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Cancer
One of the most problematic health conditions associated with HPV is cancer. HPV causes changes in the structure of infected cells and some of these changes can transform the cell to the point where it becomes cancerous. Almost all cervical cancers are associated with HPV, as are 50% of oral cancers, 65% of vaginal cancers, 35% of penile cancers, 95% of anal cancers, and about 60% of oropharyngeal cancers (cancers involving the throat, tongue, and the tonsils). As well, recent available data shows that the rate of HPV-related throat cancer has risen by 225% over the years. Throat cancer is more common in men than women, and theories have been developed that female genitalia may spread human papillomavirus to the mouth more readily than male genitalia since the vagina contains more body fluid than the penile shaft. Even so, in the United States, death rates from cervical cancer in females are still higher than death rates related to throat cancer. There is unfortunately no way to determine which individuals infected with HPV will go on to develop cancer or other problems such as warts.

CIN is usually caused by HPV 16, 18, 31, 33, or 35. It is occasionally found in visible genital warts and has been associated with external genital squamous cell carcinoma in situ (cancer), bowenoid papulosis, Erythroplasia of Queyrat, and Bowen’s disease of the genitalia. These variants of HPV also have been associated with vaginal, anal, anogenital, and some head and neck squamous cell carcinomas.

Detecting Oral Cancer and HPV

It is known that most oral cancers result from HPV 16, but to date there is no test available to detect oral HPV infection. For this reason, any suspicious growths, discolorations, non-healing sores, or other types of lesions persisting for more than 2 weeks should be evaluated by an experienced physician.

Cancer Prevention
There are several methods of preventing HPV-related cancers:

Pap smear
Pap smears are primarily used to evaluate a woman’s cervix and endocervix, and detect any cancers or other abnormalities. This test is only effective for determining cervical and endocervical cellular changes, however, and does not confirm HPV infection.

HPV DNA Test
There is also an HPV DNA test for the female cervix. This can be performed at time of a Pap smear or on its own. There are currently 2 types of HPV DNA testing, one for high-risk HPV and one for low-risk HPV. These tests are usually performed together, and the results show whether a patient has high-risk HPV, low-risk HPV, both, or neither. An individual who is positive for for high-risk HPV is at higher risk of developing cervical cancer, but this does not guarantee a future diagnosis of cancer; some patients with high-risk HPV never develop cancer in any form.

Anal Pap Smear
An anal Pap smear is similar to a vaginal/cervical pap smear and tests for abnormal changes in the cells of the anus.

Physical Examination
Physical exam by an experienced physician is an important aspect of cancer prevention through detection of suspicious lesions.

Biopsy
Any suspicious lesions found by physical examination should be biopsied and sent to a laboratory for evaluation by a pathologist (a physician who evaluates tissue samples under a microscope). Any cancer or other abnormalities are then reported to the physician who performed the biopsy.