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Lingering infection with high-risk HPV types, such as types 16, 18, 31, and 45, can favor the development of cancer. Furthermore, HPV can induce a tumorigenic process through integration into a host genome which is associated with alterations in DNA copy number. Normally, p53 acts to prevent cell growth, and promotes cell death in the presence of DNA damage. In short, p53 is a tumor-suppressor protein that arrests the cell cycle and prevents cell growth and survival when DNA damage occurs. Thus, inactivation of p53 by E6 can promote unregulated cell division, cell growth, and cell survival, characteristics of cancer. E6 also has a close relationship with the cellular protein E6-associated protein E6-AP , which is involved in the ubiquitin ligase pathway, a system that acts to degrade proteins. E6-AP binds ubiquitin to the p53 protein, thereby flagging it for proteosomal degradation. Studies have also shown a link between a wide range of HPV types and squamous cell carcinoma of the skin. In such cases, in vitro studies suggest that the E6 protein of the HPV virus may inhibit apoptosis induced by ultraviolet light. Because the process of transforming normal cervical cells into cancerous ones is slow, cancer occurs in people having been infected with HPV for a long time, usually over a decade or more persistent infection. Sexually transmitted HPVs are found in a large percentage of anal cancers. Throat cancers associated with HPV have been estimated to have increased from 0. Moreover, findings indicate this type of cancer is much more prevalent in men than in women, something that needs to be further explored. The International Agency for Research on Cancer has found that people with lung cancer were significantly more likely to have several high-risk forms of HPV antibodies compared to those who did not have lung cancer. The virus, unchecked by the immune system, causes the overproduction of keratin by skin cells , resulting in lesions resembling warts or cutaneous horns. Low-risk HPVs cause warts on or around the genitals. High-risk HPVs cause cancer and consist of about a dozen identified types. Type 16 and 18 are two that are responsible for causing most of HPV-caused cancers. It does not spread via common items like toilet seats. HPV may still be transmitted even after lesions are treated and no longer visible or present. However, the lack of appearance does not rule out asymptomatic latent infection, as the virus has proven to be capable of hiding for decades. Genital infections[ edit ] Since cervical and female genital infection by specific HPV types is highly associated with cervical cancer, those types of HPV infection have received most of the attention from scientific studies. HPV infections in that area are transmitted primarily via sexual activity. Hernandez tested the genitals and dominant hand of each person in 25 heterosexual couples every other month for an average of seven months. She found two couples where the man's genitals infected the woman's hand with high-risk HPV, two where her hand infected his genitals, one where her genitals infected his hand, two each where he infected his own hand, and she infected her own hand. Winer found all 14 fingertip samples from virgin women negative at the start of her fingertip study. However, as non-sexual transmission of HPV by other means is not uncommon, this could not be definitively proven. In , a group tested Australian Red Cross blood samples from healthy male donors for HPV, and subsequently found DNA of one or more strains of the virus in 15 8. As such, it remains to be determined whether HPV can or cannot be transmitted via blood.
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