What are my chances of getting cancer if I have high-risk HPV?

Dear Reader, 

Receiving positive test results can be upsetting, whether it’s a diagnosis of basal cell carcinoma (BCC)—a common kind of skin cancer—or the human papillomavirus (HPV). The short answer to your question is that high-risk HPV strains are often the cause of many cervical cancer cases. However, a positive HPV test doesn’t necessarily mean you will develop cervical cancer. In fact, only about ten percent of individuals with an HPV infection will develop a longer-lasting HPV infection that puts them at risk for cervical cancer. Before continuing, it may be helpful to first review what HPV is and the role it plays in the development of cervical cancer. 

HPV is made up of a group of over 150 viral strains that are transmitted through sexual contact. Some of these strains are considered “high-risk,” meaning they’re associated with cellular changes that may develop into cancer (such as anal, cervical, penile, and vulvar cancer). Two strains in particular, HPV-16 and HPV-18, account for most cervical cancer cases caused by an HPV infection. However, a positive test result for these types of HPV doesn’t necessarily mean a diagnosis of cervical cancer. Before reaching this stage, precancerous cells often undergo abnormal changes called hyperplasia—an increase in cell production—or dysplasia—an abnormal growth of cells. Cervical cancer occurs when precancerous cell changes are left untreated over time. While an HPV diagnosis doesn’t mean these changes will necessarily occur, routine screening aims to catch these cellular changes early on, so that treatment can begin as early as possible. 

You mentioned that your yearly Pap smear has been normal for some time, which is not an uncommon occurrence. Pap smears check the cervix for any precancerous cell changes that might turn into cervical cancer. Therefore, your test results indicate that your cervical cells currently have no abnormal changes! Even if you do receive an abnormal pap smear result in the future, it still doesn’t necessarily mean you have cervical cancer. Abnormal pap smear results can also be caused by bacterial, yeast, and sexually transmitted infections such as herpes and trichomoniasis. For further diagnosis, a health care provider may recommend a colposcopy, which is a procedure that can further examine your cervix, vulva, and vagina for any abnormal cell changes. If abnormal cells are observed, they may perform a biopsy or remove the abnormal cells with a heated wire loop. 

Because you mentioned your age, it may be helpful to know that age can be a factor in monitoring HPV. Studies show that it can take about five to ten years for HPV-infected cells to progress into precancerous cells, and up to 20 years after to fully develop into cancer. Health care providers often administer HPV tests to check for HPV that could cause abnormal cells and to use pap smears to monitor positive HPV results for those over 30 as part of the routine screening process. 

You also mentioned having been diagnosed with basal cell skin cancer, a cancer in the basal layer of the skin. While there are currently no studies linking cervical cancer to basal cell carcinoma, there’s evidence of a correlation between squamous cell carcinoma, cancer in the squamous layer of the skin, and cervical cancer. 

That said, since there are similarities between the two types of skin cancer, it may be helpful to speak with a health care provider about your risk factors. Additional risk factors can include being immunocompromised or taking medications that suppress the immune system. Based on what you discuss, they may suggest that you: 

• Avoid smoking 
• Receive more frequent pap smears 
• Use barrier methods such as condoms or dental dams during anal, vaginal, or oral sex 

Hopefully, this information has helped put your mind more at ease regarding your concerns around developing cervical cancer. Speaking with a health care provider about your history and questions around cervical cancer could help you create a game plan that you feel comfortable with. For more information, feel free to check out this Center for Disease Control and Prevention (CDC) fact sheet on cervical cancer.