Human papillomavirus (HPV) is the most common sexually transmitted infection, and most infections clear by themselves within two years. Low-risk types cause genital warts, while persistent high-risk types such as 16 and 18 can cause cervical, anal and throat cancers.
Key symptoms
- Usually no symptoms
- Painless, flesh-colored bumps in the genital or anal area
- Itching or discomfort from warts
- Bleeding after sex or between periods
- Persistent sore throat or a lump in the neck
What you find on exam
- Soft, raised or cauliflower-like warts on the genitals or anus
- Speculum exam of the cervix
- Anal exam and anoscopy when indicated
- Mouth, throat and neck lymph node exam
Tests
- Warts are diagnosed by looking; biopsy if atypical
- Cervical screening: Pap test every 3 years from age 21 to 29
- Age 30 to 65: primary HPV test every 5 years, or cotesting
- Colposcopy and biopsy for abnormal screening results
Treatment basics
- No antiviral cure; the immune system clears most infections
- Warts: imiquimod or podofilox cream, cryotherapy or removal
- Precancer of the cervix: excision such as LEEP
- HPV vaccine routinely at 11 to 12 years, from age 9, and through 26
- Two doses if started before age 15, three doses after
Red flags
- Bleeding after sex or after menopause
- Growing, bleeding or ulcerated genital lesion
- Neck lump or hoarseness that does not go away
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.