WHAT IS HPV?​

Have you ever had genital warts? It was most likely caused by the human papillomavirus (HPV). There are more than 100 strains of the virus and around 40 HPV types that affect the genital area1.

HPV is so common that nearly all sexually active men and women get the virus at some point in their lives2.

HPV IN MALAYSIA

The prevalence of HPV in Malaysia follows the global pattern where younger people (below 25 years of age) had the highest HPV infection rate8. Although prevalence spikes were recorded in women between the ages of 31-40 and 51-60, the risk of HPV infection generally declined as women grew older. However, unlike women, older men are as likely as younger men to be HPV infected9.

HPV can be categorized as high-risk HPV (cancer-causing) or low-risk HPV (non-cancer causing).

High-risk HPV

Of the over 100 types of HPV, at least 14 are cancer-causing or also known as high-risk types10. Two high-risk HPV types (16 and 18) cause 70% of cervical cancers in women. In Malaysia, the most prevalent high-risk HPV strains found in healthy men include 16, 18, 45, 51 and 52 and these reflect a similar distribution in Malaysian women as well11. Additionally, HPV 58, which is associated with a high risk of developing cervical dysplasia and cervical cancer, is also highly prevalent among women in Malaysia12,13.

When the body’s immune system can’t get rid of a high-risk HPV, it can linger over time and turn normal cells into abnormal cells and subsequently become cancer14. About 10% of women with high-risk HPV on their cervix will develop long-lasting HPV infections that put them at risk for cervical cancer14.

Similarly, when high-risk HPV lingers and infects the cells of the vulva, vagina or anus, it can cause cell changes called pre-cancers14. These may eventually develop into cancer if they are not detected and removed in time. These cancers are much less common than cervical cancer14.

Low-risk HPV

Apart from high-risk HPV, most types of HPV cause ‘common’ warts that appear on the hands or feet, but genital type HPV can affect the genital area of both men and women5. Low-risk genital HPV can cause warts or lesions. These growths vary in size, shape, and number, but they rarely lead to cancer14.

Non-cancer-causing types of HPV, HPV 6 and HPV 11, cause about 90% of genital warts5. Genital warts are common, highly infectious and affect a person’s sexual life10. The HPV types that cause genital warts are not the same as the types that cause cancer14.

HPV also affects men, leading to an increased risk of anal cancer and genital warts5. Globally, the prevalence of external genital HPV infection in men is higher than cervical HPV infection in women6. However, persistent HPV infection in men is less likely15. Similar to women, some HPV infections in men can clear up on its own without causing any health problems. The most prevalent types of HPV strains that affect Malaysian men include 6, 16, 18, 45, and 5211.

In Malaysia, approximately 21% and 13.5% of men had HPV infection in the genital and anal areas respectively7. Additionally, the incidence rate of HPV associated cancers in men have seen an upward trend over the past decade.

The high uptake of vaccination among Malaysian women of over 80% may be beneficial to men as a result of herd immunity. However, prevention remains one of the best precautionary steps. Find a clinic closest to you and set up an appointment to speak with your doctor to learn more about HPV in men.

HPV often shows no signs or symptoms16, and the majority of infections clear on their own. In cases where the virus remains, it may turn into genital warts or HPV-related cancers. Some people find out they have HPV when genital warts appear, others when they are diagnosed with more serious problems like cancers of the cervix, anus, vagina and vulva2. Pap smear and HPV DNA test results can help to detect if women have abnormal cervical cells and checks for HPV that can cause abnormal cells before symptoms occur, which is why a regular checkup is important17.

Exposure can happen with any intimate behaviour that involves genital contact with someone who has HPV – intercourse isn’t necessary, but it’s the most common way to get the virus17. Since there are often no HPV symptoms or signs, anyone can get the virus without knowing it and then pass it on17.

No, there are currently no available medicines for HPV treatment. For most people, HPV clears on its own. But some persistent strains can lead to HPV-related cancers and other serious diseases, which is why it’s important to prevent HPV to protect yourself2.

HPV-RELATED DISEASES

Ignoring HPV symptoms and infections can lead to some pretty serious HPV-related diseases. HPV infections are responsible for:

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Approximately
99%
of cervical cancer cases3,4

Certain types of HPV, known as high-risk strains, are strongly linked to cancers including anal cancer4. The high-risk subtype most likely to cause anal cancer is HPV 16. Another high-risk type is HPV 18, but this is seen less often with anal cancer4. Anal cancer is a disease in which cancer cells form in the tissue of the anus. HPV is linked to approximately 91% of all anal cancer cases3.

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Approximately
91%
of anal cancer cases18

Certain types of HPV, known as high-risk strains, are strongly linked to cancers including anal cancer4. The high-risk subtype most likely to cause anal cancer is HPV 16. Another high-risk type is HPV 18, but this is seen less often with anal cancer4. Anal cancer is a disease in which cancer cells form in the tissue of the anus. HPV is linked to approximately 91% of all anal cancer cases3.

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>50%
of vulvar cancer cases19

The vulva is the outer part of the female genitals6. The vulva includes the opening of the vagina (sometimes called the vestibule), the labia majora (outer lips), the labia minora (inner lips), and the clitoris6. Cancer of the vulva most often affects the inner edges of the labia majora or the labia minora6. More than half of all vulvar cancers are linked to infection with high-risk HPV types5.

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Approximately
90%
of genital warts cases20

Warts are caused by viruses and can appear anywhere on the body8. Those that show up in the genital area are caused by HPV and are easily transmitted by sexual contact. Low-risk HPV strains, such as HPV 6 and 11, cause about 90% of genital warts, which rarely develop into cancer7.

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Approximately
70%
of vaginal cancer cases6

Vaginal cancer usually starts at the lining of the vagina9. Most vaginal cancers are squamous cell carcinoma (90%) generally attributable to HPV10. HPV DNA is detected among 70% of invasive vaginal cancer10. HPV 16 is one most frequent HPV types that are detected in vaginal cancers in Asia and in the world6.

HPV-RELATED CANCERS

Some people find out they have HPV when genital warts appear, others when they are diagnosed with more serious conditions like cervical cancer in women, and other less common HPV cancers – like cancers of the anus, vagina, and vulva2.

HPV causes approximately 99% of all cervical cancer cases3,4. In 2018, cervical cancer was the second most common cancer among Malaysian women between the ages of 15-4421.

More Resources

INFOGRAPHIC: AM I AT RISK FOR HPV?

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INFOGRAPHIC: HPV BY THE NUMBERS

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You can protect yourself

Getting infected with HPV is more common than you might think1. The good news is you can protect yourself through vaccination and regular cervical screening for women.

ASK THE RIGHT QUESTIONS

It can be hard to know what to say. Here are some helpful questions you can take to your next appointment.

Make an appointment

Find a clinic closest to you and set up an appointment to speak with your doctor about vaccination and screening for women.

MY-GSL-00186 Aug/2020,MY-GSL-00232 Jan/2021