Deborah Howell (Host): HPV is the most common sexually transmitted infection in the U.S. and is a rising concern for American parents and their teens. It can cause cancers of the throat, as well as cancers of the genital regions in men and women. This is why the American Cancer Society recommends the HPV vaccine to prevent cervical cancer and precancers.

Today, let's learn more about HPV prevention and cancer awareness with an expert in the field. I'm Deborah Howell, and my guest today is Katie Lawless, a Nurse Practitioner at the Women's Cancer Center at Deaconess The Women's hospital. Welcome, Katie.

Katie Lawless: Hi, thank you. I'm glad to be here.

Host: Let's dive right in. First of all, what is HPV?

Katie Lawless: HPV is the human papilloma virus. It's a group of viruses, more than 40 HPV types. They include both the cancer causing and non-cancer causing types of this virus and they are spread through intimate contact that can infect the skin, genital area, the throat, the mouth.

Host: Okay. And is HPV on the rise? And if so, with what populations?

Katie Lawless: Well, it is the most, as you said, the most commonly transmitted, sexually transmitted infection in the United States, of 14 million people become infected with HPV every year. About 85 percent of people will have HPV infection in their lifetime. So almost all sexually active individuals become infected at some point in their life with HPV. Sometimes people don't ever know that they have this virus and it can happen in both men and women.

Host: Sure. And what are the symptoms?

Katie Lawless: There are actually no real symptoms of HPV. Like I said, a lot of patients and a lot of people will become infected with HPV and never know it. If there are health problems that come from HPV, those sometimes will have symptoms like genital warts, small rough lumps on the vagina or the penis, sometimes in the throat. Those warts can be itchy, painful, they may be red or bleed, but just the virus itself, we don't often see any symptoms with that.

Host: Interesting. What kind of cancer is associated with HPV?

Katie Lawless: So HPV is associated with cervical cancer. It can cause cancer of the vagina. It can cause vulvar cancer, penile cancer, and anal cancer, and then it can also cause oropharyngeal cancers, which are cancers of the mouth and the back of the throat.

Host: And what's the treatment for HPV, Katie?

Katie Lawless: There is no treatment for HPV itself. The virus is usually ridded by our immune system after about one to two years. There are treatments available for the health concerns that HPV causes, like those warts that we talked about, cancers, but for the, the virus itself there is no treatment.

Host: That's fascinating. So let's talk about vaccines. Who's a good candidate for an HPV vaccine?

Katie Lawless: So the HPV vaccine, we know that it can prevent up to 90 percent of cancers caused by HPV. And because of this, it works best before there's ever any contact with HPV. So the CDC recommends that the most beneficial time period for this vaccine would be ages 9 to 12 and that's because it's long before we expect those patients to ever come in contact with the HPV virus. It's also recommended for patients age 26 or through the age of 26, if they have not been vaccinated when they were younger.

Host: What about older Americans?

Katie Lawless: People over the age of 26, it is not generally recommended for and that is because it provides minimal benefit. By the time we're 26, most people are already exposed to the HPV virus, unless they haven't had the vaccines or unless they are at high risk; that will be something that those types of patients will want to discuss with their primary care providers.

Host: Okay, got it. Now, is the HPV vaccine given just once?

Katie Lawless: It's actually recommended in a two dose schedule. So, for patients who get the first dose before their 15th birthday, they will get a second dose six to twelve months after that first dose. And then if it is initiated after their 15th birthday, or they have an immunocompromised condition, then there's a three dose schedule for that.

Host: Got it. And are people with HPV more likely to get cancer?

Katie Lawless: Well, in general, the oncogenic or the cancer causing types of HPV are thought to be responsible for more than 90 percent of those anal, cervical, vulvar, vaginal cancers, and 60 percent of penile cancers. So recent studies show that 60 to 70 percent of cancers of the oropharynx can also be caused by HPV.

So we know that there is an association with HPV and cancer. Not all HPV infections result in cancer or precancerous cells, but we know there's a correlation.

Host: Okay, good to know. Should I worry about getting cancer from HPV?

Katie Lawless: Research has found that it can take 5 to 10 years for an HPV infected cell to develop into a precancer. Sometimes up to 20 years for that to turn into a cancerous cell. Having a very aggressive or oncogenic HPV type, such as the HPV16 or 18, being a smoker, being immunocompromised or having a weakened immune system, having HIV or taking medications that suppress your immune system; can definitely put you at increased risk, but we don't know. We don't know who the people are that will eventually have an infection that causes these cancers from the HPV.

Host: And, Katie, does HPV ever go away?

Katie Lawless: The immune system usually clears HPV in one to two years. However, for again, those people that have immunocompromised conditions, sometimes the HPV can't be taken care of by the immune system and so it lingers or it remains dormant. And so those are the times where those cells are infected by the HPV virus for a longer period and are more concerning for turning into cancer.

Host: I see. And what is it that kills HPV naturally?

Katie Lawless: Our immune system can usually recognize and control the HPV virus, and that usually occurs within a year or two before that HPV virus can continue to linger and reach the point where it may cause cancer.

Host: Thanks for making that clear. And how long is HPV contagious?

Katie Lawless: It's contagious for as long as it is active. If it is an active infection, then it can be contagious via intimate contact, like we've talked about, whether that's sexual intercourse, oral sexual intercourse, any kind of sexual intimacy where bodily fluids are exchanged can cause infection.

Host: Is there anything else you'd like to add to our conversation?

Katie Lawless: Well, you know, cancers caused by HPV are the only cancers at this time that are preventable through vaccination. So I'm hopeful that the information that we've discussed today helps encourage people to have that discussion, to be open to that discussion with their primary care providers, to make the decision on whether that is something that would be good for them and for their families.

Host: And is there anyone else they should discuss this with besides their primary care provider?

Katie Lawless: Their pediatricians, for their kids. Like we said, the CDC recommends that this vaccination is given between the ages of, of 9 and 12, where it's most beneficial. So definitely opening that conversation with your child's pediatrician on whether you all agree that this would be something that would be a good step for your child.

Host: Sounds like a plan. Well, this is some really good information around HPV, Katie. Thanks so much for being with us today.

Katie Lawless: You're welcome. Thanks so much for having me.

Host: And that wraps up this episode of the podcast series from Deaconess the Women's Hospital, a place for all your life. Head on over to our website at deaconess.com/womenscancer for more information and to get connected with one of our providers.

Please remember to subscribe, rate, and review this podcast and all the other Deaconess Women Hospital podcasts. And for more health tips and updates, follow us on your social channels. I'm Deborah Howell, thanks for listening and have yourself a great day.