Human papillomavirus

Teenagers sitting outside looking at a cellphone

What do I need to know about HPV?

You may have heard about HPV – or the human papillomavirus. It’s mostly spread through sexual intercourse, genital skin-to-skin contact and oral sex. And it’s very common. In fact, it’s more common than all other sexually transmitted infections combined!

HPV is not spread by casual contact, such as hugging, shaking hands, sneezing or coughing. HPV is also not spread through air, food or water.

Teenagers sitting outside looking at a cellphone

What is HPV exactly?

HPV is a group of more than 100 different types of viruses. More than 40 types of HPV are spread through sexual contact. These types can infect the genital areas of both women and men, including the cervix, vulva, vagina, anus and penis, as well as some parts of the mouth and throat.

How do I know if I have HPV?

About 75% of sexually active men and women will get at least one HPV infection in their lifetime. Most of them will never know they’ve been infected because HPV often doesn’t cause any symptoms. This makes it hard to know exactly when or how the virus was spread.

Most HPV infections come and go over the course of a few years. While an HPV infection can’t be treated, the conditions it causes (such as genital warts) can.

For most people, the virus will clear in the same way as a common cold virus. HPV that doesn’t clear is what can lead to cancer.

Researchers are learning more and more about how this infection is linked to several types of cancer. There is now a vaccine available to protect against HPV infection.

HPV and cancer

Most men and women who are sexually active will have an HPV infection at some point in their life. In most cases, high-risk HPV infections come and go over within a couple of years. But sometimes the HPV infection does not go away and this can lead to cancer.
HPV and cervical cancer

A high-risk HPV infection can lead to changes in the cells of the cervix, which can develop into cervical cancer if they are not found early (through a Pap test) and treated. HPV infection causes almost all cervical cancers.

HPV and other cancers

In Canada, about two-thirds of HPV-related cancers happen in areas other than the cervix. 

HPV infection is related to:

  • 80% to 90% of anal cancers
  • 40% of vaginal and vulvar cancers
  • 40% to 50% of penile cancers
  • 25% to 35% of mouth and throat cancers

Most of these cancers are related to high-risk HPV types 16 and 18.

High-risk HPV

Infection with high-risk HPV can cause cells to change or become abnormal. These changes can lead to cancer. HPV16 and HPV18 are the most common high-risk types and cause 70% of cervical cancers.

Infection with high-risk HPV is also linked to cancers of the penis, anus, vulva, vagina and mouth and throat.

If you have a high-risk HPV infection that does not go away, precancerous cervical changes can develop. Regular cervical screening with a Pap test is important because it can find these changes. Precancerous cervical changes and cervical cancer can be treated.

Low-risk HPV

Infection with low-risk HPV doesn’t cause precancerous changes and doesn’t increase your risk of cancer. But low-risk types of HPV can cause genital warts.

The 2 low-risk types of HPV that are responsible for 90% of genital warts are HPV6 and HPV11. Genital warts caused by low-risk types of HPV can appear weeks or months after skin-to-skin sexual contact with an infected person. There are treatments for genital warts. Talk to your health care professional to discuss your treatment options.

How can I prevent HPV?

Get vaccinated

Vaccines are available that can protect against the most common types of HPV that cause cancer. The Canadian Cancer Society recommends that Canadians get vaccinated to reduce their risk of HPV-related cancer.

Get vaccinated or have your children vaccinated through school-based programs where available. If you are not eligible for a free vaccination, talk to your doctor about which vaccine is right for you and when you should have it.

Practise safer sex

If you are sexually active, use a condom and other barriers safely to help protect against HPV.

Condoms or other barriers such as an oral dam can reduce HPV infection if put on before skin-to-skin sexual contact. However, areas not covered by these barriers still allow some skin-to-skin contact during sexual activity. Using these barriers will reduce – but not eliminate – the risk of HPV infection.

All about HPV vaccines

HPV vaccines do not treat HPV infections you already have or treat diseases or cancers related to HPV. They help protect against future HPV infection.

There are 3 types of vaccines to protect against HPV infection in Canada.

What are the HPV vaccines?

Cervarix

This vaccine protects females against HPV types 16 and 18. Because Cervarix protects against 2 types of infection, it is called a bivalent vaccine. Cervarix does not protect against genital warts.

Gardasil

Gardasil protects males and females against 2 types of HPV that cause genital warts and 2 types of HPV that cause cancer, types 16 and 18. Because Gardasil protects against 4 types of infection, it is called a quadrivalent vaccine.

Gardasil 9

Gardasil 9 protects males and females against 2 types of HPV that cause genital warts and 7 types of HPV that cause cancer, including types 16 and 18. Because Gardasil 9 protects against 9 types of infection, it is called a nonavalent vaccine.

Who should be vaccinated for HPV?

Vaccinating women and girls

Females between 9 and 45 years of age can be vaccinated with Cervarix, Gardasil or Gardasil 9 to prevent cervical cancer and precancerous cervical changes. Gardasil and Gardasil 9 may also prevent vaginal, vulvar and anal cancers and their precancers, as well as anogenital warts. 

It’s important to know that HPV vaccines do not replace cervical cancer screening. Your doctor will still recommend a Pap test. HPV vaccines prevent infection from the most common types of HPV related to cancer, but not all.

Vaccinating men and boys
In Canada, about one-third of HPV-related cancers occur in males. Gardasil and Gardasil 9 are available for boys and young men between the ages of 9 and 26 to prevent anal cancer, its precancer and anogenital warts.
School-based HPV vaccination programs
All provinces and territories have publicly funded, school-based HPV vaccination programs for girls 9 to 13 years of age (grades 4 to 8). Most vaccination programs also include boys.
Person getting a vaccine injected into their arm

When should you be vaccinated?

The vaccines are given 2 or 3 times over a 6- to 12-month period. The timing of doses is important to make sure the vaccines are as effective as possible. If all doses of the vaccine are not given, or they are not given at the right time, you may not get the full benefit of the vaccine. 

The vaccines are most effective if they’re given before a person becomes sexually active because their risk of infection will be lower. The vaccines are also more effective in young teens when the immune system is most responsive to the vaccine. 

Person getting a vaccine injected into their arm

Our recommendation

The Canadian Cancer Society recommends that girls and women between the ages of 9 and 45 are vaccinated against HPV to help reduce their risk of HPV-related cancers. These include cervical, vaginal, vulvar and anal cancers and precancerous conditions linked to these cancers. HPV vaccination should be used along with, not instead of, cervical cancer screening.

We also recommend that boys and young men between the ages of 9 and 26 are vaccinated against HPV to help reduce their risk of HPV-related cancers such as anal and penile cancer.

HPV vaccines should be available in all provinces and territories and affordable for Canadians.

How safe are the vaccines?

Current evidence tells us that the HPV vaccines are safe, and their side effects are similar to the side effects of other types of vaccines. In Canada and in other countries, the safety of all 3 HPV vaccines is being monitored on a regular basis. The vaccines are not recommended for anyone under 9 years of age or for pregnant women. 

Health Canada and the National Advisory Committee on Immunization (NACI) have approved and recommend HPV vaccines. Health Canada approves vaccines based on their effectiveness and safety. NACI provides recommendations for how the vaccines should best be used to prevent disease. 

How long do the vaccines last?

Research so far shows that protection can last at least 8 years for Gardasil and more than 9 years with Cervarix. With longer follow-up of both vaccines, we’ll learn more about how long protection lasts and whether booster doses are needed for continued protection. There are currently no recommendations to have a booster.

Get your child vaccinated against HPV

Meet Tiffany Bond. A mother and cancer survivor whose type of throat cancer is related to HPV and may have been prevented by the vaccine. Tiffany was diagnosed at the age of 39. 

"I wish the vaccine had been available when I was younger," says Bond. "Having gone through what I went through, I cannot understand why parents would choose not to have their children vaccinated against HPV." 

Can I be tested for HPV?

HPV testing is most effective for women 30 years of age and older. There is currently no approved test for HPV in men. 

While HPV infections are very common in women under 30 years old, most of them clear up on their own and are unlikely to result in abnormal cervical changes that could lead to cancer. Testing of young women is more likely to result in unnecessary diagnoses and treatments. 
A patient talking to a doctor

HPV tests check for high-risk types of HPV

These tests are usually used to identify women who are at high-risk of having precancerous changes and developing cervical cancer. Research shows that HPV testing is more accurate than the Pap test in finding precancerous changes in the cervix. Researchers are still trying to find the best way to use the HPV test as a part of cervical cancer screening. Pap tests are an effective way to find cervical cancer.

HPV tests are available in some areas of Canada. In provinces that use HPV tests as part of their cervical cancer screening programs, they are generally used as a follow-up to abnormal Pap tests results.

A patient talking to a doctor