[Question #1810] Low Risk HPV

42 months ago
Hello, 

I have been treating warts and they appear to be gone. I had a small recurrence and treated it promptly and it went away. I had the warts for three years and they showed no signs of going away before treatment. 

I have only had two partners in my life, I am pretty sure that I contracted the warts from my wife since I had not had a partner for several years before her, and they appeared about 6 months into our relationship. She has never had an abnormal pap, which eases my worries about confection with a high risk strain. 

I had all but put the warts out of my head until I stumbled across this article: https://academic.oup.com/jid/article-lookup/doi/10.1093/infdis/jis228 . I know 90% of warts are low risk strains 6 & 11, but what about the other 10%? Are they be caused by high risk strains?  

I suppose my largest concerns would be penile cancer (rare I know) and oral cancer. Would having  warts increase my risk for these at all? Im ready to leave these warts behind me  and move on with my life. 


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome back to the forum. I'm glad to learn your warts have been properly treated and are clearing up.

In my reply to your previous question, I pointed out that although low risk (wart-causing) HPV types don't cause cancer, many people with HPV are infected with more than one type. Because of that, it has been known for decades that people with warts have higher risks of HPV related cancers (cervix, anus, throat, etc). In some cases, a few wart causing types might also cause cancer; but more often, it is because there was more than one HPV infection at the start, one of which was high risk. In fact, the single most common of all HPV types is HPV16, the most cancer-causing of all types.

So the report you found is nothing new. It is one of the more recent and better studies, based on the fact that health registries in Denmark and other Scandinavian countries anonymously track all people with HPV and various kinds of cancer. It is from the Scandinavian studies that we know, for example, that up to a quarter of all people get genital warts by age 30 or so. However, nowhere near 25% of Danes get HPV related cancers of the penis or anywhere else. Don't get worked up over the increased risk. While I haven't re-read that research paper in detail, it shows that penile cancer is 8 times higher in people with past genital warts than those without warts. What that means is that the rate might be, say, 1 chance in a million instead of one in 8 million. I'm making up these numbers, but you get the idea. For every health risk that you see published in the media -- increased rates of heart disease in those with diabetes, colon cancer in meat eaters, and cancers related to HPV -- you need to pay attention not only to increased risk ratios, but to the actual rates in the population. With or without HPV, well under 1 in 10,000 people with HPV will ever get either penile or throat cancer. (You can find such data to see actual rates in the US, e.g. CDC.gov, the American Cancer Association, etc.)

In other words, to the extent you may be at increased risk for either throat or penile cancer, the actual chance of either one is miniscule. And penile cancer is almost always easily curable -- typieally a wart-like spot that doesn't respond to wart treatment, or a non-healing sore. At this stage and usually for several more years, it is easily cured by simple surgical removal. Nobody dies of penile cancer and almost nobody requires dramatic treatment like amputation. And most HPV related throat cancers also are discovered early during routine dental exams and also easily treated. Also, both of these typically don't occur in people until age 50 or more.

I hope this information is reassuring. Let me know if anything remains unclear.

HHH, MD
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42 months ago
Thank you, Im trying to be pragmatic about this and not fill myself with unnecessary worry. It seems like the more I research the less clear it gets though. 


In your opinion would warts that do not clear on their own increase the risk of a confection with a high risk or cancer causing strain? 

also, with my few number of partners would vaccination be a viable option? I am 29 so I am outside the recommended age ranges. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
"It seems like the more I research the less clear it gets though." As you may have noticed, the question imeediately after yours (1811) also concerns HPV related cancer. Please read that reply, which you may find reassuring. The fact is that all HPV related cancers remain quite uncommon. I would also advise you to give your online searching a rest for a couple of months. Like many anxious persons, you are being drawn to alarming or conflicting information, often without context, and are tending to miss (or misinterpret) the reassuring information that also is there.

To my knowledge, there is no evidence that delayed clearance or treatment of warts increases cancer risk or the probability of a high risk HPV type. But even with high risk types, the vast majority are eventually cleared and never lead to cancer. (See your neighboring thread.)

The 26 year recommended age limit for HPV immunization is not only based on no. of partner, but on the statistical fact that new HPV infections are quite uncommon after that age. I would not recommend you be vaccinated.

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42 months ago
Thank you for your help. 

After this conversation I think I will to quit researching and just accept that my worries are very unlikely to happen. 

My final question is just out of curiosity: Do you think that there will be a therapeutic vaccine for HPV in the near future? Also, what do you make of the small study that showed that AHCC has potential for HPV treatment? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
AHCC is quackery. The avilable report was scientifically very flawed, and I don't expect ever to see serious research on it. If that's ever done, I would be surprised if it turns out to be effective.

Therapeutic vaccines have more promise, but if this pans out, I would expect at least a decade before availability to the public, and then probably at very high cost. So don't hold your breath!

Thanks for the thanks. I hope you're indeed able to move on. I'm glad to have helped.

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