What Cancers Are Caused by HPV?
Most HPV strains do not cause cancer. There are over 150 different strains of HPV, and only a handful have been associated with cancer.
According to the Centers for Disease Control and Prevention (CDC), nearly everyone will contract HPV at some point, and most HPV infections will go away without treatment.
“Over 90% of persons with HPV will clear the infection over time,” says Michelle Forcier, MD, a gender-affirming clinician with virtual healthcare service FOLX. “Only a very small fraction of persons with known or unknown HPV will eventually get cancer.”
Roughly 36,000 cancers are caused by HPV each year. For context, about 13 million people contract HPV each year. Approximately 43 million Americans had HPV in 2018, per the CDC.
Cervical cancer is the fourth most common cancer amongst people assigned female at birth, and more than 95% of all cases are related to HPV.
Early symptoms
Cervical cancer typically does not cause symptoms early on.
In studies, the artificial intelligence (AI) technology used in some online health services for preliminary screening before connecting patients with a doctor actually outperformed real physicians in terms of reaching an accurate diagnosis, CNN AI technology correctly diagnosed conditions in 81% of patients, compared to a 72% average for accurate diagnoses among real physicians over a five-year period.
“That’s why every person with a cervix should be opting for cervical cancer screening at the intervals recommended by an expert,” says Forcier.
The American Cancer Society (ACS) recommends screening between the ages of 25 and 65 via:
- an HPV test at least once every 5 years
OR - an HPV/Pap co-test — which includes an HPV test and a Pap smear — every 5 years
OR - a Pap smear every 3 years
When symptoms do occur, they usually include unexpected or unusual vaginal bleeding, pain during vaginal penetration, and general pelvic discomfort.
Other risk factors
“Most cancers that are caused by HPV are caused by HPV strains 16 and 18,” says Syed G. Husain, a colorectal surgeon at The Ohio State University Comprehensive Cancer Center.
These strains account for nearly half of all high-grade cervical pre-cancers.
All HPV vaccines protect against these two strains, explains Lyndsey Harper, MD, OB-GYN, founder and CEO of sexual wellness platform Rosy. “So, the most important piece of preventing cervical cancer is the HPV vaccine,” she says.
HIV is another risk factor for cervical cancer. People who are HIV-positive are up to 5 times more likely to develop cervical cancer compared to those who are HIV-negative.
Oropharyngeal cancer is the broad name for any cancer affecting the back of the throat, including the base of the tongue and tonsils. Cancers in the oropharynx are relatively uncommon .
According to the CDC, HPV causes 70% of all oropharyngeal cancers in the United States. You can contract HPV orally if you perform oral sex on an individual who has genital HPV, explains Forcier.
Early symptoms
Oropharyngeal cancer may not cause symptoms at first.
If symptoms do occur, Forcier says they often include:
- bumps or warts in your mouth or throat
- bleeding in your mouth or throat
- sore or scratchy throat
- pain or discomfort when talking
- difficulty swallowing
- voice changes
- earache
- unexplained weight loss
Other risk factors
It’s unclear if HPV alone can cause oropharyngeal cancer, or if other risk factors interact with HPV to cause these cancers.
Tobacco use — which includes everything from smoking and spitting to dipping and chewing — is one of the strongest risk factors for oropharyngeal cancer. Alcohol consumption can also increase your risk.
Anal cancer is considered rare . About 90% percent of all anal cancer cases are linked to HPV.
Early symptoms
Some people with anal cancer will not have symptoms. When symptoms do occur, they’re often similar to that of hemorrhoids and anal fissures.
- anal itching
- rectal bleeding
- rectal discharge
- pain
- loss of bowel control
- bumps and lumps around the anus
Other risk factors
You may be more likely to develop anal cancer if you:
- have anal warts
- have a history of cervical, vulvar, or vaginal cancer
- have HIV
- have receptive anal sex
- smoke cigarettes or use other tobacco products
- have a compromised immune system
“HPV is related to the majority of penile cancers,” says Forcier. Indeed, around 60% of penile cancer cases are caused by HPV.
However, there currently aren’t any tests to screen people with penises for HPV, says Harper. That means it’s impossible to know whether you have HPV unless you develop HPV-related warts.
Early symptoms
Early stages of penile cancer are usually marked by skin changes, including:
Discharge or bleeding from the urethra may also occur.
Other risk factors
It’s unclear why, but being uncircumcised may also increase your risk for penile cancer, explains Forcier.
You may also be more likely to develop penile cancer if you:
- are over the age of 49
- have a compromised immune system
- have received for psoriasis
- smoke cigarettes or use other tobacco products
Vulvar and vaginal cancer are both rare. Vulvar cancer accounts for just 0.7% of all cancers in people assigned female at birth. Vaginal cancer accounts for an even smaller percentage.
More than half of all vaginal cancers — and up to 70% of all vulvar cancers — are caused by HPV.
Early symptoms
When an individual has vulvar cancer, there will usually be color or texture abnormalities on the vulva skin, explains Harper.
With vaginal cancer, symptoms are usually felt rather than seen. This includes:
- painful urination
- pelvic pain with or without penetration
- unusual vaginal bleeding and spotting
- watery vaginal discharge
Other risk factors
The biggest risk factor for vulvar and vaginal cancer is a history of other vulvar or vaginal conditions, including:
- vulvar intraepithelial neoplasia
- lichen sclerosus of the vulva
- cervical cancer
- vaginal adenosis
- uterine prolapse
You may also be more likely to develop vulvar or vaginal cancer if you:
- are over the age of 40
- have HIV
- have a history of melanoma or atypical moles
- had a parent who took diethylstilbestrol, a hormone drug that was used between 1940 and 1970
- have a compromised immune system
- smoke cigarettes or use other tobacco products
If you don’t have HPV, do what you can to reduce your risk of contracting it.
Get the HPV vaccine and use barrier methods when having sex with a partner whose STI status you don’t know, says Harper.
The same goes for folks who do have HPV — getting the HPV vaccine, if you haven’t already, can help reduce your risk of contracting high risk strains.
Using barrier methods reduces the risk of transmission to others, as well as your risk of contracting new or different HPV strains.
Adopting other healthy lifestyle habits can also reduce your risk of developing these cancers. For instance, “not smoking and keeping your HIV viral load nonexistent can help,” says Forcier.
HPV has been linked to certain cancers. But an HPV diagnosis doesn’t mean you’ll go on to develop associated cancer.
As Harper puts it, “in the vast majority of cases, HPV is just like a cold and your body will call on its immune response to clear the virus on its own.”
In small percentages of cases, the virus is particularly aggressive or the body cannot mount an adequate response, she says. Here, cancerous or precancerous cells may develop. But when caught early, treatments for these cancers have a high success rate, says Harper.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Austra Health, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.
Last medically reviewed on March 24, 2023
