Human papillomavirus (HPV) infections are the most common sexually transmitted infection in the U.S., with the virus typically spreading through vaginal, anal or oral sex as well as close skin-to-skin contact during sex, according to the Centers for Disease Control and Prevention. About 80% of women will have HPV at some point in their lives.
But they’re not the only ones who get infected. A new study published in the Lancet Global Health found that nearly 1 in 3 men has at least one type of HPV, and 1 in 5 is carrying at least one high-risk type, which can cause several types of cancer in women, including cervical cancer.
Yet, only women are routinely screened for HPV. Why is that the case? Experts explain.
First, what you need to know about HPV
In most cases, HPV has no noticeable symptoms and clears up on its own within two years, thanks to the body’s immune system. So it can be tempting to think that HPV is not a big deal. However, there are more than 200 types of HPV, according to the National Cancer Institute (NCI).
Dr. G. Thomas Ruiz, ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, Calif., tells Yahoo Life that some types of HPV are quite dangerous, while others are not.
Most low-risk types of HPV don’t cause disease, but some can cause warts on or around the genitals, anus, mouth or throat, per the NCI. High-risk types of HPV that persist can cause cancer, including cervical cancer, cancer that develops in the back of the throat, and cancer of the anus, penis, vagina and vulva. (The HPV vaccine Gardasil 9 protects against several cancer-causing strains of HPV, as well as the ones that cause genital warts.)
“The body can ‘cure’ the HPV,” Fosnight says. “However, with it taking up to two years to clear the virus, this can be too long, and those high-risk types are more susceptible to turning into cancer.”
According to the CDC, about 11,500 new cases of cervical cancer are diagnosed every year in the U.S., and about 4,000 women die of this cancer annually.
However, thanks to HPV vaccines and cervical cancer screenings, it’s one of the most preventable cancers, the CDC reports.
So why isn't there routine screening for HPV in men?
In a nutshell, it’s hard to get reliable test results in men. Aleece Fosnight, a medical adviser at Aeroflow Urology and a physician assistant specializing in sexual medicine and urology, tells Yahoo Life that “research has shown that results in testing for HPV have been inconsistent in men. Getting a sample from the penile skin can be difficult.”
In addition, the area where the virus would “set up shop” is much less permeable in men than in women. Fosnight explains the cervix is the perfect place for the virus to infiltrate, but the glans of the penis thickens and becomes callused in those who have been circumcised, making it less permeable.
Fosnight also notes that “there are several medical research studies that look at removal of the foreskin decreasing the risk against HPV and HIV transmission, along with decreasing risk of urinary tract infections, penile infections and penile cancers.”
According to the American Sexual Health Association (ASHA), men are typically screened visually by a doctor to check for lesions, which include genital warts. Fosnight explains that “symptoms, such as a lesion on the genitals, can be removed and tested for the presence of HPV. However, there is no official ‘Pap’ [test] of the penis that has been FDA-approved.”
The ASHA concurs, stating: “There is no specific way to test directly for HPV in men that is approved for clinical use. Researchers are looking at ways to better screen men, but the current lack of testing options for males can be very frustrating.”
The burden of testing is on women
Both Ruiz and Fosnight say the onus of getting screened for HPV regularly is on women and that they typically carry the emotional and physical toll of an HPV infection.
“The ramifications to men are nowhere near the ramifications to women,” Ruiz says.
According to the CDC, cancers from HPV aren’t common in men. However, HPV infections may play a role in male infertility. Dr. Alex Robles, a reproductive endocrinologist and fertility specialist at Columbia University Fertility Center, tells Yahoo Life that some evidence suggests that HPV infections in men “may alter semen quality.”
He explains that, “in laboratory testing, HPV may cause DNA damage in sperm, which can lead to sperm degradation. Other studies looking at overall associations have also consistently seen a relationship with HPV infection and lower sperm quality. The most common findings are decreased sperm motility and concentration. It is important to note that other factors may also be involved, and HPV is just a risk factor.”
So what can men do to help prevent the spread of HPV? Ruiz says it’s important for boys and men — not just girls and women — to get the HPV vaccine if they’re eligible, since it protects against 90% of HPV-related cancers. He also recommends wearing a condom. Although it doesn’t completely eliminate the risk of HPV, since the virus can be passed from skin-to-skin contact, he says this “diminishes” the probability.