Dear Alice,

I am 28 years old, and became sexually active two years ago. My husband is the only man I've ever had sex with, and I am his only sexual partner as well. Where does the gene or whatever it is that the HPV vaccine helps guard against come from? Because I'm too old to get the vaccine, are my chances of getting cervical cancer from this particular gene increased then? Thank you for your help.

Dear Reader,

First, to clear up some confusion: although the likelihood of getting some types of cancer may be passed down through genes, cervical cancer is not one of them. Instead, most cases of cervical cancer are caused by different strains, or types, of a virus known as the human papillomavirus (HPV). The vaccines protect against the most common strains of HPV, some of which are associated with cervical cancer (HPV itself is not a form of cancer, it is a virus). Second, being over the recommended age for receiving the vaccine does not mean you are necessarily at increased risk of getting cervical cancer; read on to find out why.

HPV does not come from a gene, nor does it affect any genes that you pass on. Rather, transmission of the HPV virus most often occurs via skin-to-skin contact during sexual activity. HPV is a common viral infection, however many infected people never have any symptoms and the virus often clears from the system on its own. In some people, HPV will cause symptoms, which can include genital warts or precancerous lesions in the genital area that may, if left untreated, lead to cancer (including cervical cancer).

All of the available vaccines protect uninfected people against types 16 and 18 of the HPV virus, which have been shown to cause about 70 percent of cervical cancer cases. Both Gardasil and Gardasil-9 protect against additional strains that commonly cause a number of other genital cancers and genital warts. While the vaccines provide protection against HPV to folks who have previously not been exposed to these strains of HPV, it is not a cure for people who already have been infected with these strains.   

Being too old to receive the HPV vaccine does not mean that you are more likely to get HPV. In fact, age may be an asset; the vaccines was approved first for people under the age of 26 years old, primarily because younger people have a higher risk of being infected with HPV. This increased risk may be due to the immaturity of younger women's cervical cells, which can be more susceptible to HPV infection.

Risk factors that can make someone more likely to contract HPV include:

  • Having had many sexual partners
  • Early sexual activity (having sex before the age of 18)
  • Having other sexually transmitted infections (STIs)
  • A weakened immune system
  • Being a regular cigarette smoker

Vaccinated or not, having regular Pap smears, a simple test of cells from a woman's cervix, is a good way to find any cervical abnormalities before they become dangerous. It's recommended that women have an initial Pap smear within three years of having sex or at age 21, and can then discuss with their health care providers about how often to have subsequent exams. There is not an equivalent HPV screening test for men; if men are concerned about HPV or genital warts, they can speak with a health care provider for more information about risk and transmission.

Even if you are at low risk for getting cervical cancer, you may want to consult with your health care provider about whether the vaccine or other prevention measures are right for you. The vaccine is a great option for some women; however, it is not the only way to protect yourself from HPV. Having regular pap smears, limiting the number of sexual partners, and practicing safer sex can all go a long way in steering clear of HPV, and the warts or cervical lesions that may result.  


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