Human Papillomavirus (HPV) Test

What is an HPV test?

HPV stands for human papillomavirus. There are many types of HPVs. Some of them are spread through close skin-to-skin touching during sex with a person who has the virus. These HPVs are the most common cause of sexually transmitted infections (STIs).

Certain types of HPV cause genital warts. Other types, called "high-risk HPV," can cause cancer, especially cancer of the cervix. The cervix is the lower part of the uterus where a baby grows during pregnancy. Most cervical cancers are caused by HPV. That means if you have a cervix and are infected with certain types of HPV, you have a higher risk of getting cervical cancer.

HPV tests use a sample of cells from your cervix to look for signs of infection with high-risk HPVs that can lead to cervical cancer. Knowing whether you have HPV helps your health care provider understand your risk for developing cervical cancer. If you have an HPV infection, you can discuss whether you need other tests and how often you should be checked for cervical cancer.

Usually, your immune system gets rid of an HPV infection naturally within two years without causing any health problems. But in certain cases, high-risk HPV infections can stay in the body for many years, even decades. These long-lasting infections can lead to cancer.

Other names: genital human papillomavirus, high risk HPV, HPV DNA, HPV RNA

What is it used for?

The test is used to check a sample of cervical cells for signs of infection with high-risk HPV that can lead to cervical cancer. The test is often done at the same time as a Pap smear, which is a test that checks cervical cells for abnormal changes caused by HPV. When an HPV test and a Pap smear are done at the same time, it's called an HPV/Pap cotest.

An HPV test may also be used to make treatment decisions after a diagnosis of oropharyngeal cancer. This cancer grows in the back of the throat, including the tonsils and the base of the tongue. It is mostly caused by HPV. Oropharyngeal cancer from HPV has its own treatment and usually has a better chance of recovery than other throat cancers.

Why do I need an HPV test?

You may need an HPV test to screen for cervical cancer if you:

• Had an abnormal result on a Pap smear. An HPV test can show whether HPV caused the abnormal changes in your cervical cells.
• Are age 30 through 65. An HPV test alone or an HPV/Pap cotest is recommended every five years as long as you have had normal test results.

If you are between ages 21 and 29, you should have a Pap smear every three years. But you don't need HPV testing if your Pap smear results are normal. While HPV infections are common in this age group, they usually clear up on their own within a year or two without causing any problems. Some medical experts recommend starting HPV testing at age 25 and getting tested every 5 years if your last test was normal.

If you have a high risk for developing cervical cancer, you may need to get tested more often. Your risk may be higher if you:

• Had an abnormal HPV test, Pap smear, or cervical biopsy in the recent past
• Have HIV. You may also need screenings after age 65.
• Have a weakened immune system
• Have had cervical cancer
• Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between 1940-1971, DES was sometimes prescribed to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it before birth.

Ask your provider which cervical cancer screening test is right for you and how often you should be tested.

If you have been diagnosed with oropharyngeal cancer, you may also need an HPV test of your throat, tonsils, or tongue to find out which treatment you should have.

What happens during an HPV test?

If you're getting an HPV test to screen for cervical cancer, you will lie on an exam table. Your provider will use a plastic or metal instrument called a speculum to widen the vagina, so the cervix can be seen. Your provider will then use a small, soft brush or swab to collect cells from the cervix. The cell sample is sent to a lab for testing.

HPV testing is often done as part of a routine pelvic exam. During a pelvic exam, your provider examines your uterus, ovaries, and genital area. But a pelvic exam doesn't always include an HPV test. So, when you have a pelvic exam, ask your provider whether you'll have and HPV test, too.

At-home tests to screen for cervical HPV are available. These kits provide a special swab so you can collect a sample of cells from your cervix and vagina to send to a lab. Talk with your provider if you are considering at-home HPV testing.

If you have oropharyngeal cancer, you probably won't need another test to find out whether HPV caused your cancer. That's because oropharyngeal cancer is usually diagnosed by examining a sample of throat tissue that's removed during a biopsy. The tissue sample is usually checked for HPV, too.

Will I need to do anything to prepare for the test?

You should not have the test while you are having your period. For two days before your test, you should not:

• Use tampons
• Use birth control foam, jelly, or cream
• Use other creams or medicines in the vagina
• Douche (rinse the vagina with water or other fluid)
• Have vaginal sex

For an at-home test, be sure to read all the instructions before you collect your sample.

Are there any risks to the test?

You may feel some mild discomfort when the cervical cells are collected. Afterward, you may have some very light bleeding. But there are no known risks to an HPV test.

What do the results mean?

Negative/Normal HPV test results mean that high-risk HPV was not found in your sample. Your provider will let you know when you should be tested again.

Positive/Abnormal HPV test results mean that signs of high-risk HPV were found. Some HPV tests also show whether HPV16 or HPV18 was found. These types of HPV are the most common cause of cervical cancer.

A positive test result does not mean you have cancer or will get cancer. It does mean that you have an HPV infection that increases your risk for getting cervical cancer in the future.

There's no treatment to get rid of an HPV infection. So, the next steps will depend on your risk for developing cervical cancer. To estimate your risk, your provider will consider past test results, your age, and other health conditions you have or have had.

Your provider may suggest other tests to check your cervical cells for abnormal changes. You may also need more frequent HPV tests or HPV/Pap cotests.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about an HPV test?

The HPV vaccine is a safe, effective way to protect yourself from HPV infections that can cause cancer and genital warts. The vaccine could prevent many of the cancers that HPV causes, including cancer of the cervix, vagina, throat, anus, and penis.

The vaccine works best when it's given before a person has any exposure to the virus. That's why it's recommended for children before they become sexually active.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that 11 to 12-year-olds have two shots of HPV vaccine 6 to 12 months apart. But the vaccine can be given as early as age 9. Ask your child's provider about when to vaccinate your child against HPV.

Teens and young adults who get their first HPV shot between ages 15 and 26 need to have 3 doses. If you're over 26 and haven't been vaccinated, routine HPV vaccination is not usually recommended. Talk with your provider about the possible benefits of vaccination if you are at risk for a new HPV infection.