HUMAN PAPILLOMAVIRUS This infrmatin may help answer sme f yur questins and help yu think f ther questins that yu may want t ask yur cancer care team; it is nt intended t replace advice r discussin between yu and yur cancer care team. AN OVERVIEW TO HUMAN PAPILLOMAVIRUS Human papillmavirus (HPV) refers t a grup f mre than 150 related viruses. Many f these viruses are easily spread by sexual transmissin thrugh vaginal, ral and anal sex. Sme types f HPV may cause genital warts, while ther types (usually types 16 and 18) are called high-risk because they may cause cancer. THE ASSOCIATION BETWEEN HPV AND CANCER HPV infectins accunt fr rughly 5% f all cancers wrldwide. Hwever, mst infectins with HPV g away within 1 t 2 years, have n symptms and d nt cause cancer. Sme HPV infectins that persist fr many years may increase a persn s risk f develping cancer. HPV is a cmmn cause f rpharyngeal cancer (cancers f the tngue base and tnsil) and currently accunts fr the majrity f new cases. Smking and alchl use may als cause rpharyngeal cancer and accunt fr mst nn-hpv related cases. High-risk HPVs may als cause: virtually all cancers f the cervix mst cancers f the anus sme cancers f the vagina, vulva and penis. 2016 Beynd Five 1
ACQUIRING ORAL HPV INFECTION HPV is transmitted t the muth by ral sex; it may als be pssible t get ral HPV in ther ways such as ral-anal cntact (rimming). HPV may als be transmitted frm the vagina r penis t the muth by fingers and sex tys. Perfrming ral sex and having many ral sex partners can increase the chances f cntracting an ral HPV infectin. Having ral HPV infectin des nt mean yu r yur partner have been prmiscuus r unfaithful. HPV can lie drmant fr many years. It is nt knwn exactly hw lng it takes frm first becming infected with ral HPV t develping cancer; hwever it is understd it takes many years and perhaps decades. HOW COMMON IS ORAL HPV INFECTION? Fur ut f five peple will have sme kind f HPV infectin smewhere in their bdy at sme pint in their lives. Many peple are expsed specifically t ral HPV during their lifetime. It is estimated that at any given time 10% f men and 4% f wmen have ral HPV infectin. Mst f these are with lw-risk types f HPV that d nt cause cancer. Mst peple are able t clear their infectins n their wn within 1 t 2 years, withut ever knwing they had it. 2016 Beynd Five 2
GIVING HPV INFECTION TO OTHERS Oral HPV infectin is nt transmitted by casual cntact such as sharing drinks r kissing n the cheek. It is unknwn if pen-muth kissing (i.e. French kissing) can transmit HPV. Yu and yur spuse/partner have likely already shared whatever infectins yu have. Yu d nt need t change yur sexual behaviur in established relatinships. Mst patients with rpharyngeal cancer n lnger have HPV detectable in their muth and cannt transmit the infectin. Even in patients that cntinue t have detectable ral HPV after treatment, this may nt be infectius. Althugh there is n increased risk f HPV infectin in partners f patients with rpharyngeal cancer, prtectin with cndms when having casual sex t prevent sexually transmitted diseases (STDs) f any kind is recmmended. THE MEANING OF BEING HPV-POSITIVE AND ITS RELATION TO CANCER Patients with HPV in their rpharyngeal cancer have a better chance f cure than thse with cancers due t ther causes, like smking. This is believed t be because HPV-psitive cancers usually respnd well t treatment. Patients with HPV-psitive cancers wh als smke tbacc r have smked fr a lng time in the past have a lwer chance f cure than patients wh have never smked. Patients wh currently smke shuld strngly cnsider quitting as this may imprve their prgnsis. 2016 Beynd Five 3
PREVENTING HPV INFECTION The nly reliable way t prevent infectin with HPV is t avid sexual cntact with thers. Fr thse wh are sexually active, the risk f HPV infectin is very lw in peple wh have nly had ne lng-term partner. Althugh use f cndms will nt prvide cmplete prtectin, research has shwn that crrect and cnsistent use des reduce the risk f sexual transmissin between partners. The HPV vaccine currently available in Australia is called Gardasil (registered trademark f Merck & C. Inc.). The vaccine prevents infectin with high-risk HPV types 16, 18, 6 and 11. Having the vaccine will prtect thse wh have never been expsed t these types f HPV. The vaccine is mst effective if given t bys and girls befre the start f sexual activity. The vaccine has been ffered fr free thrugh schl-based immunisatin prgrams fr bys and girls aged 12 15 years in Australia since 2007. YOUR PARTNER AND HPV INFECTION Yur partner has likely been expsed t HPV already frm yurself r previus partners. Despite this, they prbably d nt have ral HPV infectin. Partners f patients with HPV-assciated rpharyngeal cancer d nt have a higher risk f ral HPV infectin r getting rpharyngeal cancer. Partners f patients with HPV-assciated rpharyngeal cancer may have slightly higher rates f ther HPV-related cancers such as cervical, anal and penile cancer than the general ppulatin. But this is prbably nly because f the assciatin between these cancers and having multiple sexual partners. Wmen with ral HPV and female partners f patients with ral HPV shuld have the same regular cervical Pap smear screening as all ther wmen. Natinal guidelines recmmend a Pap smear every 2 years fr all wmen between the ages f 18 70 years wh have ever had sex. There are currently n screening guidelines fr HPV-assciated cancers f the head and neck that can be applied t yur partner. Sme patients wnder if their spuse shuld get the HPV vaccine. It is likely that yur spuse has already been expsed t HPV and wuld therefre prbably nt benefit frm vaccinatin. 2016 Beynd Five 4
Yu may want t write questins here fr yur dctr r cancer care team Beynd Five disclaimer: Yu acknwledge and accept that the infrmatin in this factsheet is fr general infrmatin purpses nly. It is nt intended, nr shuld it be relied n, as medical r legal advice, r as a substitute fr cnsultatin with a physician r ther licensed healthcare prvider. Yu agree that if yu have individual healthcare-related questins yu shuld cntact yur dctr prmptly and shuld nt disregard prfessinal medical advice, r delay seeking it, because f infrmatin cntained here. Yu als agree that Beynd Five is nt liable fr any injury r damage t persns r prperty (hwsever caused, including by negligence) arising ut f r related t any use f Beynd Five s patient educatin materials, r fr any errrs r missins. Last updated: 18 Octber 2016 2016 Beynd Five 5