Human papillomavirus, or HPV, is associated with several forms of cancer. Most notable among them is cervical cancer, which claims the lives of approximately 260,000 women worldwide each year, but this virus is also commonly linked to anal, oropharyngeal, vulvar, vaginal, penile, and other cancers. The good news is, cervical cancer and other HPV-related cancers are now largely preventable through timely vaccination.
According to Hammad Rashid, MD, of The Toledo Clinic Cancer Centers, HPV is transmitted through sexual activity or other close skin-to-skin contact. Most HPV infections resolve on their own within about a year, but in some individuals, the infection becomes chronic, potentially leading to cancer. “The risk of developing HPV-related cancer is directly proportional to a few risk factors, specifically having sex with multiple partners or having sex with an individual who has had multiple partners,” he states. In addition, individuals who are immunocompromised, especially those with HIV, are at substantial risk of developing HPV-related cancer.
How does chronic infection with HPV lead to cancer? Dr. Rashid explains that in order to replicate, the virus must enter a human cell and utilize the cell’s “machinery” to produce the proteins it needs to make copies of itself. In the process, the infected cells can become damaged to the extent that cancer begins to develop.
However, it’s important to note that there are numerous subtypes of HPV and not all of them are associated with cancer. Nor does infection with a cancer-related subtype inevitably lead to cancer. “For example, HPV types 1, 2, and 4 are associated with common warts, and other types are known to cause genital warts, but these are benign conditions, not malignancies. Cervical cancer is usually caused by types 16 and 18, and these same types are associated with anal and oral cancers,” Dr. Rashid says.
Based on epidemiological data, men and women appear to be at approximately equal risk of developing some form of HPV-related cancer. “Cervical cancer is the number-one HPV cancer, and of course cervical cancer is much more common in women than penile cancer is in men. Also, the risk of anal cancer is slightly skewed toward a greater risk for women. On the other hand, when you look at oral cancers, the risk appears to be the other way around, with men being at greater risk,” says Dr. Rashid.
In addition to avoiding the sexual behaviors known to have a direct correlation with increased risk, the best defense we have against cervical cancer and other HPV-related cancers is vaccination at the appropriate age. In the United States, the available vaccine is Gardasil 9, which is effective against nine different subtypes of HPV, including those involved in cervical, anal, and oropharyngeal cancers. In fact, Gardasil vaccination reduces the risk of developing HPV-related cancers by greater than 95 percent.
The timing of vaccination is critical, however. “It’s important for Gardasil to be given before sexual debut, ideally at age 11 to 12. Once the virus is in the body creating chronic infection, the vaccine is no longer effective. In the US, the vaccine is usually given to boys and girls in the 9 to 12 age group, but there is some consensus that it can also be given to the 13 to 25 age group based on the thought that this population may have been exposed to some, but not all, HPV subtypes. Over age 25, there’s no consensus that the vaccine has a role to play,” Dr. Rashid explains.
Furthermore, Gardasil is generally very well tolerated. Some questions have been raised about a link between the vaccination and multiple sclerosis, but there is no scientific evidence to support this connection. “In the medical field, we believe the benefits of getting vaccinated far outweigh any potential risks,” Dr. Rashid says.
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy and IV services. The cancer center consists of 7 medical and 2 radiation oncologists along with 8 nurse practitioners and 4 research nurses. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice level 3 recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer Centers at 419-479-5605.