HPV (human papillomavirus) causes six types of cancer: cervical, oropharyngeal (throat), anal, penile, vaginal, and vulvar. Together, these account for tens of thousands of cancer diagnoses in the United States each year. Most people who get HPV never develop cancer, but a small percentage of infections persist long enough to trigger cellular changes that eventually become malignant.
The Six Cancers Linked to HPV
Not all HPV-related cancers are equally common. Oropharyngeal cancer, which affects the back of the throat, base of the tongue, and tonsils, is now the most frequently diagnosed HPV-associated cancer overall, with roughly 22,585 cases per year in the U.S. Of those, an estimated 16,000 are directly caused by HPV. Cervical cancer remains the most common HPV-associated cancer among women specifically.
The remaining four types are less common but still significant:
- Anal cancer: Affects both men and women, with the large majority of cases driven by HPV.
- Vulvar cancer: Occurs in the outer area of the female genitals.
- Vaginal cancer: A rare cancer almost always linked to HPV.
- Penile cancer: The least common of the six, but HPV is responsible for a substantial share of cases.
Two specific strains, HPV 16 and HPV 18, are responsible for roughly 76% of cervical cancers. HPV 16 alone drives the overwhelming majority of HPV-related throat cancers. These are classified as “high-risk” strains, distinct from the low-risk types that cause genital warts but not cancer.
Why Throat Cancer Is Surging in Men
The shift in HPV-related cancer patterns over recent decades has been striking. Oropharyngeal cancer now affects men at nearly five times the rate of women: about 18,776 cases per year in men compared to 3,809 in women. An estimated 13,600 of those male cases are directly attributable to HPV. This makes HPV-driven throat cancer more common in men than cervical cancer is in women.
The reasons for this disparity aren’t entirely understood, but differences in immune response to oral HPV infection likely play a role. Men also have no routine screening test for oral HPV, which means these cancers are typically caught only when symptoms appear, such as a persistent sore throat, difficulty swallowing, or a lump in the neck.
How HPV Turns Cells Cancerous
HPV doesn’t cause cancer quickly. The process typically takes years to decades after the initial infection. The virus produces two proteins that essentially disable the cell’s built-in safety mechanisms against uncontrolled growth.
The first protein targets the cell’s main tumor-suppressing system, which normally detects DNA damage and either repairs it or triggers the cell to self-destruct. By destroying this watchdog system, the virus allows damaged cells to keep dividing. The second protein disables a separate brake on cell division, forcing cells into their growth phase prematurely. With both safety systems offline, infected cells accumulate genetic errors over time, and a fraction of those cells eventually become cancerous.
This slow timeline is actually good news. It means there’s a long window between infection and cancer, which is why screening programs for cervical cancer are so effective at catching problems early.
Most HPV Infections Never Lead to Cancer
HPV is extremely common. Most sexually active people will contract at least one strain at some point. But the vast majority of infections resolve on their own without any treatment or lasting effects. In one prospective study tracking women over time, about 81% cleared their HPV infection within roughly 19 months.
The infections that matter are the ones that persist. When a high-risk HPV strain lingers for years, the ongoing viral activity in infected cells accumulates the kind of damage described above. Factors that increase the risk of persistence include a weakened immune system, smoking, and having multiple high-risk HPV strains at once. Still, even among persistent infections, only a fraction progress to cancer.
Screening Catches Cervical Cancer Early
Cervical cancer is the only HPV-related cancer with a well-established screening program. You have three options: an HPV test that checks for the presence of high-risk virus strains, a Pap test that looks for precancerous cell changes on the cervix, or both tests done together (called co-testing). Any of these can detect problems years before cancer develops, when treatment is straightforward and highly effective.
For the other five HPV-related cancers, no routine screening tests exist. Anal, vulvar, vaginal, penile, and oropharyngeal cancers are generally diagnosed based on symptoms. Some clinicians recommend anal Pap tests for people at higher risk, but this isn’t part of standard guidelines for the general population. This gap in screening is one reason prevention through vaccination is so important.
Vaccination Dramatically Reduces Risk
The HPV vaccine targets the high-risk strains responsible for the vast majority of HPV-related cancers. When given before exposure to the virus, early vaccination has been shown to reduce cervical precancers by 40% and cut the overall risk of developing cervical cancer by more than 80%.
The vaccine is recommended for preteens at age 11 or 12, though it can be given as early as age 9 and provides the most benefit when administered before any sexual activity. Catch-up vaccination is available through age 26 for anyone who wasn’t vaccinated on schedule, and it may be offered through age 45 based on individual circumstances. While the vaccine’s impact on cervical cancer has the most data behind it, it protects against all six HPV-related cancer types by targeting the same high-risk strains.
Because the vaccine prevents infection rather than treating it, it has no benefit against HPV strains you’ve already been exposed to. This is why timing matters, and why public health efforts focus heavily on vaccinating young adolescents before exposure occurs.