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 US, ACIP recommends routine HPV vaccination for adolescents, typically starting at ages 11–12 (and as early as age 9). It is most effective when given before any sexual activity. Catch-up vaccination is recommended through age 26; adults ages 27–45 may benefit after shared clinical decision-making with a healthcare provider.
Pap tests, HPV co-testing, and screening
In the US, USPSTF-aligned cervical screening for people with a cervix typically runs from ages 21–65. Options include Pap testing alone (ages 21–29 every 3 years), and for ages 30–65 either Pap alone every 3 years, high-risk HPV testing alone every 5 years, or Pap/HPV co-testing every 5 years. If high-risk HPV or abnormal cells are found, further evaluation or monitoring may be needed. Keeping up with recommended screening is one of the most important steps 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 program, speaking with your healthcare provider about disclosure is advisable.