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 by having vaginal or anal sex with someone who has the virus. It also spreads through oral sex and through genital skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms. And it’s very common. In fact, it’s more common than all other sexually transmitted infections combined.

HPV isn't spread through casual contact such as hugging, shaking hands, sneezing or coughing. It's also not spread through air, food or water.

What is HPV?

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 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 people 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 go away in the same way as a common cold virus. HPV that doesn’t go away is what can lead to cancer.

HPV and cancer

Most people 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 within a couple of years. But sometimes the HPV infection doesn't 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 the affected cells aren't found early (through a Pap test) and treated. Almost all cervical cancer cases are due to HPV.

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 doesn't 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 healthcare professional to discuss your treatment options.

Get vaccinated

Vaccines are available that can protect against the most common types of HPV that cause cancer. The Canadian Cancer Society recommends that people in Canada 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 aren't 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 2 types of vaccines to protect against HPV infection in Canada.

Our recommendation

We recommend that children and adults between the ages of 9 and 45 be vaccinated against HPV to help reduce the risk of HPV-related cancers. These include cervical, head and neck, 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 for people with a cervix.

School-based HPV vaccination programs

All provinces and territories have publicly funded, school-based HPV vaccination programs for children ranging from grades 4 to 8.

Catch-up HPV vaccination programs

All provinces and territories have catch-up programs for people who have missed the school-based immunization programs in some form. These catch-up vaccinations are publicly funded under the provincial and territorial health plan, but eligibility varies based on age or whether an individual is male or female.

Person getting a vaccine injected into their arm

When should I be vaccinated?

HPV vaccines are given in either a 2- or 3-dose series and over a 6-month period, depending on your age and whether you are immunocompromised. The schedule of doses makes sure the vaccines are as effective as possible. If all doses of the vaccine aren’t given, or they aren’t given at the right time, you may not get the full benefit of the vaccine.

You should speak with your healthcare provider on the number of doses required for your unique circumstance.

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

How safe are the vaccines?

Current evidence tells us that the HPV vaccines are safe, and that their side effects are similar to the side effects of other types of vaccines. In Canada and in other countries, the safety of the 2 HPV vaccines is being monitored on a regular basis. The vaccines aren't 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

Can I be tested for HPV?

HPV testing is most effective for women and people with a cervix who are 30 years of age and older. There is currently no approved test for HPV in men.

While HPV infections are very common in women and people with a cervix under 30 years old, most infections go away on their own and are unlikely to result in abnormal cervical changes that could lead to cancer. Testing of young people is more likely to result in unnecessary diagnoses and treatments.

HPV tests check for high-risk types of HPV

These tests are usually used to identify people with a cervix who are at a higher 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. Provinces and territories are moving towards implementing primary HPV testing as a part of cervical cancer screening. Given how effective Pap tests are in detecting cervical cancer and reducing cervical cancer death, Canadians should still participate in existing cervical cancer screening programs.

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