Human papillomavirus (HPV)
Key Findings
The disease
Human papillomavirus (HPV) is a common virus. There are more than 100 different types of HPV, and these can affect different parts of the body. Some types of HPV can infect the anal, genital or throat areas; others can cause common warts on the hands or plantar warts on the feet. Infection with certain high-risk HPV types can cause cancer of the cervix, vulva, vagina, penis, anus or throat.
Transmission
Anal and genital HPV are spread through certain types of sexual contact (vaginal or anal sex). HPV infections of the throat are spread through oral sex. While condoms offer some protection against sexually transmitted infections, they give incomplete protection against HPV, since they do not cover all of the genital skin. Anyone who has had sexual contact could have HPV.
Signs and symptoms
HPV infections can often cause no symptoms and therefore go undetected. Certain types of HPV can cause genital warts and other types can cause cancers such as cervical, anal and penile cancer. Even if a person doesn’t have any symptoms of HPV, they can still spread the virus to someone else.
Vaccination recommendations and coverage
As of February 2023, the National Immunisation Program provides 1 free dose of HPV vaccine to those aged 12–13 years. This replaces a 2-dose schedule that was previously delivered 6 months apart to those aged 12–14 years of both sexes. Young people who receive a single dose before 26 years of age no longer need a second dose of the HPV vaccine to be fully vaccinated. Those who are immunocompromised should still receive 3 doses; these are still funded under the National Immunisation Program before the age of 26.3
HPV vaccine coverage (2 doses were needed at this time to be considered fully vaccinated) in Aboriginal and/or Torres Strait Islander adolescents aged 15 years in 2019 was 68.5% overall (71.6% in females and 65.4% in males). HPV vaccine coverage among Aboriginal and/or Torres Strait Islander people is lower than for other Australians.
Vaccination does not prevent infection with all HPV types, so HPV cervical screening also remains an important preventive strategy for cervical cancer in women.
a In 2019, fully vaccinated coverage was based on the completion of 2 doses of HPV vaccine.
Who is most affected?
HPV infection commonly occurs close to the time of an individual’s first sexual experience. Aboriginal and/or Torres Strait Islander women have double the rate of cervical cancer, and more than three times the mortality rate from cervical cancer, compared with non-Aboriginal and/or Torres Strait Islander Australian women.4
How common is it?
HPV is not a nationally notifiable disease; however, HPV types that could produce tumours are recorded through the National Cervical Screening Program. The National Cervical Screening Program does not report on Aboriginal and/or Torres Strait Islander women separately.
Australia has seen remarkable reductions in HPV infection, genital warts, cervical pre-cancers and recurrent respiratory papillomatosis, with recent data suggesting Aboriginal and/or Torres Strait Islander people are benefiting as much as non-Aboriginal and/or Torres Strait Islander Australians.
- Up to 90% of people will be infected with genital HPV at some time in their life.
Hospitalisations/deaths
During 2016–2019, there were 7039 HPV-related hospitalisations (3148 female, 3891 male), with 226 (3.2% – 124 female, 102 male) of these in Aboriginal and/or Torres Strait Islander people.
As we look to the future, Australia’s leadership in cervical cancer prevention and control via the HPV vaccination program, coupled with our HPV-based cervical screening program, means that Australia is likely to be the first country to achieve cervical cancer elimination as a public health problem, as defined by the World Health Organization (<4 cases per 100,000 women per year). 5, 6