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Posted on Wed, Jan 11, 2012 : 11:30 a.m.

Get the facts about HPV and make reproductive health a priority in 2012



Erin Cook, MD

You may have heard a lot about Human papillomavirus (HPV) and the Gardasil vaccination in the media. It is important to be aware of this virus, since an estimated 75-80 percent of males and females will be infected with it in their lifetime.

Most of these people will exhibit no symptoms. In most people, HPV infection will be cleared by their immune system.

But, for some people who are unable to clear certain types of the virus, significant consequences could develop, including cervical, vaginal and vulvar cancers in women, and genital warts in both men and women.

Unfortunately there is no way to know who will and who will not have the virus cleared by their immune system. Therefore, protection against HPV should be a priority for all of us.

Key points about HPV to remember:

  • HPV transmission can happen with any type of genital contact (intercourse isn't necessary).
  • Most people with HPV don't know it because they have no symptoms, yet can still spread the virus to others.
  • There are many different types of HPV: those called "low-risk" cause genital warts, while those called "high risk" cause precancers and cancers of the cervix, vagina and vulva.
  • There are 6 million new cases of genital HPV in the U.S. each year, and almost three out of four occur in 15-24 year olds.

There are some ways to help protect yourself against HPV like using condoms or avoiding genital contact. However, the best way is through vaccination before exposure to HPV occurs. Gardasil is a vaccination that protects against four types of HPV: two types which cause about 75 percent of cervical cancers, and two types which cause 90 percent of genital wart cases.

Important facts about Gardasil:

  • Gardasil will not protect against some other HPV types and may not be effective if a person has already been exposed.
  • Gardasil is FDA-approved for use in boys and girls ages 9-26 and has been used safely in the U.S. since 2006.
  • Gardasil is given as three injections over a six-month period.
  • Gardasil is highly effective and safe.

It is also important to be screened for HPV-related diseases by your physician. A genital exam can identify genital warts as well as other sexually transmitted infections in both males and females, and pap testing is a screening test for HPV related changes of the cervix.

Because we have learned so much about HPV-related diseases, many changes have occurred in screening.

  • Pap testing should start at age 21 (for women not old enough for pap testing regular wellness visits are still recommended).
  • For women at low risk, pap testing should occur every two to three years depending on age. Ask your doctor about how frequently you should be screened.
  • For some women, testing for "high-risk" types of HPV may be indicated.

Obstetrician gynecologists, family practitioners, internal medicine physicians, and pediatricians are all trained on and aware of the importance of HPV education, prevention, and screening. Take the new year as an opportunity to make a preventive health visit for yourself or your child.

*For more information on Gardasil vaccination, go to

Erin Cook, MD, is an obstetrician gynecologist at IHA Associates in Gynecology & Obstetrics. Dr. Cook has clinical interest in pediatric and adolescent gynecology, contraception and family planning, and also comprehensive obstetrical care. IHA Associates in Gynecology & Obstetrics - Arbor Park is located at 4936 W. Clark Road, Suite 100, Ypsilanti, MI 48197. She can be reached at 734-434-6200. For more IHA Associates in Gynecology & Obstetrics locations, more information, or to read more posts from the IHA Cares blog, please visit


Rork Kuick

Fri, Jan 13, 2012 : 2:37 p.m.

I thought the cost effectiveness was still not-so-great - it's not that cheap is the problem, and I wish it were much less expensive so that the cost effectiveness argument would be smashing. (I think I last saw estimates of 50K per quality-adjusted year of life, which is usually acceptable - sorry I don't have a link for that right now, but it's probably a very fuzzy estimate anyway.) I am still enthusiastic. The article failed to mention increased incidence of head and neck cancers, perhaps thanks largely to HPV. Males are in the lead there, so if you have sons or are one, you can share in the anxiety - if you really needed more reason to be part of the solution. We might be much more frank about what we do know (and what we suspect) about transmission, but it's a delicate subject, perhaps best left for a professional to write or say, and perhaps in a different place. My advice to young unvaxed people would be rather sad, but I could use more information about transmission myself.


Thu, Jan 12, 2012 : 1:41 p.m.

The political noise surrounding this issue is unfortunate. Evidence-based science has demonstrated that this is a low-cost, low-risk measure which has the ability to prevent subsequent illness which can be extremely expensive and painful to treat and can be fatal. Vaccination has a huge upside and a low downside. Think of it as spending a penny today to eliminate a 1% chance of needing to spend $1,000 tomorrow.