High-risk and low-risk HPV
Not all HPV strains are equal. Low-risk strains — particularly HPV 6 and 11 — cause genital warts but are not associated with cancer. High-risk strains — particularly HPV 16 and 18 — are linked to cervical, anal, penile, oropharyngeal, vulval, and vaginal cancers. Most high-risk infections still clear on their own; it is persistent infection with high-risk strains that poses a cancer risk.
Genital warts
Genital warts are soft, flesh-coloured growths that appear on or around the genitals and anus. They are caused by low-risk strains of HPV (primarily 6 and 11) and are not associated with cancer. They can be treated with topical creams, cryotherapy, or surgical removal, though they may recur. The presence of genital warts does not indicate a high-risk HPV infection.
HPV vaccination
The Gardasil 9 vaccine protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 — covering the strains responsible for most HPV-related cancers and genital warts. In the UK, the vaccine is offered routinely to adolescents. It is most effective when given before any sexual activity. Adults up to age 45 may benefit from vaccination — discuss with a healthcare provider.
Cervical screening and HPV
Cervical screening (the smear test) in the UK now tests for high-risk HPV first. If HPV is found, cells are examined for abnormalities. Most people with HPV will have normal cells and will be asked to attend their next routine screen. Abnormal cells (not cancer) may need monitoring or treatment. Attending cervical screening as invited is one of the most important things a person with a cervix can do to prevent cervical cancer.
Telling a partner about HPV
Because HPV is so common, has no routine test for adults, and often clears without either person knowing, partner notification is generally not recommended in the same way as it is for other STIs. However, it is reasonable to discuss vaccination status with a new partner. If you have been diagnosed with genital warts or high-risk HPV through a screening programme, speaking with your healthcare provider about disclosure is advisable.