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Published June 08, 2012, 11:30 PM

HPV facts: While most people carry HPV, most will never know it

FARGO – Dr. Stefanie Gefroh-Ellison says her field has learned a lot about human papillomavirus in the past 10 years. “We understand much more about how it’s transmitted and who’s at risk,” the Essentia Health ob-gyn says.

By: Meredith Holt, INFORUM

FARGO – Dr. Stefanie Gefroh-Ellison says her field has learned a lot about human papillomavirus in the past 10 years.

“We understand much more about how it’s transmitted and who’s at risk,” the Essentia Health ob-gyn says.

Here’s some of the information about HPV shared by the medical providers interviewed for this story:

What you need to know

• HPV is the most common sexually transmitted disease.

Sanford ob-gyn Dr. Jon Dangerfield says 75 to 85 percent of the sexually active population carries at least some strand of HPV.

Nurse practitioner Audrey Eckes says “the reality is most sexually active people will have it at some time.”

• There are often no signs or symptoms.

“Only about 20 percent of people who have it will ever know they have it,” says Eckes, a women’s health care specialist with Fargo Cass Public Health.

• Most types of HPV will clear on its own.

Ninety percent of people with the virus will get rid of it naturally, Eckes says.

“Not to downplay it, but it isn’t a panic situation,” she says.

• HPV can be spread without sexual intercourse.

“There needs to be some skin-to-skin contact for the virus to be transmitted,” Eckes says, “but you don’t necessarily have to have intercourse.”

• “It’s not a disease of promiscuity,” Dangerfield says.

Your risk does increase with the more sexual partners you have, but other factors include age, a weakened immune system and damaged skin.

“It’s not something you should be embarrassed about, but something you should be vigilant about,” he says.

• It’s difficult – if not impossible – to determine who you contracted it from.

“There’s no way of pinpointing when or who came into contact with the virus, particularly because most men don’t have symptoms, and most women don’t really either,” Gefroh-Ellison says.

• There are more than 100 known strains of HPV, more than 40 of which affect the genital area.

“As technology improves, we’re probably going to find a lot more,” Dangerfield says.

• HPV can cause genital warts, cervical cancer and other HPV-related cancers.

Only a “small percentage” (between 1 and 5 percent) of those infected with HPV develop genital warts, Gefroh-Ellison says.

“Of the cervical cancers that we do still diagnose, about 97 percent are associated with HPV,” she says.

Each year, about 12,000 women get cervical cancer in the U.S., and almost all of them are HPV-associated, according to the Centers for Disease Control and Prevention.

Eckes says it’s also associated with vulvar cancer, penile cancer, rectal cancer and throat cancer.

• HPV “screening” isn’t recommended.

All three doctors say unless a woman has genital warts or an abnormal Pap, there’s no reason to “test” for HPV.

If someone comes in for her first Pap test and says, “Well, just test me for HPV,” there’s a 75 percent chance it’s going to come back positive, Gefroh-Ellison says. Then what does she do with that information?

“I think it’s easier to do the traditional Pap test first, then go to the HPV test as needed,” she says.

• Regular Pap tests are the key to preventing cervical cancer.

Since the introduction of the Pap test, the rates of cervical cancer, particularly in the U.S., have steadily declined, Gefroh-Ellison says.

“It’s a very useful, cost-effective, simple, fairly non-invasive screening tool,” she says.

Gefroh-Ellison says most women with cervical cancer at some point stopped getting their annual exams.

“The only reason we do Pap smears is because of HPV,” Eckes says. “If there was no HPV, we wouldn’t be doing Paps.”

• An abnormal Pap smear doesn’t mean you have cancer.

Abnormal cervical cells can be present for several reasons, but even if they are caused by HPV, it would take a long time for them to develop into cancer, if they do at all.

“It’s a slow-moving process,” Eckes says.

Dangerfield says the purpose of screening is to detect the problem while it’s still easily treated.

“The goal is to prevent cervical cancer,” he says.

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