How HPV Leads to Cancer and What You Should Know

HPV can cause several types of cancer, but most people who get the virus never develop cancer at all

Human papillomavirus (HPV) is a common virus that spreads through skin-to-skin contact, usually during sexual activity. Most people who catch HPV clear it on their own within a year or two. But in some cases, the virus stays in the body for years, and certain types can damage cells in ways that eventually lead to cancer.

The cancers most strongly linked to HPV are cervical cancer, anal cancer, and cancers of the throat and mouth. HPV also plays a role in some vaginal, vulvar, and penile cancers. The risk depends on which type of HPV you have, how long it stays in your body, and factors like smoking or a weakened immune system.

The good news is that cervical cancer screening catches precancerous changes before they become cancer, and HPV vaccines prevent infection with the types most likely to cause disease. Understanding how HPV works and what your options are can help you make informed decisions about prevention and screening.

Key Takeaways

HPV is extremely common, but most infections clear on their own and never cause cancer.
A small number of HPV types — mainly types 16 and 18 — are responsible for most HPV-related cancers.
Cervical cancer develops slowly over years, giving screening tests time to find and treat precancerous changes before cancer forms.
HPV vaccines prevent infection with high-risk types and are most effective when given before sexual activity begins.
People with cervical cancer risk should have regular screening; those at risk for other HPV cancers should discuss screening options with their doctor.

Which HPV types cause cancer

There are more than 200 types of HPV, but only about a dozen are considered high-risk for cancer. HPV-16 and HPV-18 cause the majority of HPV-related cancers — roughly 70 percent of cervical cancers and most HPV-linked throat and anal cancers come from these two types.

Other high-risk types include HPV-31, HPV-33, HPV-35, HPV-39, HPV-45, HPV-51, HPV-52, HPV-56, HPV-58, HPV-59, and HPV-66. Low-risk types like HPV-6 and HPV-11 rarely lead to cancer but can cause genital warts.

You can be infected with more than one type at the same time. Having a high-risk type does not mean you will develop cancer — most people clear even high-risk HPV without any health problems. The risk rises when infection persists for many years.

How HPV infection becomes cancer over time

When high-risk HPV infects cells in the cervix, throat, or anus, it can cause changes in those cells. In most people, the immune system fights off the virus and the cells return to normal. But sometimes the virus stays, and the infected cells begin to grow abnormally.

This process usually takes years — often 10 to 15 years or longer for cervical cancer to develop from an initial HPV infection. The cells go through stages: first they become mildly abnormal (called dysplasia), then more abnormal, and eventually some may turn into cancer if left untreated.

The longer a high-risk HPV type stays in your body, the higher the risk. Factors that make it harder for your immune system to clear the virus include smoking, a weakened immune system (from HIV or immunosuppressive medications), and long-term stress. People with these risk factors are more likely to develop persistent infection and move toward cancer.

Cervical cancer and HPV screening

Cervical cancer is the most common HPV-related cancer and the one we can screen for most effectively. The Pap test looks for abnormal cells in the cervix before they become cancer. The HPV test checks for the presence of high-risk HPV types.

Screening guidelines vary, but generally people with a cervix should begin screening at age 21 (or within three years of first sexual activity) and continue at regular intervals — usually every three years for Pap tests alone, or every five years if HPV testing is included. Screening can continue into the 60s or 70s depending on prior results and individual risk.

If screening finds abnormal cells, your doctor may recommend a colposcopy — a closer look at the cervix using a magnifying instrument — and possibly a biopsy to determine the severity. Most abnormal findings are mild and resolve on their own, but some require treatment to prevent cancer from developing.

HPV vaccines and cancer prevention

HPV vaccines work by training your immune system to recognize and fight high-risk HPV types before infection occurs. The vaccines available in the United States are Gardasil 9 (which protects against nine HPV types, including HPV-16 and HPV-18) and Cervarix (which protects against HPV-16 and HPV-18).

Vaccination is most effective when given before a person becomes sexually active, ideally in the early teens. The CDC recommends routine vaccination for all people ages 11 to 26, and vaccination may be considered for people up to age 45 on a case-by-case basis. The vaccine does not treat existing HPV infection, only prevent new infections.

Studies show that HPV vaccination has dramatically reduced the rate of cervical precancers and cancers in vaccinated populations. Over time, as more people are vaccinated, rates of HPV-related cancers are expected to decline significantly.

What to do if you have been diagnosed with HPV

If you test positive for HPV, the next steps depend on the test result and your age. For cervical HPV findings, your doctor will likely recommend follow-up testing or a colposcopy to see whether abnormal cells are present. Most people with HPV have no symptoms and never develop cancer.

If abnormal cells are found, treatment options range from monitoring (for mild changes that often resolve on their own) to procedures that remove or destroy the abnormal tissue. These procedures are usually done in an office setting and have high success rates in preventing cancer.

You should continue with recommended screening even after an HPV diagnosis. Tell your sexual partners if you have been diagnosed, though HPV is so common that many people have already been exposed. Using condoms can reduce (though not eliminate) the risk of spreading HPV to partners.

Frequently Asked Questions

If I have HPV, will I definitely get cancer?

No. Most people who get HPV clear the infection on their own and never develop cancer. Only a small percentage of people with persistent high-risk HPV infection develop cancer, and that usually takes many years. Regular screening catches precancerous changes before cancer forms.

Can men get screened for HPV-related cancers?

There is no routine screening test for HPV-related cancers in men. The best prevention is HPV vaccination before sexual activity. Men at higher risk — such as those with HIV or a history of receptive anal intercourse — should discuss screening options with their doctor, though guidelines are still developing.

Is HPV the only cause of cervical cancer?

HPV causes about 99 percent of cervical cancers. The remaining cases are rare and usually involve other factors. This is why HPV vaccination and regular cervical screening are so effective at preventing cervical cancer.

Can I get HPV again after clearing an infection?

Yes, you can be infected with a different HPV type even after clearing one. However, your immune system usually remembers the type you had before and can fight it off if exposed again. Vaccination provides protection against multiple types at once.

When should I start cervical cancer screening?

Screening typically begins at age 21 or within three years of first sexual activity, whichever is later. If you have never been screened or have not had screening in several years, talk to your doctor about when to start and how often you need testing based on your individual risk.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.