What is HPV?

Human papillomavirus (HPV) is a group of related viruses. They can cause warts on different parts of your body. There are more than 200 types. About 40 of them are spread through direct sexual contact with someone who has the virus. They can also spread through other intimate, skin-to-skin contact. Some of these types can cause cancer.

There are two categories of sexually transmitted HPV. Low-risk HPV can cause warts on or around your genitals, anus, mouth, or throat. High-risk HPV can cause various cancers:

• Cervical cancer
• Anal cancer
• Some types of oral and throat cancer
• Vulvar cancer
• Vaginal cancer
• Penile cancer

Most HPV infections go away on their own and don't cause cancer. But sometimes the infections last longer. When a high-risk HPV infection lasts for many years, it can lead to cell changes. If these changes are not treated, they may get worse over time and become cancer.

Who is at risk for HPV infections?

HPV infections are very common. Nearly all sexually active people are infected with HPV soon after they become sexually active.

What are the symptoms of HPV infections?

Some people develop warts from certain low-risk HPV infections, but the other types (including the high-risk types) have no symptoms.

If a high-risk HPV infection lasts for many years and causes cell changes, you may have symptoms. You may also have symptoms if those cell changes develop into cancer. Which symptoms you would have depends on which part of the body is affected.

How are HPV infections diagnosed?

Health care providers can usually diagnose warts by looking at them.

For women, there are cervical cancer screening tests which can find changes in the cervix that might lead to cancer. As part of the screening, women may have Pap tests, HPV tests, or both.

What are the treatments for HPV infections?

An HPV infection itself cannot be treated. There are medicines that you can apply to a wart. If they don't work, your health care provide could freeze, burn, or surgically remove it.

There are treatments for the cell changes caused by infection with high-risk HPV. They include medicines that you apply to the area that is affected and various surgical procedures.

People who have HPV-related cancers usually get the same types of treatment as people who have cancers that are not caused by HPV. An exception to this is for people who have certain oral and throat cancers. They may have different treatment options.

Can HPV infections be prevented?

Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading HPV. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

Vaccines can protect against several types of HPV, including some that can cause cancer. The vaccines provide the most protection when people get them before they are exposed to the virus. This means that it is best for people to get them before they become sexually active.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Some health effects caused by HPV can be prevented by the HPV vaccines.

What is HPV?

HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). 79 million Americans, most in their late teens and early 20s, are infected with HPV. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening.

How is HPV spread?

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected.

Does HPV cause health problems?

In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer.

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area.

Does HPV cause cancer?

HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer).

Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers.

There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV.

How can I avoid HPV and the health problems it can cause?

You can do several things to lower your chances of getting HPV.

Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below) CDC recommends HPV vaccination at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. For more information on the recommendations, please see: https://www.cdc.gov/vaccines/vpd/hpv/public/index.html

Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer.

If you are sexually active

• Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV;
• Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you.

Who should get vaccinated?

HPV vaccination is recommended at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.

How do I know if I have HPV?

There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat.

There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years.

Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.

How common is HPV and the health problems caused by HPV?

HPV (the virus): About 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that almost every person who is sexually-active will get HPV at some time in their life if they don’t get the HPV vaccine.

Health problems related to HPV include genital warts and cervical cancer.

Genital warts: Before HPV vaccines were introduced, roughly 340,000 to 360,000 women and men were affected by genital warts caused by HPV every year.* Also, about one in 100 sexually active adults in the U.S. has genital warts at any given time.

Cervical cancer: Every year, nearly 12,000 women living in the U.S. will be diagnosed with cervical cancer, and more than 4,000 women die from cervical cancer—even with screening and treatment.

There are other conditions and cancers caused by HPV that occur in people living in the United States. Every year, approximately 19,400 women and 12,100 men are affected by cancers caused by HPV.

*These figures only look at the number of people who sought care for genital warts. This could be an underestimate of the actual number of people who get genital warts.

I’m pregnant. Will having HPV affect my pregnancy?

If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Abnormal cell changes can be found with routine cervical cancer screening. You should get routine cervical cancer screening even when you are pregnant.

Can I be treated for HPV or health problems caused by HPV?

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

1. Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
2. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment.
3. Other HPV-related cancers are also more treatable when diagnosed and treated early.

HPV, or human papillomavirus, is a common virus that can cause cancers later in life. You can protect your child from these cancers with HPV vaccine at age 11–12 years.

HPV infections are common

HPV infections are very common. Nearly everyone will get HPV at some point in their lives.

• More than 42 million Americans are infected with types of HPV that cause disease.
• About 13 million Americans, including teens, become infected each year.

HPV is spread through intimate skin-to-skin contact. You can get HPV by having vaginal, anal, or oral sex with someone who has the virus, even if they don’t have signs or symptoms.

Some HPV infections can lead to cancer

Most HPV infections (9 out of 10) go away by themselves within 2 years. But sometimes, HPV infections will last longer and can cause some cancers. HPV infections can cause cancers of the:

• Cervix, vagina, and vulva
• Penis
• Anus
• Back of the throat (called oropharyngeal cancer), including the base of the tongue and tonsils

Every year in the United States, HPV causes about 36,000 cases of cancer in both men and women.

Prevent cancer with HPV vaccine

CDC recommends two doses of HPV vaccine at ages 11–12 years. HPV vaccination can be started at age 9 years.

Children who get the first dose before their 15^th birthday only need two doses. People who get the first dose on or after their 15^th birthday need three doses.

The HPV vaccine series is most effective when given before a person is exposed to the virus.

HPV infections can cause certain cancers in men and women. Talk to your child’s doctor about getting HPV vaccine to prevent HPV infections.

HPV can cause cancers of the:

• Cervix, vagina, and vulva in women
• Penis in men
• Anus in both men and women
• Back of the throat, including the base of the tongue and tonsils (oropharynx), in both men and women

Cancer usually takes years, even decades, to develop after a person gets HPV. There is no way to know who will develop cancer or other health problems from HPV.

• People with weakened immune systems (like people living with HIV/AIDS) may be less able to fight off (clear) HPV infections, and more likely to develop health problems caused by HPV.

HPV vaccination can prevent over 90% of cancers caused by HPV, as well as anal, vaginal, cervical, and vulvar precancers (abnormal cells that can lead to cancer).

That’s why HPV vaccines work best when given at age 11–12 years, before contact with the HPV virus.

Source: How Many Cancers Are Linked with HPV Each Year?
Data as of August 2020

Cervical cancer and HPV

More than 9 of every 10 cases of cervical cancer are caused by HPV. Almost all cervical cancer can be prevented by HPV vaccination.

Every year in the United States:

• Nearly 200,000 women are diagnosed with a cervical precancer
• 11,000 women are diagnosed with cervical cancer caused by HPV
• Over 4,000 women die from cervical cancer

Cervical cancer was once the leading cause of cancer deaths among women in the United States. HPV vaccines and cervical cancer screening have made it one of the most preventable cancers. Even women who are vaccinated should still get regular cervical cancer screening starting at age 21 years.

Cervical cancer is the only type of cancer caused by HPV that can be detected early by a recommended screening test. The other types of cancer caused by HPV may not be detected until they cause more serious health problems. HPV vaccination prevents infections that cause these cancers.

Vaccinating boys can prevent cancers caused by HPV in men

HPV doesn’t only affect women. More than 4 out of every 10 cases of cancer caused by HPV occur among men. Every year in the U.S., over 14,000 men get cancers caused by HPV. You can protect your child from these cancers with HPV vaccine at age 11–12 years. Talk to your child’s doctor about HPV vaccination.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. HPV vaccines can prevent some of the health effects HPV causes.

What is HPV?

HPV is a very common STI. Among 15- to 59-year-olds, 2 in 5 (40%) people will have HPV. There are many different types of HPV; most do not cause any health problems.

HPV is a different virus than HIV or (HSV) herpes.

How do men get HPV?

You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It most commonly spreads during anal or vaginal sex. It also spreads through close skin-to-skin touching during sex. HPV can spread even when a person with the infection has no signs or symptoms.

If you are sexually active, you can get HPV even if you have had sex with only one person. Symptoms can appear years after you have sex with someone who has the infection. This makes it hard to know when you first got it.

What are the symptoms of HPV?

Most men who get HPV never have symptoms. The infection usually goes away by itself. But, if HPV does not go away, it can cause genital warts or certain kinds of cancer.

Talk to your healthcare provider about anything new or unusual on your penis, scrotum, anus, mouth, or throat. This includes:

• Warts,
• Unusual growths,
• Lumps, or
• Sores.

Will HPV cause health problems for me?

Most HPV infections go away on their own and don’t cause any health problems. However, if HPV does not go away, it can cause health problems like genital warts. It also can cause certain kinds of cancer.

We do not know why HPV causes health problems in some people and not others.

What are the symptoms of genital warts?

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. The warts may go away, stay the same, or grow in size or number. A healthcare provider can usually diagnose genital warts by looking at them. Genital warts can come back, even after treatment. The types of HPV that cause warts do not cause cancer.

Can HPV cause cancer?

Yes. HPV itself isn’t cancer but it can cause changes in the body that lead to cancer. HPV infections usually go away by themselves. When they don’t, they can cause certain kinds of cancer to grow. These include:

• Cervical cancer in women
• Penile cancer in men
• Anal cancer in both women and men
• Oropharyngeal cancer, cancer in the back of the throat, including the base of the tongue and tonsils

All of these cancers come from HPV infections that did not go away. Cancer grows very slowly. The diagnosis may not be until years, or even decades, after a person gets HPV. Currently, there is no way to know who will get cancer after getting HPV.

How common are cancers from HPV in men?

Cancers from HPV are not common in men.

Certain men are more likely to develop cancers from HPV:

• Men with weak immune systems (including those who are living with HIV).
• Men who receive anal sex are more likely to get anal HPV. They may develop anal cancer.

Is there testing for HPV in Men?

No, there is currently no approved test for HPV in men.

CDC does not recommend routine testing (also called ‘screening’) for HPV in men. CDC also does not recommend routine testing for diseases from HPV before there are signs or symptoms in men. Some healthcare providers offer anal Pap tests to men who may be at greater risk for anal cancer. This includes men with HIV or men who receive anal sex. If you have symptoms and have concerns about cancer, please see a healthcare provider.

Can I receive treatment for HPV or health problems that develop from HPV?

There is no specific treatment for HPV. But, there are treatments for health problems that develop from HPV. Your healthcare provider can treat genital warts with prescription medication. Cancers from HPV are more treatable when found and treated early.

How can I lower my chance of getting HPV?

There are two steps you can take to lower your chances of getting HPV and diseases from HPV:

• Get vaccinated. The HPV vaccine is safe and effective. It can protect men against warts and certain cancers caused by HPV. Ideally, you should get vaccinated before ever having sex.
• Use condomsthe right way every time you have sex. This can lower your chances of getting all STIs, including HPV. However, HPV can infect areas the condom does not cover. So, condoms may not offer full protection against getting HPV.

Can I get the HPV vaccine?

In the United States, the HPV vaccination recommendation is for:

• All preteens (including boys and girls) at age 11 or 12 years (or can start at age 9 years)
• Everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination.

HPV vaccination for ages 27 through 45 provides less benefit. Most sexually active adults have already been exposed to HPV, although vaccination does not target all HPV types.

At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection.

What does having HPV mean for me or my sex partner’s health?

See a healthcare provider if you have questions about anything new or unusual on your or your partner’s:

• Penis,
• Scrotum,
• Anus,
• Mouth, or
• Throat

Anything new or unusual could be warts, unusual growths, lumps, or sores.

Even if you are healthy, you and your sex partner(s) may also want to get tested for other STIs.

If you or your partner have genital warts, stop having sex until you no longer have warts. We do not know how long a person is able to spread HPV after warts go away.

What does HPV mean for my relationship?

HPV infections are usually temporary. A person may have HPV for many years before it causes health problems. If you or your partner receive a diagnosis of a disease from HPV, there is no way to know:

• How long you have had HPV;
• Whether your partner gave you HPV; or
• Whether you gave HPV to your partner.

HPV is not always a sign that one of you is having sex outside of your relationship. It is important that sex partners discuss their sexual health and risk for STIs with each other.

CDC now recommends 11 to 12 year olds get two doses of HPV vaccine—rather than the previously recommended three doses—to protect against cancers caused by HPV. The second dose should be given 6-12 months after the first dose.

A vaccine is available to prevent the human papillomavirus (HPV) types that cause most cervical cancers as well as some cancers of the anus, vulva (area around the opening of the vagina), vagina, and oropharynx (back of throat including base of tongue and tonsils). The vaccine also prevents HPV types that cause most genital warts.

Why is the HPV vaccine important?

Genital HPV is a common virus that is passed from one person to another through direct skin-to-skin contact during sexual activity. Most sexually active people will get HPV at some time in their lives, though most will never even know it. HPV infection is most common in people in their late teens and early 20s. There are about 40 types of HPV that can infect the genital areas of men and women. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and other less common cancers — like cancers of the anus, penis, vagina, and vulva and oropharynx. Other types of HPV can cause warts in the genital areas of men and women, called genital warts. Genital warts are not life-threatening. But they can cause emotional stress and their treatment can be very uncomfortable. Every year, about 12,000 women are diagnosed with cervical cancer and 4,000 women die from this disease in the U.S. About 1% of sexually active adults in the U.S. have visible genital warts at any point in time.

Which girls/women should receive HPV vaccination?

HPV vaccination is recommended for 11 and 12 year-old girls. It is also recommended for girls and women age 13 through 26 years of age who have not yet been vaccinated or completed the vaccine series; HPV vaccine can also be given to girls beginning at age 9 years. CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. For more information on the recommendations, please see: https://www.cdc.gov/hpv/parents/questions-answers.html

Will sexually active females benefit from the vaccine?

Ideally females should get the vaccine before they become sexually active and exposed to HPV. Females who are sexually active may also benefit from vaccination, but they may get less benefit. This is because they may have already been exposed to one or more of the HPV types targeted by the vaccines. However, few sexually active young women are infected with all HPV types prevented by the vaccines, so most young women could still get protection by getting vaccinated.

Can pregnant women get the vaccine?

The vaccine is not recommended for pregnant women. Studies show that the HPV vaccine does not cause problems for babies born to women who were vaccinated while pregnant, but more research is still needed. A pregnant woman should not get any doses of the HPV vaccine until her pregnancy is completed.

Getting the HPV vaccine when pregnant is not a reason to consider ending a pregnancy. If a woman realizes that she got one or more shots of an HPV vaccine while pregnant, she should do two things:

• Wait until after her pregnancy to finish any remaining HPV vaccine doses.
• Call the pregnancy registry [800-986-8999 for Gardasil and Gardasil 9, or 888-825-5249 for Cervarix].

Should girls and women be screened for cervical cancer before getting vaccinated?

Girls and women do not need to get an HPV test or Pap test to find out if they should get the vaccine. However it is important that women continue to be screened for cervical cancer, even after getting all recommended shots of the HPV vaccine. This is because the vaccine does not protect against ALL types of cervical cancer.

How effective is the HPV Vaccine?

The HPV vaccine targets the HPV types that most commonly cause cervical cancer and can cause some cancers of the vulva, vagina, anus, and oropharynx. It also protects against the HPV types that cause most genital warts. The HPV vaccine is highly effective in preventing the targeted HPV types, as well as the most common health problems caused by them.

The vaccine is less effective in preventing HPV-related disease in young women who have already been exposed to one or more HPV types. That is because the vaccine prevents HPV before a person is exposed to it. The HPV vaccine does not treat existing HPV infections or HPV-associated diseases.

How long does vaccine protection last?

Research suggests that vaccine protection is long-lasting. Current studies have followed vaccinated individuals for ten years, and show that there is no evidence of weakened protection over time.

What does the vaccine not protect against?

The vaccine does not protect against all HPV types— so they will not prevent all cases of cervical cancer. Since some cervical cancers will not be prevented by the vaccine, it will be important for women to continue getting screened for cervical cancer. Also, the vaccine does not prevent other sexually transmitted infections (STIs). So it will still be important for sexually active persons to lower their risk for other STIs.

How safe is the HPV vaccine?

The HPV vaccine has been licensed by the Food and Drug Administration (FDA). The CDC has approved this vaccine as safe and effective. The vaccine was studied in thousands of people around the world, and these studies showed no serious safety concerns. Side effects reported in these studies were mild, including pain where the shot was given, fever, dizziness, and nausea. Vaccine safety continues to be monitored by CDC and the FDA. More than 60 million doses of HPV vaccine have been distributed in the United States as of March 2014.

Fainting, which can occur after any medical procedure, has also been noted after HPV vaccination. Fainting after any vaccination is more common in adolescents. Because fainting can cause falls and injuries, adolescents and adults should be seated or lying down during HPV vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries.

Why is HPV vaccination only recommended for women through age 26?

HPV vaccination is not currently recommended for women over age 26 years. Clinical trials showed that, overall, HPV vaccination offered women limited or no protection against HPV-related diseases. For women over age 26 years, the best way to prevent cervical cancer is to get routine cervical cancer screening, as recommended.

What about vaccinating boys and men?

HPV vaccine is licensed for use in boys and men. It has been found to be safe and effective for males 9 -26 years. ACIP recommends routine vaccination of boys aged 11 or 12 years with with a series of doses. The vaccination series can be started beginning at age 9 years. Vaccination is recommended for males aged 13 through 21 years who have not already been vaccinated or who have not received all recommended doses. The vaccine is most effective when given at younger ages; males aged 22 through 26 years may be vaccinated. CDC recommends 11 to 12 year olds get two doses of HPV vaccine to protect against cancers caused by HPV. For more information on the recommendations, please see: https://www.cdc.gov/hpv/parents/questions-answers.html

Is HPV vaccine covered by insurance plans?

Health insurance plans cover the cost of HPV vaccines. If you don’t have insurance, the Vaccines for Children (VFC) program may be able to help.

How can I get help paying for HPV vaccine?

The Vaccines for Children (VFC) program helps families of eligible children who might not otherwise have access to vaccines. The program provides vaccines at no cost to doctors who serve eligible children. Children younger than 19 years of age are eligible for VFC vaccines if they are Medicaid-eligible, American Indian, or Alaska Native or have no health insurance. “Underinsured” children who have health insurance that does not cover vaccination can receive VFC vaccines through Federally Qualified Health Centers or Rural Health Centers. Parents of uninsured or underinsured children who receive vaccines at no cost through the VFC Program should check with their healthcare providers about possible administration fees that might apply. These fees help providers cover the costs that result from important services like storing the vaccines and paying staff members to give vaccines to patients. However, VFC vaccines cannot be denied to an eligible child if a family can’t afford the fee.

What vaccinated girls/women need to know: will girls/women who have been vaccinated still need cervical cancer screening?

Yes, vaccinated women will still need regular cervical cancer screening because the vaccine protects against most but not all HPV types that cause cervical cancer. Also, women who got the vaccine after becoming sexually active may not get the full benefit of the vaccine if they had already been exposed to HPV.

Are there other ways to prevent cervical cancer?

Regular cervical cancer screening (Pap and HPV tests) and follow-up can prevent most cases of cervical cancer. The Pap test can detect cell changes in the cervix before they turn into cancer. The HPV test looks for the virus that can cause these cell changes. Screening can detect most, but not all, cervical cancers at an early, treatable stage. Most women diagnosed with cervical cancer in the U.S. have either never been screened, or have not been screened in the last 5 years.

Are there other ways to prevent HPV?

For those who are sexually active, condoms may lower the chances of getting HPV, if used with every sex act, from start to finish. Condoms may also lower the risk of developing HPV-related diseases (genital warts and cervical cancer). But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV.

People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That’s why the only sure way to prevent HPV is to avoid all sexual activity.

Pap tests (or Pap smears) look for cancers and precancers in the cervix. Precancers are cell changes that can be caused by the human papillomavirus (HPV). If not treated, these abnormal cells could lead to cervical cancer. An HPV test looks for HPV in cervical cells. Most women 21 to 65 years old need to get Pap tests or a Pap test and HPV test together. Not all women need to be tested every year.

What is a Pap test?

A Pap test is a test your doctor or nurse does to check your cervix for any cells that are not normal. The cervix is the lower part of the uterus (womb), which opens into the vagina. Abnormal cervical cells, if not found and treated, can lead to cervical cancer.

During a Pap test your doctor or nurse puts a speculum (a tool that helps your doctor or nurse see your cervix) into your vagina and uses a special stick or soft brush to collect cells from the outside of your cervix. The cells are sent to a laboratory for testing.

What is an HPV test?

An HPV test looks for DNA from HPV in cells from your cervix. The cervix is the lower part of the uterus (womb), which opens into the vagina. HPV is a sexually transmitted infection (STI) that goes away on its own in most people. If it does not go away, HPV can cause abnormal cervical cells that can lead to cervical cancer.

Certain types of HPV are more likely to cause cervical cancer. The HPV test can tell your doctor if you have HPV and which type it is.

During an HPV test, your doctor or nurse puts a speculum (a tool that helps your doctor or nurse see your cervix) into your vagina and uses a soft brush to collect cells from the outside of your cervix. The cells are tested in a laboratory.

Pap tests and HPV tests can be done at the same time (called co-testing).

Why do I need a Pap and HPV test?

A Pap test can save your life. It can find cervical cancer cells early. The chance of successful treatment of cervical cancer is very high if the disease is caught early. Pap tests can also find abnormal cervical cells before they become cancer (precancers). Removing these precancers prevents cervical cancer over 95% of the time.

An HPV test can give your doctor more information about the cells from your cervix. For example, if the Pap test shows abnormal cervical cells, the HPV test can show whether you have a type of HPV that causes cervical cancer.

Who should get regular Pap or HPV tests?

Most women 21 to 65 years old should get Pap tests as part of routine health care. Even if you are not currently sexually active, got the HPV vaccine, or have gone through menopause, you still need regular Pap tests. Experts recommend:

• Women 21–29 get a Pap test every 3 years
• Women 30–65 get:
  • A Pap test every 3 years, or
  • An HPV test every 5 years, or
  • A Pap and HPV test together (called co-testing) every 5 years

Women older than 65 need a Pap test if they have never been tested, or if they have not been tested after age 60.

HPV tests are recommended for women 30 and older. Although HPV is common in women younger than 30, it usually goes away on its own in these women. Pap tests combined with HPV tests, or HPV tests alone, are most useful for women 30 and older.

Who does not need to get regular Pap or HPV tests?

The only women who may not need regular Pap or HPV tests are:

• Women older than 65 who have had three normal Pap tests or two normal co-tests in a row within the last 10 years, with the most recent test happening within the last 5 years, and who have been told by their doctors that they don’t need to be tested anymore
• Women who do not have a cervix (usually because of a hysterectomy) and who do not have a history of cervical cancer or abnormal Pap test results

Always talk to your doctor or nurse before stopping regular Pap and HPV tests.

I had a hysterectomy. Do I still need Pap and HPV tests?

Even if you have had a hysterectomy, you may need a Pap and HPV test. It depends on the type of hysterectomy you had and your health history. Talk to your doctor or nurse about whether you need Pap and HPV tests.

• If you no longer have a cervix because you had a hysterectomy for reasons other than abnormal cervical cells or cervical cancer, you do not need Pap and HPV tests.
• If you had a hysterectomy because of abnormal cervical cells or cervical cancer, you should continue to get Pap and HPV tests. Talk to your doctor or nurse about how often you should have Pap and HPV tests.
• If you had your uterus removed but you still have a cervix (this type of hysterectomy is not common), you need regular Pap and HPV tests until you are 65 and have had three normal Pap tests or two normal co-tests in a row within the last 10 years with the last test happening within 5 years.

How often do I need to get a Pap test or Pap and HPV tests together?

It depends on your age and health history. Talk with your doctor or nurse to find out how often you need to get a Pap test or Pap and HPV tests together. Most women can follow these current recommendations from the U.S. Preventive Services Task Force:

• If you are 21 to 29 years old, you should get a Pap test every 3 years.
• If you are 30 to 65 years old, you should get:
  • A Pap test every 3 years, or
  • An HPV test every 5 years, or
  • A Pap test and HPV test together (called co-testing) every 5 years
• If you are older than 65, ask your doctor whether you can stop having Pap and HPV tests.

Who needs Pap and HPV tests more often?

Your doctor or nurse may recommend getting Pap and HPV tests more often if:

• You have had treatment for abnormal Pap results or cervical cancer in the past. Women with a medical history of precancerous cells or cervical cancer may need to be tested more often, because their medical history puts them at higher risk in the future.
• You are living with HIV. Women who are living with HIV (the virus that leads to AIDS) are at higher risk of cervical cancer and other cervical diseases because of a weakened immune system. All women living with HIV should get an initial Pap test at the time of the HIV diagnosis and a second Pap test (or Pap and HPV test if you are older than 30) 12 months later. Some experts recommend a second Pap test or Pap and HPV test 6 months later, so talk to your doctor or nurse. After three normal Pap tests in a row, women living with HIV can get follow-up Pap tests every 3 years.
• Your mother was exposed to diethylstilbestrol (DES) while pregnant with you. Daughters, and possibly granddaughters, of women who took DES while pregnant with them have a higher risk of cervical cancer and some other types of cancer.
• You have a weakened immune system because of organ transplant, chemotherapy, or steroid use. HPV may not go away on its own in a person with a weakened immune system.

Are Pap and HPV tests painful?

Some women find Pap and HPV tests uncomfortable, but the tests should not be painful. You will feel pressure as your doctor or nurse puts the speculum (a tool that helps your doctor or nurse see your cervix) into your vagina.

If you have never had sexual intercourse or if you have had pain when something is put into your vagina, you can ask your doctor or nurse to use a smaller speculum.

You can also help lessen or prevent pain by urinating before the test to empty your bladder or by taking an over-the-counter pain reliever, such as aspirin, acetaminophen, or ibuprofen, about an hour before your Pap or HPV test.

Can I get a Pap or HPV test if I’ve been sexually assaulted in the past?

Yes. If you were sexually assaulted or abused in the past, and this experience makes medical exams difficult for you, talk to your doctor or nurse first.

Before the test, while you are still fully clothed, tell your doctor or nurse that you’ve been assaulted in the past and that you have concerns about the test. It may be difficult to lie on an exam table with your legs in footrests (cradles for your feet that help keep your legs bent and open) or to have a doctor or nurse put a speculum (a tool that helps your doctor or nurse see your cervix) into your vagina. Your doctor or nurse will talk with you about ways to make the Pap or HPV test easier.

How do I prepare for a Pap or HPV test?

You do not have to do anything special to prepare for a Pap or HPV test. Also, you should not douche before a Pap or HPV test. Most doctors do not recommend douching for any reason. You also should not put anything in or around your vagina to clean it, other than soap and water on the outside of your vagina.

Can I get a Pap or HPV test when I am having my period?

Yes, you can get a Pap or HPV test during your period. It’s better to schedule the test for a time when you do not expect to have your period. But it’s also better to get a Pap test at any time than to miss your appointment because of your period.

Depending on how heavy your flow is, your period may affect the results of the Pap or HPV test. If you’re uncomfortable or not sure, call your doctor or nurse before your appointment.

What happens during Pap and HPV tests?

Your doctor or nurse can do a Pap test in the exam room of a doctor’s office. You will lie down on your back on an exam table. You will place your feet on either side of the table in footrests (cradles for your feet that help keep your legs bent and open). Your doctor or nurse will put a tool called a speculum into your vagina (you may feel pressure) and will open it to see your cervix.

Your doctor or nurse will use a special stick or soft brush to take a few cells from the surface of and inside your cervix and vagina. Your doctor or nurse will put the cells on a glass slide or in a small container and send them to a lab for testing. If your doctor or nurse orders an HPV test, the cells taken for your Pap test are tested for HPV at the same time.

Pap and HPV tests usually last about 5 minutes. You may have some spotting (light bleeding from the vagina) afterward.

When will I get my Pap and HPV test results?

Usually, it takes 1 to 3 weeks to get Pap and HPV test results. Most of the time, test results are normal.

If you do not get the results of your Pap and HPV tests 3 weeks after the test, call your doctor’s office to get the results. If the doctor or nurse tells you to schedule another appointment to follow up on abnormal results, be sure to go to the appointment.

What do my Pap test results mean?

Your Pap test results will say one of these three things:

• Normal. The cells collected from your cervix during the Pap test look like they should and you do not have to do anything until your next Pap test.
• Unclear. Your doctor does not know whether the cells collected from your cervix are normal or abnormal. If results are unclear, your doctor may do more testing right away to rule out any problems, or your doctor may have you come back in 6 months or a year for another Pap test.
• Abnormal. The cells collected from your cervix during your Pap test look abnormal. Abnormal Pap test results do not mean you have cancer, so your doctor must do other tests to find out what should happen next. Your doctor may do another Pap test right away or, if the cell changes are minor, wait 6 months or a year before doing another Pap test. If the test finds more serious changes in the cells of your cervix, your doctor will do more tests, such as a colposcopy and biopsy.

What is a colposcopy?

During a colposcopy, your doctor or nurse takes a closer look at abnormal areas on your cervix and uses an instrument with a light and magnifier (called a colposcope) to make the abnormal areas easier to see. Your doctor or nurse might use a small amount of vinegar on your cervix to make any abnormal areas stand out.

If there is an abnormal area on the cervix, your doctor or nurse will perform a biopsy (remove a sample of tissue from your cervix) to check for cancer cells. Results of these tests will help your doctor or nurse decide on the best treatment to recommend.

What causes “unclear” or “abnormal” Pap test results?

A Pap test could come back “unclear” or “abnormal” for many reasons. Most often, abnormal cell changes are caused by HPV. HPV is an STI that can lead to cervical cancer.

Other reasons you may have Pap test results that are “unclear” or “abnormal” include:

• An infection, such as a yeast infection, or inflammation
• Growths or cysts that are benign (not cancerous)
• Changes in hormones, such as during pregnancy or menopause
• Smoking, which may increase the risk of an HPV infection developing into cervical cancer. Get tips for women about quitting smoking at women.smokefree.gov.
• Problems with your immune system caused by certain medicines or health problems, such as diabetes, cancer, HIV, or autoimmune diseases

Do Pap tests have risks?

Yes. Although Pap tests are very safe, they do have limits.

• The Pap test may not find abnormal cells that are actually there. This means your doctor may tell you your cervical cells are normal, but the test missed a problem with the cells. This can delay the discovery and treatment of abnormal cells of the cervix. But having regular Pap tests increases your chances of finding problems. Cervical cancer usually takes many years — on average 10 to 20 years — to develop.⁷ If a Pap test misses abnormal cells, your doctor or nurse will probably find them on your next Pap test. Therefore, it is important to have Pap tests on the recommended schedule for your age and medical history.
• The Pap test results may report abnormal cells that are not really there. This means your doctor may tell you that your cervical cells are abnormal, but they are actually normal. There is no way to know that the cells are normal without further testing. Therefore, your doctor may do another Pap test or a different test to find out more. If the next Pap test or other test comes back normal, you don’t have to do anything until your next Pap test is scheduled.

What do my HPV test results mean?

Your HPV test results will show whether you have HPV and what type of HPV it is. Researchers know of about a dozen types of HPV, out of more than 200, that can cause cervical cancer.

HPV test results are usually given with Pap test results. Having the two tests together (called co-testing) can help your doctor figure out if you need to be tested more often or need different tests.

If you do not have HPV and your Pap test results are normal, you can probably wait to be tested again for 5 years.

Can a Pap test tell me whether I have a sexually transmitted infection (STI)?

No. A Pap test is not used to find STIs. A Pap test is used to find abnormal cells that may cause cervical cancer. You must ask your doctor to test you for STIs if you want to have STI testing.

If you tell your doctor you would like to be tested for other STIs, your doctor can collect samples of fluid from your cervix to test for common STIs, such as chlamydia and gonorrhea. You will need blood tests to test for other STIs.

How can I lower my chances of getting cervical cancer?

You can lower your chances of getting cervical cancer in several ways:

• Get regular Pap tests. Regular Pap tests help your doctor find cell changes and treat any unhealthy cells before they turn into cancer.
• Get regular Pap and HPV tests together or an HPV test alone (if you are between 30 and 65 years old). Doctors recommend getting an HPV test or co-testing (getting a Pap and HPV test together) for most women between 30 and 65.
• Get the HPV vaccine. Cervical cancer is usually caused by types of HPV that are passed from person to person through genital contact. Most women do not have symptoms of HPV, and HPV sometimes goes away on its own. If HPV does not go away on its own, it can cause changes in the cells of the cervix that can lead to cervical cancer. The HPV vaccine prevents you from getting most cancer-causing types of HPV. The Food and Drug Administration (FDA) approved the HPV vaccine for people ages 9 through 45.
• Take steps to lower your risk. If you have sex, lower your risk of getting HPV with the following steps:
  • Use condoms. Condoms are the best way to prevent STIs when you have sex. HPV can happen in female and male genital areas that are not protected by condoms. But research shows that condom use is linked to lower cervical cancer rates.Also, the HPV vaccine does not replace or decrease the need to wear condoms. Make sure to put the condom on before the penis touches the vagina, mouth, or anus. Other methods of birth control, like birth control pills, shots, implants, or diaphragms, will not protect you from HPV or other STIs.
  • Get tested. Be sure you and your partner are tested for STIs. Talk to each other about the test results before you have sex.
  • Be monogamous. Having sex with only one partner can lower your risk of STIs. After being tested for STIs, be faithful to each other. That means that you have sex only with each other and no one else.
  • Limit your number of sex partners. Your risk of getting STIs goes up with the number of sexual partners you have.
  • Do not douche. Douching removes some of the normal bacteria in the vagina that protect you from infection. This may increase your risk of getting STIs.
  • Be aware of how much alcohol you drink and keep control of your own drink. Some people use alcohol or drugs as a way to make a person drunk or high. Someone who is drunk, drugged, or high on drugs is unable to consent or understand what is happening. This puts you at risk of sexual assault and possible exposure to STIs.

These steps work best when used together. No single step can protect you from cervical cancer.

How can I get free or low-cost Pap and HPV tests?

Most insurance plans cover Pap and HPV tests with no copay, coinsurance, or deductible.

• If you have insurance, check with your insurance provider to find out what’s included in your plan.
• If you don’t have insurance, find a program near you that offers free or low-cost Pap and HPV tests.
• If you have Medicare, find out how often Medicare covers Pap and HPV tests and pelvic exams.
• If you have Medicaid, the benefits covered are different in each state, but certain benefits must be covered.

All children ages 11–12-years should get HPV vaccine to protect against cancers caused by HPV infections.

85% of people will get an HPV infection in their lifetime.

Almost every unvaccinated person who is sexually active will get HPV at some time in their life. About 13 million Americans, including teens, become infected with HPV each year. Most HPV infections will go away on their own. But infections that don’t go away can cause certain types of cancer.

HPV can cause cancers of the:

• Cervix, vagina, and vulva in women
• Penis in men
• Anus in both women and men
• Back of the throat (called oropharyngeal cancer), including the base of the tongue and tonsils, in both men and women

HPV vaccination works.

HPV infections, genital warts, and cervical precancers (abnormal cells on the cervix that can lead to cancer) have dropped since the vaccine has been in use in the United States.

• Infections with HPV types that cause most HPV cancers and genital warts have dropped 88% among teen girls and 81% among young adult women.
• Among vaccinated women, the percentage of cervical precancers caused by the HPV types most often linked to cervical cancer have dropped by 40 percent.

HPV vaccination is cancer prevention.

HPV is estimated to cause nearly 36,000 cases of cancer in men and women every year in the United States. HPV vaccination can prevent 33,000 of these cancers by preventing the infections that cause them. That’s the same as the average attendance for a baseball game.

Preventing cancer is better than treating it.

HPV can cause several kinds of cancer. Only cervical cancer can be detected early a screening test. The other cancers caused by HPV may not be detected until they are more serious. HPV vaccination prevents infections that cause these cancers.

Early protection works best.

Most children only need two doses of HPV vaccine when vaccinated before age 15 years. You can take advantage of any visit to your child’s doctor to get recommended vaccines for your child:

• Annual checkups
• Sports physicals
• Annual flu shot or other vaccine visits

HPV vaccination provides safe, effective, and long-lasting protection.

With more than 135 million doses distributed in the United States, HPV vaccine has a reassuring safety record that’s backed by over 15 years of monitoring and research.

Protect your child from developing certain types of cancers later in life with the HPV vaccine at ages 11–12.

When Should My Child Get the HPV Vaccine?

Dose #1

11–12 years

Dose #2

6–12 months after the first dose

Two doses of the HPV vaccine are recommended for all boys and girls at ages 11–12; the vaccine can be given as early as age 9. If you wait until they’re older, they may need three doses instead of two.

Children who start the vaccine series on or after their 15th birthday need three shots given over 6 months. If your teen hasn’t gotten the vaccine yet, talk to his/her doctor about getting it as soon as possible.

Vaccines protect your child before they are exposed to a disease. That’s why the HPV vaccine is recommended earlier rather than later, to protect your child long before they are ever exposed to the virus.

Teens and young adults should be vaccinated too.

HPV vaccination is also recommended for everyone through age 26 years, if not vaccinated already.

Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get HPV vaccine after speaking with their doctor about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit, as more people have already been exposed to HPV.

HPV vaccination is preventing cancer-causing infections and precancers.

HPV infections and cervical precancers (abnormal cells on the cervix that can lead to cancer) have dropped significantly since the vaccine has been in use.

• Among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 86 percent.
• Among young adult women, infections with HPV types that cause most HPV cancers and genital warts have dropped 71 percent.
• Among vaccinated women, the percentage of cervical precancers caused by the HPV types most often linked to cervical cancer has dropped by 40 percent.

HPV vaccination is very safe.

Over 12 years of monitoring and research have shown that the HPV vaccine is very safe and effective. Like all vaccines, there is ongoing monitoring of the HPV vaccine to ensure it is safe and effective.

Possible side effects

Like any vaccine or medicine, HPV vaccination can cause side effects. The most common side effects are mild and include:

• Pain, redness, or swelling in the arm where the shot was given
• Dizziness or fainting (fainting after any vaccine, including HPV vaccine, is more common among adolescents)
• Nausea
• Headache

The benefits of HPV vaccination far outweigh any potential risk of side effects.

To prevent fainting and injuries related to fainting, adolescents should be seated or lying down during vaccination and remain in that position for 15 minutes after the vaccine is given.

Help paying for the HPV vaccine

The Vaccines for Children (VFC) program helps families of eligible children who might not otherwise have access to vaccines. The program provides vaccines at no cost to children ages 18 years and younger who are uninsured, Medicaid-eligible, or American Indian/Alaska Native. To learn more, see VFC program.

HPV vaccination provides safe, effective, and long-lasting protection against cancers caused by HPV.

HPV vaccination is very safe

Over 12 years of monitoring and research have shown that HPV vaccination is very safe. Each HPV vaccine—Gardasil® 9, Gardasil®, and Cervarix®—went through years of extensive safety testing before they were licensed by the U.S. Food and Drug Administration (FDA). FDA only licenses a vaccine if it is safe, effective, and the benefits outweigh the risks.

Gardasil® 9 was studied in clinical trials with more than 15,000 females and males.

Gardasil® was studied in clinical trials with more than 29,000 females and males.

Cervarix® was studied in clinical trials with more than 30,000 females.

Each vaccine was found to be safe and effective in clinical trials. Since late 2016, Gardasil® 9 has been the only HPV vaccine available for use in the U.S.

As with all approved vaccines, CDC and FDA closely monitor the safety of HPV vaccines after they are licensed. Any safety concerns detected with these vaccines will be reported to health officials, healthcare professionals, and the public.

Over 120 million doses of the HPV vaccine have been distributed since the vaccine was licensed, and data continue to show the vaccine is safe and effective.

Possible side effects

Vaccines, like any medicine, can have side effects. Common side effects from the HPV shot are mild and go away quickly. The most common side effects include:

• Pain, redness, or swelling in the arm where the shot was given
• Fever
• Dizziness or fainting (fainting after any vaccine, including the HPV vaccine, is more common among adolescents)
• Nausea
• Headache or feeling tired
• Muscle or joint pain

To prevent fainting and injuries related to fainting, adolescents should be seated or lying down during vaccination and remain in that position for 15 minutes after the vaccine is given.

It is important to tell the doctor or nurse if your child has any severe allergies, including an allergy to latex or yeast.

HPV vaccine does not cause HPV infection or cancer. HPV vaccine is made from one protein from the virus and is not infectious, meaning that it cannot cause HPV infection or cancer.

HPV and fertility

There is no evidence to suggest that the HPV vaccine causes fertility problems. Not getting HPV vaccine leaves people vulnerable to HPV cancers and precancers (abnormal cells that can lead to cancer). Women who develop a precancer or cancer caused by HPV could require treatment that would limit their ability to have children, such as a hysterectomy, chemotherapy, or radiation. Treatment for cervical precancer could also put a woman at risk for problems with her cervix, which could cause preterm delivery.

HPV vaccination is preventing cancer-causing infections and precancers

HPV infections and cervical precancers (abnormal cells on the cervix that can lead to cancer) have dropped signi­ficantly since the vaccine has been in use.

• Among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 86 percent.
• Among young adult women, infections with HPV types that cause most HPV cancers and genital warts have dropped 71 percent.
• Among vaccinated women, the percentage of cervical precancers caused by the HPV types most often linked to cervical cancer has dropped by 40 percent.

Long-lasting protection

Studies suggest that the protection provided by HPV vaccine is long lasting. Studies have followed people who received HPV vaccine for about 10 years, and protection has remained high in those individuals. There has been no evidence of the protection decreasing over time.

CDC now recommends 11 to 12 year olds get two doses of HPV vaccine—rather than the previously recommended three doses—to protect against cancers caused by HPV. The second dose should be given 6-12 months after the first dose.

Some health effects caused by HPV can be prevented with a vaccine.

Can I be treated for HPV or health problems caused by HPV?

There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause:

1. Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number.
2. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment. For more information visit www.cancer.org .
3. Other HPV-related cancers are also more treatable when diagnosed and treated early.