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Anal HPV/Anal cancer
Hello Doctor,
first of all I would like to thank you for all the information you provide on this site. It is very useful and has helped me relieved many concerns so far.
I've read in some of your posts that a woman does not necessarily need to have anal sex in order to get an anal HPV infection. It seems possible for a woman to acquire an anal HPV infection due HPV being able to spread from the genital to the anal area, due to genital secretions often coming in contact with the anal area, infected body fluids or infected skin coming in contact with the anal area in sexual practices other than anal sex and perhaps autoinoculation in some cases. On the other hand I remember reading in an answer to a previous question that HPV related anal cancer in women is very rare and that most of the women who get it probably had anal sex several times with different sexual partners. How come anal cancer is so rare in women when anal HPV infections seem to be so common and can occur in so many ways without actually having anal sex?
Also, I have a more specific questions. I realize that since I am a sexually active person with more than one lifetime partner it is likely that I have already been infected with one or more strains of HPV and that genital HPV infections at present are a "fact of life". However, I'm very worried about transmitting that infection to my anal area (where cell changes can't be as easily detected by PAP smears and treated as in the genital area). After going to the toilet, I usually wash my genital area with cold water and then proceed to wash the anal area, during which I sometimes stick my finger up my anus to clean it (as weird as it may sound). Could HPV be transmitted this way if some of the vaginal fluids stay on my finger which then comes into contact with my anus? Should I be worried about anal HPV infection due to this as well as other types of exposure?
Thank you in advance for your answer.
first of all I would like to thank you for all the information you provide on this site. It is very useful and has helped me relieved many concerns so far.
I've read in some of your posts that a woman does not necessarily need to have anal sex in order to get an anal HPV infection. It seems possible for a woman to acquire an anal HPV infection due HPV being able to spread from the genital to the anal area, due to genital secretions often coming in contact with the anal area, infected body fluids or infected skin coming in contact with the anal area in sexual practices other than anal sex and perhaps autoinoculation in some cases. On the other hand I remember reading in an answer to a previous question that HPV related anal cancer in women is very rare and that most of the women who get it probably had anal sex several times with different sexual partners. How come anal cancer is so rare in women when anal HPV infections seem to be so common and can occur in so many ways without actually having anal sex?
Also, I have a more specific questions. I realize that since I am a sexually active person with more than one lifetime partner it is likely that I have already been infected with one or more strains of HPV and that genital HPV infections at present are a "fact of life". However, I'm very worried about transmitting that infection to my anal area (where cell changes can't be as easily detected by PAP smears and treated as in the genital area). After going to the toilet, I usually wash my genital area with cold water and then proceed to wash the anal area, during which I sometimes stick my finger up my anus to clean it (as weird as it may sound). Could HPV be transmitted this way if some of the vaginal fluids stay on my finger which then comes into contact with my anus? Should I be worried about anal HPV infection due to this as well as other types of exposure?
Thank you in advance for your answer.
Thank you, Doctor. I wish you all the best and keep up the good work.
MEDICAL PROFESSIONAL
As far as is known, the way women wash -- including the washing procedure you describe -- makes no difference in the chance of anal HPV.
Thank you very much for such a quick response. So just to make sure I understand this correctly: the way I wash my genital and anal area that I described in my previous post does not put me at greater risk for anal cancer due to HPV due to the possibility of vaginal secretions coming in contact with the inside of my anus, even if I just use cold water and no soap?
MEDICAL PROFESSIONAL
(Continued...)
If you are under age 26 and have not yet been vaccinated with Gardasil, you should do that; it will prevent new HPV infections with the types that cause 70% of genital and anal cancers (as well as the types that cause 90% of genital warts). In the future (1-2 years?), an expanded vaccine will cover an additional 5 HPV types, preventing infection with 90% of cancer-causing strains.
Finally, remember that anal cancer remains rare; and it's also almost always easily curable in the early stages. Be aware of anal bumps, non-healing sores, or bleeding and get them checked out promptly; and assure that your routine gyn exams include careful anal inspection for early problems. (In the future, anal pap smears may also have a role in prevention, but that's still a research issue.)
So the "bottom" line (if you'll pardon the pun) is that you shouldn't be especially worried about anal cancer. Take the easy, common sense precautions I have suggested and then put it out of your mind.
I hope this has been helpful. Best wishes-- HHH, MD
If you are under age 26 and have not yet been vaccinated with Gardasil, you should do that; it will prevent new HPV infections with the types that cause 70% of genital and anal cancers (as well as the types that cause 90% of genital warts). In the future (1-2 years?), an expanded vaccine will cover an additional 5 HPV types, preventing infection with 90% of cancer-causing strains.
Finally, remember that anal cancer remains rare; and it's also almost always easily curable in the early stages. Be aware of anal bumps, non-healing sores, or bleeding and get them checked out promptly; and assure that your routine gyn exams include careful anal inspection for early problems. (In the future, anal pap smears may also have a role in prevention, but that's still a research issue.)
So the "bottom" line (if you'll pardon the pun) is that you shouldn't be especially worried about anal cancer. Take the easy, common sense precautions I have suggested and then put it out of your mind.
I hope this has been helpful. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for researching your questions before asking them. You correctly understand the most important facts about anal HPV and anal cancer. As I sometimes do with insightful questions, I'm taking the opportunity to write a blog-like response that may help people with similar questions in the future.
(MedHelp currently has a software glitch that will not let me enter my entire reply in a single window. See the follow-up window below to continue.)
Your first paragraph correctly states that anal HPV is very common in sexually active women and heterosexual men with genital HPV who have never had anal sexual exposure; and yet anal cancer due to HPV is more common in those who have receptive anal sex. The more frequent the anal sex, and greater number of anal sex partners, the higher the cancer risk. The reasons for the difference aren't yet known; future research may come up with some answers. For now, all we can do is speculate about the influence of repeated exposure to HPV, the influence of minor trauma that can occur with anal sex, whether the dose of HPV may be greater by direct inoculation during sex, and so on.
I would advise you not go to overboard in trying to prevent anal HPV. There is no evidence that the measures you are taking would make any difference. Certainly how a woman washes her genital and anal area is unlikely to have any effect, since soap and water instantaneously kills the virus. More likely anal infection occurs through unconscious self-transmission (e.g., by gential-anal scratching, often without awareness) and/or through direct cell-to-cell contact, spreading silently in the skin. It is commonly advised that women wipe away from the vagina after bowel movements, and forward after urinating. The idea is to help prevent non-STD urinary tract infections (nobody knows if it make any difference) -- and perhaps that would slightly reduce the chance of anal transfer of HPV. But I doubt it.
(Continued...)
(MedHelp currently has a software glitch that will not let me enter my entire reply in a single window. See the follow-up window below to continue.)
Your first paragraph correctly states that anal HPV is very common in sexually active women and heterosexual men with genital HPV who have never had anal sexual exposure; and yet anal cancer due to HPV is more common in those who have receptive anal sex. The more frequent the anal sex, and greater number of anal sex partners, the higher the cancer risk. The reasons for the difference aren't yet known; future research may come up with some answers. For now, all we can do is speculate about the influence of repeated exposure to HPV, the influence of minor trauma that can occur with anal sex, whether the dose of HPV may be greater by direct inoculation during sex, and so on.
I would advise you not go to overboard in trying to prevent anal HPV. There is no evidence that the measures you are taking would make any difference. Certainly how a woman washes her genital and anal area is unlikely to have any effect, since soap and water instantaneously kills the virus. More likely anal infection occurs through unconscious self-transmission (e.g., by gential-anal scratching, often without awareness) and/or through direct cell-to-cell contact, spreading silently in the skin. It is commonly advised that women wipe away from the vagina after bowel movements, and forward after urinating. The idea is to help prevent non-STD urinary tract infections (nobody knows if it make any difference) -- and perhaps that would slightly reduce the chance of anal transfer of HPV. But I doubt it.
(Continued...)
You are reading content posted in the STDs Forum
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