an early stage and allow for timely intervention.

Should I worry about getting cancer from HPV?

A little awareness is healthy. A lot of worry is not. HPV is common, cancer from HPV is uncommon, and almost everything you can do to reduce your risk – get vaccinated, keep up with screening, do not smoke, pay attention to persistent symptoms – is well within your reach.

If anxiety is interfering with your daily life, please talk to a healthcare provider or mental health professional. You deserve support, and worry is not a sign of weakness – it is a sign that you care about your health.

What does HPV look like on a woman?

In most cases, HPV has no visible signs at all. People often carry it without ever knowing. When HPV does cause something visible, it is usually one of two things.

Some HPV types can cause genital warts – small, flesh-coloured or pinkish bumps that can be raised or flat, appearing on the vulva, vagina, cervix, anus, or surrounding skin. These are caused by low-risk HPV types and are not cancerous, though they can be uncomfortable or distressing.

High-risk HPV infections can lead to changes in cells that are invisible to the eye but detectable by a Pap test or HPV test. These are the changes that routine screening is designed to catch. If you notice a new bump, sore, or change in your genital area, it is worth having a healthcare provider take a look.

Is HPV an STD?

Yes. HPV is passed through close skin-to-skin contact, most often during vaginal, anal, or oral sex. It can spread even when no warts or symptoms are visible, and even when partners are using condoms, because the virus can live on skin not covered by a condom. This is one reason HPV is so common, and why having it is not a reflection of anyone’s character or choices.

Condoms and dental dams do reduce the risk of transmission, and the HPV vaccine is highly effective at preventing infection with the types most likely to cause cancer.

Can you tell how long you’ve had HPV?

Usually not. HPV can stay in the body silently for years, and testing cannot reliably date the infection. This means a new HPV diagnosis does not necessarily mean a new infection, and it is not a reliable indicator of when or from whom the infection came. Many HPV infections do not cause visible symptoms, making it hard to pinpoint when the infection occurred.

Should I tell my partner I have HPV?

Telling a partner can feel difficult, but most people find that honest conversation strengthens a relationship rather than damages it. Sharing your status lets your partner make informed decisions about their own health, such as whether to get vaccinated, what screenings to consider, and how to support you.

Choose a private, unhurried time to talk. Lead with facts: HPV is extremely common, usually harmless, and often impossible to trace back to any single encounter. Share reliable resources if they have questions, and give them space to react – surprise is not the same as blame. If a partner responds badly, that is a reflection of their readiness for the information, not of your worth.

Do I need a colposcopy if I have HPV?

Not always. A colposcopy – a closer look at the cervix using a lighted magnifier – is usually recommended only when there are additional signals, such as an abnormal Pap result, a persistent high-risk HPV infection (especially HPV 16 or 18), or unexplained symptoms. Your provider will weigh your history, age, and test results together.

If a colposcopy is recommended, try not to be alarmed. The majority of colposcopies find either nothing concerning or a mild change that simply needs monitoring.

How long is HPV contagious?

HPV can potentially be transmitted whenever the virus is active in the body, even without visible symptoms. For many people, this is a relatively brief window before the immune system clears it. Because testing cannot give a clear end date, the most helpful steps are steady ones: get vaccinated, keep up with screening, and communicate openly with partners.

People infected with HPV can shed the virus even without visible warts or symptoms. Condoms and dental dams reduce the risk of transmission but do not eliminate it entirely, as the virus can infect areas not covered by barriers.

Can HPV cancer return?

It can, though recurrence is generally less common for HPV-related cancers than for some other types. The best protection is regular follow-up care, which is designed to catch any sign of recurrence early, when it is most treatable.

The success of the initial treatment plays a significant role in determining the likelihood of recurrence. A strong immune response also helps. Continuing healthy behaviours – avoiding tobacco, maintaining a balanced diet, and getting regular exercise – can contribute to reducing the risk. It is also possible, though uncommon, to develop a second HPV-related cancer in a different area. Your provider can guide you on what additional screening makes sense for you.

Can HPV cancer be treated?

Yes. HPV-related cancers can be treated, and many people with these cancers achieve successful outcomes. HPV-related cancers are often responsive to treatment, especially when caught early.

Treatment approaches can include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and clinical trials. Most people work with a multidisciplinary team – surgeons, radiation oncologists, medical oncologists, nurses, nutritionists, and social workers. Asking questions and bringing a companion to appointments can help you absorb a lot of information.

How do you prevent HPV cancer?

Prevention works in layers, and no single step has to be perfect. Getting vaccinated against HPV is one of the most effective measures available – vaccines protect against the high-risk types most likely to cause cancer and are recommended for adolescents and young adults, ideally before potential exposure. Practicing safe sexual behaviours, keeping up with regular screenings, avoiding tobacco, eating well, staying active, and having open conversations with sexual partners and healthcare providers all contribute to reducing risk.

Can men be tested for HPV?

There is no routine HPV test for men in the United States. HPV tests approved for clinical use sample cervical cells, which men do not have. Research is underway on anal and oral HPV testing, but these are not yet standard.

This can feel unfair, but it does not leave men unprotected. The HPV vaccine, awareness of symptoms, regular dental and medical visits, and anal screening for higher-risk groups are all meaningful layers of protection.

Is it too late to get the HPV vaccine if I’m an adult?

Probably not. The HPV vaccine is approved for people through age 45 and can still offer protection even if you have already been exposed to some HPV types. If you are between 27 and 45, your provider can help you decide whether it makes sense for you. For a full overview of available vaccines, dosing schedules, and insurance coverage, visit our HPV vaccine page.

Can I get the HPV vaccine if I already have HPV?

Yes. The vaccine does not treat an existing HPV infection, but it can still protect against the HPV types you have not yet been exposed to. Since the vaccine covers several high-risk types, many people who already have one type still benefit. Learn more on our HPV vaccine page.

Is the HPV vaccine safe?

Yes. The HPV vaccine has been studied in millions of people worldwide and has an excellent safety record. The most common side effects are mild and short-lived: a sore arm, brief redness at the injection site, mild fever, or a headache. Serious side effects are very rare. For more details, including dosing and coverage information, see our HPV vaccine page.

Can I pass HPV to my baby?

Transmission from mother to baby is possible but very rare, and it is not usually a reason to change how a baby is delivered. Having HPV does not mean you cannot have a vaginal birth, and it does not mean you cannot breastfeed. Your obstetrician can discuss your specific situation.

Is it safe to have sex if I have HPV?

Yes. Having HPV does not mean you have to stop being sexually intimate. If you and a long-term partner have been together a while, there is a good chance you share the same HPV exposure already. For new partners, open communication, condoms, and vaccination for anyone eligible all help reduce risk.

During active treatment, your care team will give you guidance on when to pause sexual activity and when to resume. Many people find that intimacy looks different during this time, but closeness, affection, and communication all matter, even when intercourse is on hold.