Human papillomavirus (HPV) is a very common virus that can lead to cancer in some people. There are over 100 types of HPV, with around 13 types considered high risk as they are linked to cancer. High risk HPV is also called oncogenic HPV. The question of whether high risk HPV needs treatment is an important one to understand.
What is high risk HPV?
High risk or oncogenic HPV types include HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82. These HPV types can lead to cell changes that may develop into cancer over time if left untreated. The two most common high risk HPV types are:
- HPV 16 – Responsible for around 60% of all HPV-related cancers
- HPV 18 – Responsible for around 15% of all HPV-related cancers
High risk HPV is contracted through intimate skin-to-skin contact and can reside in the body for years without symptoms. Over time it can lead to cell changes and precancerous lesions. If left untreated, these lesions may progress to cervical, vaginal, vulvar, penile, anal, or throat cancers.
Does high risk HPV always lead to cancer?
No, the majority of high risk HPV infections do not lead to cancer. Around 79 million Americans are currently infected with HPV, but only around 33,000 HPV-related cancers occur each year. This is because in 90% of cases, the immune system clears the HPV infection naturally within 1-2 years. Only infections that persist for many years tend to progress to cancer. Nonetheless, regular screening and follow up is important for high risk infections to catch any abnormalities early.
Who is most at risk from high risk HPV?
Those at highest risk for developing cancer from high risk HPV include:
- People with persistent high risk HPV infections lasting many years
- People with compromised immune systems, such as those living with HIV/AIDS
- Older individuals, as cancer tends to develop decades after initial HPV infection
- Men and women alike, as both genders are susceptible to HPV-related cancers
Routine screening with Pap tests and HPV co-testing can help identify precancerous changes in high risk individuals before cancer develops.
What cancers are caused by high risk HPV?
High risk HPV types are responsible for nearly all cases of cervical cancer. However, they can also cause cancers in other parts of the body, including:
- Vaginal cancer
- Vulvar cancer
- Penile cancer
- Anal cancer
- Oropharyngeal cancers (in the throat, tonsils, and base of tongue)
Of these, cervical cancer is the most common, followed by oropharyngeal and anal cancers. Vulvar, vaginal, and penile cancers are rarer. But all may result from untreated high risk HPV infection.
How is high risk HPV infection detected?
HPV testing is used alongside the Pap test to screen for cervical precancers and cancer in women. HPV testing detects the high risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) that can lead to cancer. There are two main ways to test for high risk HPV:
- HPV DNA test – Looks for the DNA of high risk HPV strains in cervical cells
- HPV RNA test – Looks for RNA from the two highest risk strains, HPV 16 and HPV 18
HPV testing is not routinely recommended for men, as there are currently no approved tests to screen for HPV-related cancers in males. However, men may undergo anal Pap tests and high resolution anoscopy to detect early anal cancers.
Should you get treated for high risk HPV?
If high risk HPV is detected, additional follow up is recommended. Treatment is aimed at removing precancerous lesions caused by HPV before they become cancerous. Treatment options may include:
- Colposcopy – A procedure to closely examine the cervix and take biopsies of abnormal areas
- Cone biopsy – Removal of a cone-shaped piece of tissue from the cervix to test for cancer cells
- LEEP – Using an electrical current passed through a thin wire loop to remove abnormal cervical tissue
- Cryotherapy – Freezing and destroying abnormal cervical cells
Treatment helps eliminate precancerous changes before they potentially become cervical cancer. Even after treatment, regular follow up with cytology and HPV testing is important to monitor for recurrence.
How is HPV-related cancer treated?
If precancerous lesions progress to cervical cancer or other HPV-related cancers, treatment may include:
- Surgery – To remove cancerous growths and tissue
- Chemotherapy – Using anti-cancer drugs to kill cancer cells
- Radiation – Using high energy beams to shrink and destroy tumors
- Immunotherapy – Boosting the immune system to fight cancer
- Targeted therapy – Drugs that specifically target cancer cell mechanisms
The specific treatment depends on the location and stage of the cancer. Early detection is key, as HPV-related cancers found early are very treatable.
How can you reduce the risk of high risk HPV turning into cancer?
Steps that can be taken to decrease the likelihood of high risk HPV progressing to cancer include:
- Get vaccinated – HPV vaccines protect against cancer-causing HPV strains
- Use condoms – Barrier protection decreases HPV exposure and transmission
- Don’t smoke – Smoking with HPV increases cancer risk
- Get screened – Routine Pap/HPV tests allow early detection and treatment
- Follow up regularly – Annual exams even after treatment for precancer
- Boost immunity – Good diet and exercise supports the immune system to clear HPV
Is HPV high risk in pregnancy?
HPV is not considered a high risk factor in pregnancy. Around 3 out of 4 pregnant women have HPV. While very rarely HPV can be transmitted to a baby during vaginal delivery, it does not appear to cause problems. However, genital warts may need to be removed before delivery. It’s important pregnant women get routine Pap tests to screen for cervical cell changes that could lead to cancer.
Can HPV high risk be cured?
There is no cure for HPV infection itself. However, precancerous lesions caused by high risk HPV can be removed through procedures like LEEP or cone biopsy. Cervical and other HPV-related cancers can also be treated effectively if caught at an early stage. The immune system clears most high risk HPV infections naturally within 1-2 years, but cancer risk remains if abnormalities persist.
What foods boost the immune system against HPV?
A healthy, balanced diet supports immune function and may help clear HPV infection. Some foods to include that may specifically help boost immunity and fight HPV include:
- Citrus fruits – Vitamin C supports white blood cell function
- Red bell peppers – High in vitamin C and antioxidant beta-carotene
- Broccoli – Contains nutrients like vitamins A, C, and E to boost immunity
- Garlic – Contains allicin, which has antiviral properties
- Yogurt – Probiotics may improve immune response against HPV
- Spinach – Rich in folate, which helps immune system cell production
- Almonds – High in vitamin E, which stimulates killer T-cells
A nutritious diet is part of an overall healthy lifestyle that can aid the body in fighting off HPV before it leads to cancer.
Conclusion
High risk HPV infections do require follow up and treatment. Even though most cases clear naturally, high risk HPV can sometimes lead to persistent infection and precancerous cell changes. Catching these abnormalities early and removing them prevents progression to cervical cancer and other HPV cancers. Staying current on screening with cytology and HPV co-testing allows early detection and treatment. HPV vaccination and safe sexual practices also reduce cancer risk. With proper follow up and management, the vast majority of high risk HPV cases can be treated effectively before turning into cancer.