HPV is not just a common sexually transmitted infection-itâs the leading cause of cervical cancer and several other cancers in both men and women. Yet most people donât know how easily it can be prevented. The good news? We have powerful tools: vaccines that stop infection before it starts, screening tests that catch abnormal cells years before they turn cancerous, and clear guidelines that make prevention simple-if you know what to do.
What Is HPV, and Why Should You Care?
Human papillomavirus (HPV) isnât one virus. Itâs a family of over 200 related viruses. About 40 of them affect the genital area. Most are harmless and clear on their own within a year or two. But 14 types are considered high-risk because they can stick around and cause cell changes that lead to cancer.
HPV 16 and HPV 18 are the worst offenders. Together, they cause about 70% of all cervical cancers. Theyâre also linked to cancers of the vulva, vagina, penis, anus, and throat. The scary part? You can have HPV for years without symptoms. No itching, no discharge, no pain. Thatâs why screening and vaccination arenât optional-theyâre lifesavers.
How the HPV Vaccine Stops Cancer Before It Starts
The HPV vaccine isnât just a shot-itâs a cancer prevention tool. The current vaccine, Gardasil 9, protects against nine types of HPV, including the two most dangerous ones (16 and 18) and five others that cause most remaining cases.
It works best when given before any sexual contact. Thatâs why the CDC recommends vaccination for all kids at age 11 or 12. But itâs not too late for older teens and young adults. The vaccine is approved for people up to age 45. Even if youâve had HPV before, the vaccine can still protect you against other strains you havenât encountered.
Studies show the vaccine reduces precancerous cervical lesions by over 90% in vaccinated groups. In countries with high vaccination rates-like Australia and Sweden-cervical cancer rates in young women have dropped by more than 80% since the vaccine was introduced. The science is clear: if youâre eligible, get the vaccine.
Screening Has Changed-Hereâs What You Need to Know Now
For decades, the Pap test was the gold standard. It looked at cervical cells under a microscope to spot abnormalities. But it missed a lot. Now, screening has shifted to detecting the virus itself, not just its damage.
Primary HPV testing is now the preferred method for people aged 25 to 65, according to the American Cancer Society and other major groups. This test checks for DNA or RNA from high-risk HPV types (14 total), not just 16 and 18. Two FDA-approved tests are widely used: the cobas HPV Test and the Aptima HPV Assay.
Why is this better? HPV testing finds more precancers early. A 2018 JAMA study showed itâs 94.6% sensitive for detecting serious cell changes, compared to just 55.4% for Pap tests alone. That means fewer cancers slip through the cracks.
How Often Should You Get Screened?
Screening intervals have gotten longer because the tests are more reliable. Hereâs what the current guidelines say:
- Ages 21-24: No HPV testing. Pap test every 3 years if needed.
- Ages 25-65: Primary HPV test every 5 years (preferred option).
- Ages 30-65: You can also choose Pap test every 3 years, or both tests together (cotesting) every 5 years.
Even if youâve been vaccinated, you still need screening. The vaccine doesnât protect against all cancer-causing HPV types, and it doesnât clear existing infections. Screening is for everyone-vaccinated or not.
What Happens If Your HPV Test Is Positive?
A positive HPV test doesnât mean you have cancer. It just means the virus is present. Most infections go away on their own. But if you test positive, the next steps depend on your age and the type of HPV.
If youâre 25 or older and test positive for HPV 16 or 18, youâll usually get a colposcopy-a quick exam where a doctor looks at your cervix with a magnifying tool. If you test positive for other high-risk types but not 16 or 18, youâll often get a Pap test as a follow-up. If both are abnormal, youâll likely need a colposcopy.
Many people panic when they get a positive result. But the system is designed to catch problems early. Less than 1% of women with a positive HPV test will develop cancer within 5 years. Thatâs why the 5-year screening interval is safe-it gives your body time to clear the virus before intervention is needed.
Self-Collection Is Changing the Game
One of the biggest barriers to screening? Discomfort, fear, or lack of access. Many women skip Pap tests because theyâre embarrassed, busy, or live far from clinics.
Now, self-collected HPV tests are approved and recommended. You can swab your own vagina at home, mail in the sample, and get results just like a clinic visit. A 2024 Kaiser Permanente study found self-collected tests are 84.4% as sensitive as clinician-collected ones-with 90.7% specificity. Thatâs nearly as accurate.
Real-world data from Australia and the Netherlands show self-collection increases screening rates by 30-40% among people who hadnât been screened in years. The USPSTF now lists self-collection as a valid option. This isnât the future-itâs happening now.
Why Disparities Still Exist-and Whatâs Being Done
Despite all the progress, cervical cancer isnât equal. Black women in the U.S. are 70% more likely to die from it than White women. In low-income countries, only 19% of women have ever been screened. In the U.S., 30% of cervical cancers occur in women whoâve never had a Pap test.
These gaps exist because of systemic barriers: lack of insurance, transportation, cultural stigma, language barriers, and under-resourced clinics. The WHOâs 90-70-90 goal by 2030 aims to fix this: 90% of girls vaccinated by 15, 70% of women screened by 35 and 45, and 90% of abnormal cases treated.
Here in the U.S., community health centers and mobile clinics are starting to offer self-collection kits in pharmacies, libraries, and schools. Some states now cover self-collection under Medicaid. These efforts are saving lives.
Whatâs Next for HPV Prevention?
The next wave of innovation is already here. AI is being used to analyze Pap smears faster and more accurately. Paige.AI received FDA approval in January 2023 for its AI system that helps pathologists spot precancerous cells.
Research also suggests that after two or three negative HPV tests, screening every 6 years may be safe. Studies from Wayne State University show the risk of cervical cancer drops to less than 2.5 per 1,000 after two negative HPV tests-lower than the risk after a single negative Pap test.
By 2025, primary HPV testing will likely be the standard in most U.S. clinics. The goal isnât just to reduce cancer-itâs to eliminate it as a public health threat. The WHO estimates that with full implementation of vaccination, screening, and treatment, we could prevent 62 to 77 million cervical cancer cases over the next century.
What You Can Do Today
If youâre under 26: Get the HPV vaccine if you havenât already. Itâs covered by most insurance, including Medicaid and the Vaccines for Children program.
If youâre 25-65: Ask your provider for a primary HPV test every 5 years. If youâve been getting Pap tests, ask if you can switch. If youâve avoided screening because of discomfort, ask about self-collection kits.
If youâre over 65: You may not need screening anymore-if youâve had regular tests and no history of abnormalities. But talk to your doctor. Some people need continued screening based on past results.
HPV doesnât care if youâre rich or poor, vaccinated or not. But your choices do matter. Getting vaccinated and screened isnât just about protecting yourself. Itâs about protecting the people around you-and breaking the cycle of preventable cancer.
