Human Papillomavirus

Human Papillomavirus (HPV) is one of the most common viral infections worldwide. It is estimated that around 80% of sexually active adults will acquire at least one strain of HPV during their lifetime. For most people, HPV causes no symptoms and clears naturally. However, certain strains can cause genital warts, while high-risk strains, particularly HPV 16 and 18, are associated with cervical, anal, penile, and throat cancers.

Routine vaccination against HPV is now widely recommended, and we strongly advise vaccination for sexually active adults who have not yet been immunised.

What Is HPV?

HPV is a group of more than 100 related viruses. Around 40 strains affect the genital and anal area and are transmitted through sexual contact.

HPV is spread through:

• Vaginal intercourse

• Anal intercourse

• Oral sex

• Skin-to-skin genital contact

Because HPV is transmitted through skin contact rather than bodily fluids, condoms reduce but do not eliminate transmission risk.

Low-Risk vs High-Risk HPV

HPV strains are broadly divided into:

Low-Risk HPV

These strains (such as HPV 6 and 11) commonly cause genital warts but are not associated with cancer.

High-Risk HPV

Strains such as HPV 16 and 18 are linked to:

• Cervical cancer

• Anal cancer

• Penile cancer

• Oropharyngeal (throat) cancer

• Vaginal and vulval cancer

Persistent infection with high-risk HPV is the main cause of cervical cancer worldwide.

HPV in Men and Women

Although HPV is often discussed in the context of cervical cancer, it affects both men and women.

In men, high-risk HPV can contribute to:

• Anal cancer

• Penile cancer

• Throat cancer

Men who have sex with men (MSM) are at increased risk of anal HPV-related disease, particularly if living with HIV.

Because HPV is often asymptomatic, regular screening where appropriate is essential.

Symptoms of HPV

Most HPV infections cause no symptoms.

When symptoms occur, they may relate to either:

• Genital warts (low-risk strains)

• Pre-cancerous or cancerous changes (high-risk strains)

Symptoms that may indicate HPV-related disease include:

• Intermenstrual bleeding

• Vaginal discharge

• Bleeding or discomfort during sex

• Vaginal bleeding after menopause

• Anal or rectal bleeding

• Anal discomfort or itching

• Visible growths or lumps

HPV-related throat involvement may present with:

• Persistent, unexplained throat pain

• A lump in the throat

• Difficulty chewing or swallowing

• Persistent hoarseness

• Metallic taste or unexplained bleeding

These symptoms do not automatically mean cancer, but they warrant prompt medical assessment.

HPV and Cancer Risk

Most HPV infections clear spontaneously within 1–2 years.

However, persistent infection with high-risk strains can lead to:

• Pre-cancerous cell changes

• Dysplasia

• Cancer over time

HPV-related cancers often develop slowly over many years. Early detection of abnormal cells allows treatment before cancer develops.

This is why screening is so important.

Diagnosis and Screening

Diagnosis depends on symptoms and risk profile.

Visual Inspection

For genital warts or visible lesions, diagnosis is usually made through clinical examination using:

• Speculum examination (for cervical assessment)

• Proctoscopy (for anal assessment)

HPV PCR Testing

HPV PCR testing involves taking a swab from the affected area to detect viral DNA.

This helps determine:

• Whether high-risk HPV is present

• Which strain is involved

HPV testing is commonly combined with smear screening.

Cervical Smear (Pap Test)

A cervical smear detects pre-cancerous changes in cervical cells.

If abnormal cells are found, referral for colposcopy may be required.

Regular cervical screening dramatically reduces cervical cancer risk.

Anal Smear (Anal Cytology)

In higher-risk groups, particularly MSM and individuals living with HIV, an anal smear may be advised.

If abnormal cells are detected, referral for anoscopy is arranged.

What Happens If Abnormal Cells Are Found?

If cervical or anal smear tests detect abnormal changes:

• You may be referred for a colposcopy (cervix)

• Or anoscopy (anal canal)

These procedures allow closer examination and, if necessary, removal of abnormal tissue.

Early intervention prevents progression to cancer.

Treatment of HPV

There is currently no medication that eradicates HPV itself. In most cases, the immune system clears the virus naturally.

Treatment focuses on:

• Removing visible warts

• Monitoring abnormal cells

• Treating pre-cancerous lesions

Options may include:

• Cryotherapy

• Topical treatments

• Minor surgical removal

• Watch-and-wait monitoring

Management depends on the location and severity of the disease.

HPV Vaccination

HPV vaccination is one of the most effective tools in preventing HPV-related cancers.

Modern vaccines protect against:

• HPV 16 and 18 (high-risk strains)

• HPV 6 and 11 (genital warts)

• Additional high-risk strains depending on vaccine type

Vaccination is most effective before sexual debut, but remains beneficial for sexually active adults.

We recommend HPV vaccination for:

• All sexually active adults who have not been vaccinated

• Men who have sex with men

• Individuals with multiple partners

• Those concerned about HPV-related cancer risk

There is also emerging anecdotal evidence suggesting that vaccination may reduce progression risk in individuals already exposed to certain strains.

HPV and the LGBTQ+ Community

HPV-related anal and throat cancers are more common in some LGBTQ+ populations, particularly MSM.

Routine vaccination and screening are therefore especially important.

We provide inclusive, non-judgemental care tailored to individual risk.

Preventing HPV Transmission

While transmission cannot be completely prevented, risk reduction includes:

• HPV vaccination

• Condom use

• Limiting partner numbers

• Routine screening

Because HPV is so common, vaccination remains the most powerful preventative measure.

When Should You Seek Medical Advice?

You should book an appointment if you notice:

• Unexplained genital or anal bleeding

• Persistent throat symptoms

• Visible genital growths

• Pain during sex

• Post-menopausal bleeding

• Intermenstrual bleeding

Early assessment provides reassurance and, where necessary, prompt treatment.

HPV Care in Canary Wharf

At our private clinic in Canary Wharf, we provide:

• HPV vaccination

• Cervical smear testing

• Anal smear testing

• HPV PCR testing

• Assessment of genital warts

• Referral for colposcopy or anoscopy

• Ongoing monitoring

Our approach is discreet, evidence-based, and preventative.

Protecting Your Long-Term Health

HPV is extremely common and, in most cases, harmless. However, persistent infection with high-risk strains can lead to serious disease.

Vaccination, screening, and early detection significantly reduce cancer risk.

If you would like vaccination, screening, or assessment of symptoms, confidential sexual health appointments are available.