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What if we told you half of American men have a sexually transmitted infection (STI) that can cause penis cancer, and there’s no routinely used test for it?
You might assume it’s a castoff subplot from a dystopian thriller, but it’s an actual fact. According to the Centers for Disease Control and Prevention, 79 million American men and women are infected with HPV (human papillomavirus), the most common STI (CDC, 2019-a). More than 45% of American men have HPV, says a study published in the journal JAMA Oncology, including 29% of men between 18 and 22, and over 46% of men aged 23 to 27 (Han, 2017). “HPV is so common that almost every person who is sexually active will get HPV at some time in their life if they don’t get the HPV vaccine,” says the CDC.
HPV can lead to genital warts and cancer in both men and women—the virus can cancers of the cervix, penis, anus, and throat. But there is no routine test to determine your “HPV status” (CDC, 2019-a). Women are tested for cervical cancer via pap smear, usually once every three years, during their regular gynecological appointments. But no test has been approved for routine use in men. We’ll dig into why but first let’s get acquainted with this incredibly prevalent viral visitor.
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How do you get HPV?
HPV is transmitted through skin-to-skin contact. That skin-to-skin contact can be sexual in nature or not. That means that practically anybody can contract HPV. Anyone who is sexually active can get the strains of HPV that can cause genital warts or certain types of cancer. Even if there are no signs or symptoms of the virus, you or your partner can still be contagious. And because HPV symptoms can take months or years to show up, it can be difficult to pinpoint exactly when and where you picked it up.
What are the symptoms of HPV in men?
In the vast majority of cases, men infected with HPV have no symptoms. Signs of HPV can include warts on the genitals, anus, or groin area; common warts on the hands, fingers, or face; and plantar warts, hard growths on the soles of your feet.
There’s actually no cure for the virus itself. Current treatments are aimed at the symptoms of HPV, such as warts, and include medication and removing growths with cryotherapy or lasers.
Is it time to panic?
No. Most cases of HPV go away on their own—more than 90 percent of HPV infections are cleared by the immune system within two years, usually within the first six months after infection, the CDC says.
But some strains of HPV aren’t cleared by the body and can cause cancer. Every year, about 19,400 women and 12,100 men are affected by cancers caused by HPV. Genital cancer is much rarer in men than it is in women.
But HPV infection in men and its relation to cancer has become something of a cause celebre in recent years. In 2013, actor Michael Douglas said his throat cancer was related to HPV he contracted via oral sex. This year, actress Marcia Cross said she had anal cancer related to HPV—the same strain that caused her husband’s throat cancer nearly a decade before.
HPV and penile cancer: 60% of cases linked to these strains
Why is there no HPV test for men?
Well, technically, there is one.
Men can get an anal swab test for HPV if they request one. But the CDC doesn’t recommend routine testing for HPV in men. “The infectious disease literature supports this stance on several grounds: the high prevalence of infection, the lack of a test approved by the U.S. Food and Drug Administration for the detection of HPV in men, and the absence of adequate therapy for established infection,” wrote researchers in a study published in the Journal of the American Osteopathic Association, which noted that swabs of the mouth or throat were not a reliable way to detect HPV (McGinley, 2011).
It has to do with what happens after testing. When a pap smear discovers that a woman has abnormal cells on her cervix, they can be removed, preventing them from developing into cervical cancer. If a test for HPV in men theoretically existed, when a man “tested positive,” the only course of action would be to wait for the virus to clear. There are no treatments that can kill the virus once it’s in the body.
How can I prevent getting HPV?
The most important way to prevent contracting HPV is to be vaccinated against it. HPV vaccines can prevent up to 92% of cancers caused by the virus (CDC, 2019-b). The CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. The vaccine is approved up to age 26 for routine administration. From ages 27 to 45, the vaccine may be less effective—most people have been exposed to HPV by this time—but it can protect against strains of the virus you haven’t been exposed to.
If you’re sexually active, using condoms can lower your chances of getting HPV. They don’t provide complete protection though as HPV can infect areas that aren’t covered by the condom. You can also choose to be in a mutually monogamous relationship with an uninfected partner.
Women aged 21 to 65 should be routinely screened to prevent cervical cancer.
- Centers for Disease Control and Prevention (CDC). (2019-a) STD Facts – Human Papillomavirus (HPV). Retrieved August 20, 2019 from https://www.cdc.gov/std/hpv/stdfact-hpv.htm
- Centers for Disease Control and Prevention (CDC). (2019-b). An Estimated 92% of Cancers Caused by HPV Could Be Prevented by Vaccine. Retrieved August 22, 2019 from https://www.cdc.gov/media/releases/2019/p0822-cancer-prevented-vaccine.html
- Han, J., Beltran, T., & Song, J. (2017). Prevalence of Genital Human Papillomavirus Infection and Human Papillomavirus Vaccination Rates Among US Adult Men. JAMA Oncology, 3(6), 810., doi: 10.1001/jamaoncol.2016.6192. Retrieved from https://jamanetwork.com/journals/jamaoncology/fullarticle/2598492
- McGinley, K. (2011). Human Papillomavirus Testing in Men. The Journal of the American Osteopathic Association, 11(s32). doi: 10.7556/jaoa.2011.20026. Retrieved from https://www.degruyter.com/document/doi/10.7556/jaoa.2011.20026/html
Dr. Chimene Richa is a board-certified Ophthalmologist and Senior Medical Writer/Reviewer at Ro.