Mercy Gynecologic Oncologist Dr. Teresa Diaz-Montes Discusses HPV, The Vaccine, and What You Should Know About This Disease

HPV stands for human papillomavirus, considered the most common sexually transmitted infection. While HPV is typically harmless and will go away by itself, certain types can lead to cancer (cervical), genital warts and other issues. How do you know if you may have HPV? There’s a vaccine—should you get it? If you have HPV, will you get cancer? Teresa P. Diaz-Montes, M.D., MPH, FACOG, a board certified gynecologic oncologist with The Gynecologic Oncology Center at Mercy, recently responded to questions from WOMEN’S HEALTH magazine about HPV…

How widespread is HPV these days?
HPV is widely spread in the United States. About 79 million Americans are currently infected with the HPV. About 14 million become infected each year. Most people who are sexually active will get infected with HPV at some point in their lifetime.

Is the vaccine working?
The HPV vaccine should provide almost 100% protection against the HPV types that are covered if it is administered at the correct intervals and prior to contact with the HPV. About 50% of adolescents have completed the vaccination scheme. Based on CDC statistics about 49.5% of girls and 37.5% of boys ages 13 to 17 have received the recommended doses of the HPV vaccine.

Doesn't the vaccine only work against a couple of strains of HPV?
The current vaccine covers against 9 types of HPV virus (6, 11, 16, 18, 31, 33, 45, 52, and 58). Even thought, there are several types of HPV the vaccine includes the types that have been more commonly identified in cervical cancer cases. The new vaccine covers against 7 high risk types of HPV. If you are under age 45, you should consider getting vaccinated against HPV.

Is the vaccine only for young women? Or can someone in their 30s and 40s get it to help prevent cervical cancer?
The vaccine is both for boys and girls. Recently, vaccination age was extended to age 45. 

What if someone has already had HPV, can they still get the vaccine?
Yes. The vaccine can provide you protection against the other types of HPV that the individual has not been exposed.  

How likely is cervical cancer for those who’ve had HPV?
HPV is present in majority of the cases of cervical cancer. Most women affect with HPV do not develop cervical cancer if they continue surveillance. Multiple factors are associated with HPV to cause cervical cancer.

Should women who have had HPV consider having their cervix removed as a way of prevention?
No. This will expose a lot of women to unnecessary hysterectomies. This is not a guarantee that you will be protected against HPV as HPV can also infect the vaginal area. Women who have HPV in the cervix and undergo a hysterectomy will need to continue with pap smear surveillance. 

How has the vaccine changed over the years?
The vaccine has included more HPV types over the years. The new vaccine covers 2 low risk HPV types that are associated with genital warts and 9 high risk HPV types that are associated with cervical dysplasia and cancer. 

Anything else about HPV and the vaccine?
The vaccine is not only to protect the individuals against cervical cancer but also against other HPV related precancerous and cancer conditions like precancerous changes in the cervix, vagina, vulva, anus, and throat as well as cancer of the anus, vulva, vagina and throat.

How often should we women be getting pap smears?
It depends on each condition. The current guidelines states to start pap smear at age 21. Pap smears in that age group are done every 3 years. HPV is only requested if there is an abnormality of the pap smear. Women older than 30 should have HPV testing with the pap smear. If both are normal, then pap smear and HPV are repeated in 5 years.  If HPV is not done then pap smear should be done in 3 years.  Women who are infected with HPV are screened differently. 

Dr. Teresa P. Diaz-Montes serves as the Associate Director of The Lya Segall Ovarian Cancer Institute. She provides diagnosis and treatment for gynecologic cancers including ovarian cancer, cervical cancer, uterine cancer, vaginal cancer and vulvar cancer. Her primary clinical interests include ovarian cancer treatments, minimally invasive gynecologic surgery, including robotic surgery, and patient safety and quality. Additional areas of interest include cervical cancer, fallopian tube cancer, fertility-sparing surgery and uterine, vaginal and vulvar cancers.