There’s a lot to understand when it comes to human papillomavirus (HPV)—as there are more than 200 different types. (Check out our guide for a more comprehensive overview.) Here, we’re diving into genital warts (or, HPV warts), which are skin growths that are sexually transmitted infections (STI) caused by certain types of HPV. 

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HPV warts: What they are and what causes them

As a quick refresher, HPV is a group of viruses, some of which are spread through vaginal, anal, or oral sex. Sexually transmitted HPV falls into low-risk and high-risk groups, and within these groups, there are different genotypes of HPV (those categorized as higher-risk are routinely screened for as part of your cervical cancer screening). There are about 40 types of HPV that are sexually transmitted and can affect your genital area.

Genital warts are usually caused by low-risk types of HPV, such as types 6 and 11. These are not the types of HPV that typically cause cancer, but they can cause warts on or around the genitals, anus, or throat. If you notice these warts, you should visit your doctor; however, it’s important to note that many HPV infections can be asymptomatic. 

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HPV warts occur in both men and women. In men, if the warts are large enough to be seen, you may notice them on the tip or shaft of the penis, the scrotum, or the anus. In women, genital warts may be visible on the vulva or between the external genitals and the anus. They may also occur inside the body; on the walls of the vagina or the anal canal. Warts can also occur in the mouth or throat of someone of either sex who has had oral sex with someone infected with HPV warts. 

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Symptoms of HPV warts

Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. The warts may go away, stay the same, or grow in size or number.

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According to Teal’s Medical Director, Elizabeth Swenson, MD, “Typically, these are painless growths that can be painful or cause bleeding if irritated. The less common symptoms occur typically when [the warts] aren't visible (they can occur within the vaginal canal) where they can cause bleeding and/or pain after intercourse. They can also itch and cause painful urination.”

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HPV warts and pregnancy

Worth noting is that HPV warts can cause complications during pregnancy. The Mayo Clinic warns that while rare, warts can enlarge during pregnancy, making it difficult to urinate and/or inhibiting the stretching of vaginal tissues during childbirth. Warts can bleed when stretched during delivery, and in extremely rare cases, a baby born to a mother with genital warts can develop the infection in their airway, which is known as respiratory papillomatosis. Dr. Swenson states, “This condition can cause airway obstruction and these children can require numerous surgeries to remove the growths from their airway.” 

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As with any complication you wish to avoid, it’s always best to raise concerns with your doctor and ensure they know your medical history with HPV warts should you become pregnant. 

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How to treat (and prevent) HPV warts

If you suspect you may have genital warts, your best bet is to speak to your healthcare provider. They may be able to prescribe topical medicine to use at home or remove the warts with treatments in the office. However, it's important to note that you may still be able to to pass along the infection even if you don't have visible symptoms. If left untreated, genital warts may go away, stay the same, or grow in size or number.

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In terms of prevention, Dr. Swenson advises, “Since genital warts are an HPV-related condition, the quadrivalent and nonavalent vaccinations are the best prevention available. Protected sex (using condoms) can help prevent them.” 

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Similarly, practicing safe sex is always wise when it comes to preventing STIs like genital warts. Avoid having sex with a partner who has active warts.

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The HPV vaccine

HPV vaccines were first introduced in the U.S. in 2006 and since then, among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 88 percent. The CDC also reports that among young adult women, these same infections have dropped 81 percent. 

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Gardasil, the HPV vaccine is recommended for everyone (both females & males) between ages 9-26. While it is recommended until 26, it is approved in the United Sates though the age of 45, it is worth asking your doctor about this powerful means of prevention if you were not vaccinated as a teenager.

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It can be scary to find out you have an abnormal Pap smear or co-test. First of all, take a deep breath. There are many reasons for an abnormal co-test or Pap smear (also called a Pap test); and arming yourself with trusted information and resources to help determine your next steps is your best course of action.

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Before we dive in, it’s important to know that there are three types of tests that screen for cervical cancer: a primary HPV test, a Pap smear, or a co-test (which combines the Pap and HPV). The HPV test is the most sensitive (which means that it is best at picking up disease or infection when it is present) and is the American Cancer Society’s recommended way of screening. However, providers may still conduct Pap smears, most often as a part of a co-test.

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The Pap is a cervical ‘cytology’ screening, which means that it studies your cells. In this article, we’ll discuss different Pap smear (or cytology) results, what they mean, and what to expect as you navigate next steps with your doctor’s guidance.

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What is an abnormal Pap smear? 

A Pap smear is used to detect cell changes in the cervix. It involves collecting cells from the cervix using a smallbrush. (If you’re cringing, we hear you. That’s why we’re working on an improved, at-home experience!)

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The sample is sent to a lab for testing.Your result will come back as either normal or abnormal. An abnormal result means that there are cervical cell changes that are not normal. This usually does not mean that you have cervical cancer, but that the cell changes may require further investigation. The cause of the abnormal cytology results as well as the different abnormal results are often linked to high-risk HPV, which your doctor can test for as part of routine screening.

Here are some of the abnormal cytology results that can be found:

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I had an abnormal Pap smear or co-test—now what?

Depending on the abnormal cytology result, your doctor may recommend a colposcopy. This procedure may look and feel similar to a Pap smear or co-test, although this time, your doctor will use a magnifying device (colposcope) to look at abnormal cells within your cervix. Your doctor may apply a solution to the area of concern, which turns abnormal areas white. Once your doctor identifies the abnormal cells, they may take a small amount of tissue (a biopsy) for testing. These cells will then be sent to a lab for analysis. 

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This is an out-patient procedure. You may, however, experience some mild discomfort after the procedure, mild spotting/bleeding or discharge. These symptoms usually resolve within a few days.

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From here, you’ll wait to hear from your doctor. Waiting on medical results is never fun, so ask your doctor when you can expect to hear your results and how they will communicate the results to you (e.g. email, a phone call, a follow-up appointment, etc.). Based on the results, your doctor will be able to guide you further on next steps, which may include further testing and treatment. 

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Join us in creating a more equitable, accessible, and empowered women’s healthcare system. 

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Teal Health’s Take: It can be difficult to see cancer death rates everywhere we turn. The one positive about cervical cancer is that if detected early through routine screening, it is one of the most successfully treatable forms of cancer. But several barriers exist for routine screening. We are thankful to our community for sharing their stories and putting names to the numbers. We hope you find these inspiring and share the importance of cervical cancer screening with all the women in your life.

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Cervical cancer is highly preventable, thanks to the HPV vaccine and screening tests. Unfortunately,  when women aren’t regularly screened or haven’t been vaccinated, the asymptomatic nature of cervical cancer can have a devastating impact on women and their families. This was the case for my grandmother, Yom “Noy” Chanhom Cross, who passed away from cervical cancer in 2005, at the age of 66, after it had metastasized to her liver and lungs. 

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In sharing my story, I want to highlight the very human aspect behind cervical cancer statistics. In spreading the word about the importance of cervical cancer screening, I hope others can prevent a loss like mine in their own families. 

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My grandmother grew up in the province of Ubon Ratchathani in Thailand near the border of Laos. She was a woman of remarkable courage with a rebellious streak. Determined to escape an arranged marriage, she worked hard to save money until she had enough to run away from her village. After boarding the first train to Bangkok,  she met the love of her life, my grandfather, an American soldier named Robert Cross. They were married in 1968 and my mother was born the following year. The new family of three soon flew to the U.S., where they settled in Texas. 

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Navigating a New Language and Healthcare System in the U.S.

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My grandmother relied on American soap operas and her daughter to guide her through the complexities of learning English. Despite her progress, my grandmother still struggled to communicate at times — especially on topics relating to her health. 

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Combined with this language barrier was a generational mistrust in the medical community, which led her to keep quiet and press on despite experiencing health issues. These issues included intense pain and incontinence. It wasn't until my mother noticed my grandmother's pain that she urged her to seek medical attention. 

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Jumping Through Hoops For a Cervical Cancer Diagnosis

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One of my grandmother's greatest obstacles was her insurance coverage's limitations. She wanted to see a gastrointestinal specialist, but the insurance company imposed strict regulations and prerequisites that she had to fulfill before accessing that care.

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Since she had not visited a doctor in decades, my grandmother was required to undergo a battery of steps, including going to a primary care physician and getting a heart stress test, colonoscopy, and pap smear. 

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Because of my grandmother’s language barrier and lack of knowledge of pap smears, the process felt discouraging and overwhelming. Additionally, she had not experienced a period since giving birth to her only child, my mom, after doctors found a tumor.  The doctors in Thailand had told her that she could not have any more children. From then on, her assumption was that she had a hysterectomy, a misconception shared by her husband and daughter and not helped by the language barrier. This misconception further prevented her from seeking regular OBGYN visits.

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As part of her initial screenings for insurance, she was still required to visit the OBGYN for her overdue pap smear. During the pap smear, she experienced excruciating pain and bleeding in the cervix region. The bleeding was unusual for a typical pap smear and the doctor recognized it as a potential indicator of cervical cancer. 

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Following her appointment, results were expected within seven days — if they were normal. After three frustrating and anxiety-inducing weeks, she learned that she had stage four cervical cancer and would need immediate treatment. Unfortunately, what they didn’t know was that the cancer had already metastasized to her liver and lungs.

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Despite her valiant efforts to get answers, the time from when she first sought medical care to her passing was only three months. 

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Finding Hope and Changing Outcomes With At-Home Cervical Cancer Screening Tests

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My grandmother’s story is one that many families and doctors have heard before. It's the all-too-common narrative of "if only we could have caught it earlier." I can't help but wonder what might have been, had she had access to an at-home cervical cancer screening test. 

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Teal Health is hoping to build an open dialogue and supportive community to help all women understand the importance of routine screening, have women feel empowered (and not embarrassed) to talk about it openly and have private, flexible access through their at-home test. At-home cervical cancer screening tests allow women to quickly (and affordably) take control of their cervical health in the comfort of their homes — without the need to wait for an appointment. By reducing barriers to testing, at-home cervical cancer screening can change the conversation — and the negative outcomes — for other women and their families. 

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Reminder of current cervical cancer screening guidelines:

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It can be unnerving to receive an HPV diagnosis or an abnormal Pap smear test result, so first things first—you’ve come to the right place! If you’ve been diagnosed with HPV, you are most certainly not alone. HPV infections are very common; in fact, many will get HPV at some point in their lives. It is the most common sexually transmitted infection (STI) and in many cases, often clears up on its own.

Let’s take a closer look at what HPV is, how you can prevent it, and actionable guidance for understanding and navigating this diagnosis.

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Table of contents

• What is HPV?
• What causes HPV? How can I protect myself against HPV?
• How is HPV treated?
• Importance of cervical cancer screening.

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What is HPV?

HPV is the human papillomavirus.  This is a group of 200+ related viruses, some of which are spread through vaginal, anal, or oral sex. Sexually transmitted HPV falls into two groups: low-risk and high-risk HPV, and within these groups, there are different strains of HPV. High-risk HPV is routinely screened for as part of your cervical cancer screening (and based on your age/guidelines). There are about 40 types of HPV that are sexually transmitted and can affect your genital area, while other types of HPV can affect other parts of your body, for example, cause plantar warts on your feet.

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Low-risk HPV

Most types of low-risk HPV do not cause cancer and tend to resolve on their own. A few types of low-risk HPV (ie. Types 6 and 11), can cause genital warts. While genital warts may not be pleasant, they can be treated.

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High-risk HPV (hrHPV)

There are about 14 types of high-risk HPV (hrHPV) that can cause cancer. Types 16 and 18, are associated with most HPV-related cancers. Cervical cancer is most commonly associated with hrHPV, and according to the CDC, about 10 percent of women with an HPV infection can be at risk for developing cervical cancer. High-risk HPV can also cause cancer of the vulva, vagina, penis, anus, mouth, and throat.

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What causes HPV?

HPV is an STI. It is most commonly transmitted from one person to another through vaginal, anal, or oral sex. It is often asymptomatic, making it very easy for someone to pass it on to someone else without knowing. Therefore, it is so important to make sure you are getting screened when appropriate and medically recommended.

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How can I protect myself against HPV?

Fortunately, there is also a vaccine to help protect against HPV. The vaccine is routinely recommended for adolescents starting at ages 11-12 and can be given up until the age of 26. It is given as a 2 or 3 dose vaccination series depending on the starting age of vaccination. Some adults, ages 27 to 45, can also receive the vaccination, however this may vary from person to person based on risk, so please talk to your healthcare provider about what is best for you!

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Practicing safe sex is also important to reduce your risk of STIs, however, it doesn’t fully eliminate your risk of HPV because HPV can spread through skin-to-skin contact. It is important to take precautions to reduce your risk of HPV by using condoms and getting regularly tested for STIs (and asking any sexual partners about their test results before having sex).

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How is HPV treated?

If you’ve been diagnosed with HPV, you’re already taking the first  step in doing your research to understand what HPV is and whether you should be concerned. Hopefully, by knowing a bit more about HPV, you’ll feel confident in asking your healthcare provider the right questions.  While there is no treatment for the virus itself, there are treatments for the health conditions it causes (i.e. genital warts).  Together with your healthcare provider, you can discuss a course of action that leaves you feeling more in control of your body and health.

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The importance of cervical cancer screening

Screening for cervical cancer is our best tool for early detection and to prevent this disease. When caught early, cervical cancer is curable 92 percent of the time.

There are three types of tests that are used to screen for hrHPV and cervical cancer:

1. The primary HPV test screens for certain strains of HPV that can be associated with cervical cancer. HPV tests catch changes in the cervix earlier than any other test.
2. The Pap smear test can find changes in the cells of the cervix after they have already happened.
3. The HPV test and Pap smear can also be combined in a co-test.

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Fortunately, we have easy-to-follow recommended screening schedules you can discuss and implement with your healthcare provider, as well as more information on these screening options.

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Join us in creating a more equitable, accessible, and empowered women’s healthcare system.

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Did you know that February marks Ethnic Equality Month? This month, which is celebrated in the United States and a host of other countries, is designed to boost awareness that there are commonalities that link us all together. Yet, when celebrating this commonality, we should remember to embrace and appreciate our differences.

Part of raising awareness is also bringing to light the disparities in socio-economic and health outcomes that still impact members of certain groups. For instance, the CDC notes that there is a dramatic gap in these outcomes across the United States, which can be attributed to both individual racism and structural and institutional racism.

The Teal Health team is focused on actively dismantling these unequal systems and boosting patient outcomes. This aligns with the United Nations’ focus on sustainable growth and development that offers social equality and justice to everyone.

What Inequality Looks Like When It Comes To Cervical Cancer

It’s understood that inequality impacts healthcare outcomes, but just how much of an effect does it really have? Below we’ll bring attention to the different ways inequality affects how and when women are diagnosed with cervical cancer and also suggest ways to close the current gap.

Disparities Among Racial Groups

Depending on the racial group you’re a part of, research shows a dramatic disparity in the five-year survival rate of patients with cervical cancer. For example, in 2023, White women had a five-year survival rate of 67 percent following a cervical cancer diagnosis. However, this rate plummets to 56 percent for Black women. But why is that?

Unfortunately, many women, especially members of minority groups, are behind on their cervical cancer screenings. Screenings can detect cancer before there are any symptoms, which can improve one’s chance of survival. However, if a diagnosis is delayed until one has symptoms, the cancer has probably advanced, and the option to cure the condition has decreased.

The Human Development Index

Another potential factor that may explain these radical outcome gaps is the differences in the Human Development Index (HDI). It tries to understand a country’s development by measuring things like life expectancy, years of schooling, and per capita income.

A population’s literacy rate, poverty rate, and per capita healthcare expenditure are all related to cervical cancer cases and deaths, as they are all tied into a person’s health awareness and ability to access screenings and care. Even small improvements in overall socioeconomic development (like a 0.2 uptick in the HDI) can lead to a significant 33 percent fall in deaths from cervical cancer.

This shows that when people have access to the proper resources and preventive health services they need, the gap in care outcomes can be reduced.

Major Barriers: Lack of Health Insurance and Geographic Location

Another common reason people delay or avoid testing is that they don’t have insurance or are underinsured. Even those with health insurance may not recognize what screenings are covered under their plan or are unable to pay for out-of-pocket expenses.  

Barriers that price people out of testing have negatively affect cervical cancer screening rates, death rates from the disease, and the overall public health burden around cervical cancer screening rates, cervical cancer burden, and disease attributes. So when companies like Teal Health can make testing more easily accessible, more women can be screened and effectively treated for the condition.

One’s location could also lead to access-to-care issues. For instance, living in a rural area could contribute to screening lags. These remote areas often lack the technology or the providers to screen everyone who needs testing. In addition, transportation is a major issue for several individuals. In fact, in 2017, it was discovered that 5.8 million people in the United States delayed medical care because they didn’t have transportation. Fortunately, telehealth solutions can help expand access to care for those in areas where healthcare services may be limited.    

Other Inequalities And The Power of Education

People who identify as part of the LGBTQ+ community also tend to be more likely to be overdue on screening compared with their heterosexual peers, due to lack of support, fear of judgment, personal experiences of sexual trauma, and other factors. Many members of the LGBTQ+ community experience implicit bia from healthcare providers and may have negative experiences related to the clinic-based cervical cancer screening that uses a speculum. These barriers to engaging in screening, can lead to health disparities. Reasons such as this are why Teal Health aims to offer a self-collection option, which would enable vulnerable populations with barriers to the clinic-based exam to still engage in their routine cervical cancer screening.

In order to effectively address each of these inequalities, work must be done to educate patients, in a culturally sensitive manner, about the importance of screening. We’ve learned from research that a lack of information is a barrier to care for many patients. As one study revealed, “Education is a critical component of health and, we argue, education is a major, long-term, multifaceted cause of health.” When people become informed about best practices for cancer screening, they are more inclined to make better decisions for their health.

What Equity, Access, and Inclusion Means at Teal Health

Teal Health is strongly committed to tackling racism and inequities in the healthcare system. No one’s health should hinge on their racial group or other socio-economic factors.

We believe everyone deserves access to high-quality, judgment-free, and individually tailored healthcare, particularly regarding reproductive health. Our goal of equity, inclusivity, and access is exactly why we’re launching an FDA-approved at-home cervical cancer screening kit designed for those assigned female at birth. It’s our first step into making healthcare more accessible and equitable for patients across a wide range of demographic groups.

The Impact of Cancer and the Key Role of Prevention

Did you know that one of the top public health issues in the United States is cancer? In 2022, it was estimated that there would be almost 2 million new cancer cases in America alone. Of that 2 million, approximately 14,000 cases are estimated to include cervical cancer specifically.

Research has also shown that most cervical cancer cases affect women between the ages of 35 and 44. For women who do not participate in routine screening, early diagnosis can often be delayed because some women may not have any signs or symptoms in the early stages.

However, with advances in public health and medical technology, more than 90% of cervical cancer cases can be prevented with regular screening and timely HPV vaccinations. Despite this, cervical cancer screening has dropped by 94% in 2020 and has remained 35% below pre-pandemic levels even after stay-at-home restrictions have been lifted. As a result, late-stage cervical cancers are on the rise.

February is National Cancer Prevention Month – let’s get back on track with cervical cancer screening.

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What Is Cervical Cancer?  

Before we can effectively prevent, diagnose, and treat cervical cancer, it’s critical for people to understand what cervical cancer is.

Cervical cancer is a cancer that affects the cells of the cervix. The cervix is the lower part of the uterus that connects the uterus to the vagina.

Cervical cancer was once one of the most common causes of cancer death in women. Fortunately, cervical cancer screening has played a significant role in improving health outcomes. Because prevention is so vital, here are a few tips you can follow to reduce your risk of developing cervical cancer

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Prevention Tip #1: Get the HPV Vaccine

The vast majority of cervical cancer cases can be traced back to the human papillomavirus, typically referred to as HPV. This virus is sexually transmitted. Because it’s largely asymptomatic, it’s easy for one partner to spread it to another unknowingly.

The good news is that there is a highly effective vaccine that can help to protect against HPV. Most primary care providers recommend that both males and females get vaccinated at 11-12 years old as part of their routine vaccination schedule. You can still get vaccinated up to the age of 26 as part of routine vaccination. In some circumstances, you may be eligible for the vaccine up to age 45; this requires shared decision-making between you and your provider.

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Prevention Tip #2: Practice Safe Sex

According to the CDC, approximately 9 out of 10 cases of cervical cancer can be linked to one or more strains of HPV. Since HPV is a sexually transmitted virus, there are several steps, in addition to vaccination, that you can take to reduce your risk of getting it. These include:

• Using latex condoms when having sexual intercourse with your partner
• If you’re sexually active, get routinely screened for sexually transmitted diseases. It’s also important to have this discussion and share this information with your partners

Prevention Tip #3: Get Screened for Cervical Cancer and HPV

One of the most important proactive steps that you can take to keep yourself safe and healthy is to get screened for cervical cancer and HPV regularly. This can be done by a routine primary HPV test or a co-test which pairs a HPV test with a Pap smear (based on your age and current guidelines).  Currently, this test is done by your provider, who uses a speculum and collects a small number of cells from your cervix, which is then sent to a lab for analysis

See below for current screening guidelines in the US:

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Source: https://www.uptodate.com/contents/cervical-cancer-screening-beyond-the-basics

Take Action Today

National Cancer Prevention Month is a reminder to make sure your cervical cancer screening is up to date and if eligible, receive the HPV vaccination.

Teal Health is pleased to announce that we are working to introduce the first FDA-approved at-home cervical cancer screening kit that will put more screening options directly into patients’ hands. But, while you are waiting for us to be able to get Teal Health’s kit in your homes – don’t delay your regular screening.