Anal Warts

HPV test awareness, knowledge still low

Friends, I love hearing about HPV awareness in our nation, and how great it is.  However, if only those who I see day after day with diagnosed-HPV had been as educated.

I want to stop this cycle of amazing and brilliant people getting hurt solely by not being informed.  HPV education and prevention wasn't taught in school back in the days.  So now it's up to us to share the message.  And it's up to doctor's like me to lead the pack.   Let's do this.

I got you.

-- Dr. Dale


HPV test awareness, knowledge still low

By Shereen Jegtvig

NEW YORK (Reuters Health) - Americans are more aware that there is a test for the human papilloma virus (HPV) than counterparts in the UK and Australia, according to a new study, but few people knew much more than that.

"Awareness of HPV has tended to be low but has been rising since the introduction of testing and vaccination," said Jo Waller, the study's senior author.

People seem to be more aware of HPV vaccination than testing, however, which is not surprising given the publicity around the vaccine, added Waller, a public health researcher at University College London.

The Pap test, used to look for abnormal cell changes in the cervix, is much older and generally familiar to most people, but the newer HPV test looks for the virus that causes those changes, Waller said.

The HPV test was only introduced in the 1990s and it's used a little differently in each of the countries that were included in the new study, Waller pointed out.

In the U.S., HPV testing is used as a screening tool in women over the age of 30. In both the U.S. and the UK, HPV testing is also used along with the Pap test to determine the next steps in treatment - for instance, biopsy.

In the UK and Australia, the HPV test is also used to monitor treatment results.

Waller said that many studies have attempted to assess the public's knowledge about HPV and HPV testing, but they all used different methods and asked questions in different ways, so it's hard to compare the findings.

"We wanted to use the same questionnaire to look at knowledge across three countries where HPV testing is used in different ways," she told Reuters Health in an email.

The researchers used an online survey to find out if participants in the U.S., UK and Australia were aware of HPV testing and HPV in general.

The first question asked was 'Before today, had you ever heard of HPV?' Participants who responded 'yes' were then directed to 15 general questions about HPV.

Participants were then asked 'Have you ever heard of HPV testing?' Those who responded 'yes' were asked six more questions about the test.

Of the 2,409 men and women who answered the survey, about 61 percent had heard of HPV, Waller's team reports in the journal Sexually Transmitted Infections.

Among those who had heard of the virus, only half were aware of the HPV test. Awareness of the HPV test was higher in the U.S. than in the UK and Australia.

The participants who had heard of HPV testing, on average, answered less than half of questions about details of testing correctly. Overall, women knew more than men.

Most of the survey participants did know, for example, that the HPV test can be done at the same time as the Pap test, and that a positive HPV test doesn't mean a woman will definitely get cervical cancer.

But they didn't know a negative HPV test indicates a low risk of cervical cancer. Few also knew that the HPV test is not an indicator of whether the HPV vaccine is needed.

"It's also important for people to understand that although the HPV vaccine protects against HPV, it's still really important for women to have screening, to check for (virus) types not covered by the vaccine," Waller said.

Women who are screened and found not to have the HPV virus should be reassured that their risk of developing cervical cancer over the next five years is extremely low, Waller added.

SOURCE: Sexually Transmitted Infections, Online January 9, 2014.

HPV & Cervical Cancer: What You Should Know

Hi friends - this is an informative article on the HPV-cervical cancer connection.  Read this please, and if you have any concerns concerning protection, please come see me in the office or email me privately.  I got you. -- Dr. Dale


When a woman's Pap smear—a test for detecting precancerous or cancerous cervical cells—is abnormal, and she is diagnosed with human papilloma virus (HPV), she may feel pretty worried. After all, each year, American women develop more than 20,000 HPV-related cancers. Cervical cancer is the most common, but HPV is also associated with other cancers such as vulva, vaginal, penile, anal and throat cancer.

While a HPV diagnosis is troubling—and certainly nothing to take lightly—in most cases, there is no need to panic. The HPV virus appears to be able to "clear" on its own in young, healthy women, so a woman who receives an abnormal Pap one year may have a normal one the following year. “At least 80 percent of young women will be HPV positive at some point,” says Mary Jane Minkin, MD, clinical professor at Yale School of Medicine’s Department of Obstetrics, Gynecology and Reproductive Sciences and author of A Woman's Guide to Sexual Health. In other words, most instances of the virus won't progress to full-blown cancer.

Still, no one can assume her body will clear the virus—particularly women ages 30 and older. Additionally, while most types of HPV resolve spontaneously, certain strains of the virus are more likely to persist and cause precancerous cell changes that can lead to cervical lesions. So the more you know about HPV and how to avoid it, the safer you’ll be. Below are ways to guard yourself against this ubiquitous sexually transmitted infection.

Get vaccinated. The U.S. Food and Drug Administration (FDA) has approved two HPV vaccines. Gardasil protects against four strains of the virus (out of more than 100), says Minkin: “The high-risk ‘baddies’ are strains 16 and 18, which account for about 70 percent of cervical cancers.  Strains 6 and 11 are responsible for yucky warts. That’s why Gardasil protects against those four.”

The other vaccine, Cervarix, protects against HPV 16 and 18 but not HPV-related warts. Both are given in three injections over six months.

“All kids—girls and boys—need to be immunized,” says Minkin. Both vaccines are approved for ages 9-25. It’s best to get the vaccine before becoming sexually active. Some insurance plans cover the vaccines, as does Medicaid, and both manufacturers also offer help for those who can’t afford them (about $130 per dose).

The vaccines are not approved for people over age 26 because studies have not shown them to be effective in older people, but women 26+ can protect themselves by getting regular screenings for HPV, following up on abnormal results, having limited sexual partners (one, preferably), and making sure any sexual partner is infection-free.

Read more: Read more:

If you’re gay and you know it clap your hands. AND THEN READ THIS!

Happy Cervical Health Awareness Month! Wait. What? January is Cervical Health Awareness Month.  As an M.D. specializing in HPV, how can I not spend some time honoring such an important health topic.

HPV, the virus underlying genital warts and anal cancer in men, is one of the most commonly treated areas in my office.  Even though much of the HPV talk in the news is concerned around women and cervical cancer, there are many concerns that affect men.

Are you gay?  Or bisexual?  According to the Center for Disease Control and Prevention, you are 17 times more likely to develop HPV-related anal cancer than heterosexual men.  Why?  Well, anal cancer is one hint.  Also, “men with weakened immune systems, including those who have HIV, are more likely than other men to develop anal cancer.  Men with HIV are also more likely to get severe cases of genital warts that are harder to treat.”

In a study from 2011, it was found that more than 50% of men over the age of 15 have been infected with HPV.  The study also stated that “each year roughly 6% of men will contract a new infection of the strain that is most associated with cervical cancer in women — HPV 16.”

It’s important to know that although the overall rates of cancers are declining, the National Cancer Institute states that HPV cancers are on the rise.

PLEASE come see me if you have any questions or concerns about HPV, or if you notice anything abnormal about your body.  You can ask me anything.

I’ve saved many lives and will continue to spread the word to educate my patients, friends, family and the internet.   Don’t be afraid.

I got you!

— Dr. Dale


Understanding Anal Warts

7/5/13 || Dr. Dale Prokupek Hello friends, I hope you had a wonderful Independence Day.  I spent my day at a BBQ and unexpectedly got into conversation with a friend about HPV and Anal Warts.  He learned a lot so I figured I'd blog about it.

So, everybody is familiar what warts are all about. In fact, you may even have it at some point of your life. They can be as simple as a small solid blisters that appears harmless. In bigger cases, they may look like a cauliflower attached to your skin. They are commonly found on hands and feet and many just ignore their presence. However, do you know that you may be unaware that you have it? Yes, they can be hidden in your anal area; hence you never had the chance to see it.

Appearance and Symptoms

Once the warts are found around your anal area or inside it, this is medically termed as “Condyloma Acuminata”. However, they may not only be confined on this area. Sometimes, they are also seen on your genital area. And since they start in sizes similar to a pin’s head, they may be barely visible. The fact that they are hidden from your view without presenting any pain or discomfort, you may not even know that they are there. However, if left untreated, they can grow bigger and multiply, ultimately covering your anal area. And worse cases may even lead to skin cancer. Though it may be asymptomatic for some, other may experience certain types of discomforts. They experience bleeding, itching, have mucus discharge and a feeling of mass or lump on their anal region.

How You Acquire It

As you look at the horrible images of anal warts, you may wonder how one acquires it? Obviously, you wouldn’t want to have it one of these days and the best thing for you to do is to exercise all measures to prevent it. Actually, this is one form of a Sexually Transmitted Disease that can be acquired through direct contact. However, it does not follow that only those who had anal sex can have them. Remember that these types of warts can be present in genital areas too.  Hence, to avoid getting infected with such wart, see to it that you do not have multiple sex partners and screen your intimate partner for presence of these warts. Remember that even normal looking tissues may have embedded virus in them, causing warts to appear after a few months. Furthermore, you do not acquire the warts overnight. It will take around 3 months after contact for these warts to become visible.


If you find yourself infected with anal warts, you need to know that things are not as worse as you think it is. The good news is; anal warts can be treated. In fact, for mild cases, it can be done through in an outpatient clinic where you can go home after these have been removed. Treatment modalities include topical meds, surgical removal; freezing with a liquid nitrogen, electrical cautery or electrical coagulation. Of course factors like the severity of the condition and cost matters a lot in the choice of treatment that you need to avail.

As with other types of disorders, anal warts can be treated. However, you may need to have follow-up visits to your doctor’s clinic since there are possibilities that they can recur. Most of all, early management is often preferable.


-- Dr. Dale