Human Papillomavirus (HPV) Test

Overview

What is the human papillomavirus (HPV) test?

HPV tests detect and diagnose the human papillomavirus that can turn normal cervical cells into abnormal or precancerous cells. A positive HPV test result means you could develop cervical cancer. HPV tests detect potential cervical cancer. They don’t detect HPV in men or any other cancer.

HPV is a sexually transmitted infection (STI). It’s also a very common and complicated virus. As many as 80 million people in the United States may carry any of the 200 different HPV types. HPV infections often clear up without treatment, and you may never know you had HPV. But 13 of those 200 virus types can cause cervical cancer or other cancers.

Being tested for HPV can reduce your risk of developing cervical cancer. Being tested may also stop the virus from spreading. If you know you have HPV, you can make lifestyle changes to protect others from getting HPV. If you don’t have HPV, you can receive a vaccination that protects against HPV.

Who needs this test?

An HPV test is very important for anyone who has a cervix, as almost all cervical cancer cases stem from what’s called high-risk HPV infections. These infections cause pre-cancerous lesions and are more likely to become cervical cancer. Healthcare providers use HPV screening tests to find and remove these pre-cancerous lesions. Removing the pre-cancerous lesions means removing cancer.

There are three approaches to HPV screening:

  • Primary HPV tests to detect high-risk HPV. These are Pap smears that only test for HPV.
  • Pap smears. These test for cervical cell changes.
  • HPV/Pal co-testing. Co-testing checks the same cells for cervical cell changes and high-risk HPV types.

What tests detect HPV?

Providers use a series of tests to screen for HPV and diagnose HPV. Those tests include:

  • Pap smear. This test detects signs of cervical cancer and HPV.
  • Colposcopy. If your Pap smear shows signs of HPV, your provider may perform another test called a colposcopy. For this test, your provider will place a microscope with a light at your vagina’s entrance. This microscope is called a colposcope, and it gives your provider a close look at your cervix.
  • Cervical biopsy. This test diagnoses HPV and other early cervical cancers. Providers take a sample of your cervical tissue so your sample can be examined under a microscope.

Is a Pap smear the same as an HPV test?

The test procedure is the same. The difference is what healthcare providers look for when they examine your cervical cells under a microscope.

If they’re checking for cervical cancer, they focus on cell changes or abnormal cells in your cervix. If they’re looking for HPV, they check your cervical cells for HPV DNA., specifically high-risk HPV types that are more likely to cause pre-cancers and cancer of the cervix.

Can you test for HPV with a blood test?

No, there isn’t a blood test for HPV.

Do tests for sexually transmitted infections (STIs) detect HPV?

Providers evaluate STI and HPV tests differently, so you won’t know you have HPV unless your provider tests for HPV specifically.

Is there an HPV test for men?

While there is not an approved test for men, some healthcare providers offer anal Pap smears.

When would I need this test?

The American Cancer Society recommends primary HPV tests for anyone between the ages 25 to 65 who has a cervix. A primary HPV test is a Pap smear done just to screen for HPV. Pap smears that combine screens for HPV and cervical cancers are called cotests. People who test negative for HPV may wait five years before having another HPV test.

What should I do if my provider doesn’t offer primary HPV tests?

You should still have cotests every five years or tests for cervical cancer alone every three years.

I’ve been vaccinated for the HPV virus. Do I still need to have HPV tests?

Yes, you should still have Pap smears to screen for HPV and cervical cancer. The HPV vaccine doesn’t protect against all strains of HPV that cause cancer.

What healthcare providers perform this test?

Several types of healthcare providers may perform this test, including:

  • Primary care healthcare providers. These providers help you stay healthy. are healthcare providers who help you.
  • Healthcare providers who specialize in gynecology or gynecologists.
  • Healthcare providers who specialize in treating cancer or oncologists.

Test Details

How do I prepare for each HPV test?

Providers use Pap smears to detect HPV. They may do follow-up tests such as colposcopies or cervical biopsies.

How do I prepare for a Pap smear?

  • Schedule your appointment for at least five days after your period ends.
  • Avoid vaginal sex for at least two days before your examination.
  • Don’t use tampons, vaginal creams or medicines, birth control foams or jellies, lubricants or douches for at least two days before your Pap smear.

How do I prepare for a colposcopy?

  • Tell your healthcare provider if you’re pregnant or may be pregnant.
  • Schedule your appointment for at least five days after your period ends.
  • Avoid vaginal sex for at least two days before your examination.
  • Don’t use tampons, vaginal creams or medicines, birth control foams or jellies, lubricants or douches for at least two days before your examination.
  • Ask your provider if you should take over-the-counter pain medication before the procedure in case your provider decides to take a small sample of your cervical tissue.

How do I prepare for a cervical biopsy?

There are several kinds of cervical biopsies. Providers may use local or general anesthesia during your biopsy. Here are some suggestions to help you prepare for a cervical biopsy:

  • Tell your provider about regular medications you take that may affect how your body reacts during the procedure.
  • Tell your provider if you have any allergic reactions or sensitivities to anesthesia.
  • Ask your provider about steps you should take if your biopsy requires general anesthesia. You may need to fast for several hours before your biopsy.
  • Don’t use tampons, vaginal creams or medicines or douche for 24 hours before your biopsy.
  • Don’t have sex 24 hours before your biopsy.

What should I expect during these tests?

Pap smears and colposcopies are done in your healthcare provider’s office. Cervical biopsies are also done in your provider’s office but may be done in the hospital. You may feel some discomfort during your Pap smear or colposcopy, but the tests shouldn’t hurt. Tell your provider if you have any pain during the tests. They’ll make you comfortable so they can complete the test.

Cervical biopsies may be done in your provider’s office or the hospital. Cervical biopsies may involve general anesthesia, so you won’t feel any pain during the procedure.

During your Pap smear, your provider will:

  • Gently insert a speculum into your vagina. A speculum is a metal or plastic device that holds your vagina open so your provider can see your cervix. You may feel a bit of pressure when your provider inserts the speculum.
  • Use a small brush or spatula to gently scrape cells from your cervix.
  • Send your cells to a lab for analysis.

During your colposcopy, your provider will:

  • Gently insert a speculum into your vagina. Like a Pap smear, you may feel some pressure when your provider inserts the speculum.
  • Position a colposcope at the entrance to your vagina. A colposcope is a microscope with a light that gives your provider a clear view of your cervix.
  • Apply a weak solution of acetic acid to your cervix. Acetic acid is similar to vinegar. Applying acetic acid makes it easier for your provider to see any abnormal areas. You may feel a slight burning sensation.
  • If your provider spots an abnormal area, they may remove a small piece of tissue that will be examined under a microscope.
  • They’ll send your tissue to a lab for analysis.

During your cervical biopsy, your provider will:

  • Administer your anesthesia. You may have general anesthesia or regional anesthesia before your surgery. If you don’t have general or regional anesthesia, you may have local anesthesia given during your procedure.
  • Gently insert a speculum into your vagina so they can reach your cervix.
  • They may apply a weak solution of acetic acid to your cervix. Acetic acid is similar to vinegar and makes it easier for your provider to see any abnormal areas on your cervix.
  • There are several types of cervical biopsies. The type of biopsy done depends on your specific situation, such as the location, size and shape of abnormal cells on your cervix.
  • If you haven’t received general anesthesia, your provider may inject a numbing medication into parts of your cervix. This is called local anesthesia.
  • If you were given local anesthesia, the biopsy itself may feel like a cramp or slight pinch.
  • You may have bleeding from the biopsy. Your provider will use medication or other steps to stop the bleeding. They may place a pressure dressing on your cervix.
  • They’ll send your cervical tissue to the lab for analysis.

What should I expect after these tests?

Pap smears and colposcopies typically don’t cause any post-procedure discomfort or problems. If your provider removed some cervical tissue for testing, you may want to rest a while after the procedure.

Here’s what may happen after your cervical biopsy:

  • You’ll probably spend some time in a recovery room so providers can monitor your blood pressure, pulse and breathing.
  • If you had your biopsy as an outpatient, someone should drive you home after your procedure.
  • You may have some cramping, spotting or discharge for a few days after your procedure. You may want to wear a sanitary napkin until the spotting or discharge stops.
  • Your provider may have given you a pain reliever to take as needed.
  • They may tell you not to use tampons or douche or have sex immediately after your procedure. Ask your provider when it’s OK to resume your usual personal care and to have sex.
  • Depending on the kind of biopsy you had, your provider may recommend you limit some other activities until your cervix heals. You may go back to your normal diet unless your healthcare provider tells you otherwise.

When should I contact my provider after my cervical biopsy?

Your provider will schedule follow-up appointments to check on your recovery. Tell your provider right away if you have any of the following problems:

  • You’re bleeding. While you may have spotting after your procedure, you shouldn’t be bleeding.
  • You notice a foul-smelling discharge or drainage from your vagina.
  • You have a fever above 101 Fahrenheit (33.8 Celsius) and/or chills.
  • You have severe pain in your lower abdomen or stomach.

Results and Follow-Up

When should I know the results of my HPV test?

You should have your initial test results within one to three weeks after your test. Call your healthcare provider if you haven’t received your results after three weeks.

My HPV test result is positive. What does that mean?

A positive HPV test result means you have a type of HPV that’s linked to cervical cancer. A positive HPV test doesn’t mean you have cancer. It’s a warning sign that you’re at risk for cervical cancer.

What happens if my HPV test is positive?

Your provider may do the following:

  • If you’re sexually active, recommend steps you can take to protect your partner(s).
  • If your test shows you have a high-risk HPV type, your provider may recommend additional tests such as colposcopies or cervical biopsy.

Can my HPV be treated?

There isn’t a medical treatment for HPV. Many times HPV clears on its own. Other times tests to screen for or diagnose HPV also remove the precancerous cells.

My HPV test result is negative. What does that mean?

A negative HPV test means you do not have an HPV type that’s linked to cervical cancer. Your healthcare provider may tell you that you can wait five years for your next screening test. If you’re sexually active, your provider may recommend you receive the HPV vaccine to protect yourself from HPV.

Can I have a false positive HPV test?

A false-positive HPV test result could mean your test shows you have HPV, but not the type of HPV that causes cancer. Some studies indicate HPV cotests – Pap smears that test the same cells for cervical and HPV – have more false-positive results than primary high-risk HPV tests.

What happens if I have a false positive test?

If your initial HPV test is positive and follow-up tests, such as colposcopies, are negative, your provider may recommend you have another Pap smear to test for HPV.

If that test is negative, your provider may tell you that you can wait five years for your next screening test. If you’re sexually active, they may recommend you receive the HPV vaccine to protect yourself from HPV.

Can my HPV test results change over time?

Yes, just like a Pap smear for cervical cancer, your HPV test results can change over time. That’s why it’s important to have regular HPV and cervical cancer tests.

When should I call my doctor?

You should call your healthcare provider if you believe your lifestyle increases your risk for HPV.

A note from Cleveland Clinic

This may be your experience when it’s time for your regular Pap smear: You have your test, wait for results and breathe a sigh of relief when your results show you’re fine. So it’s understandable if you’re reluctant to add an HPV test to your list of regular — and stress-inducing — wellness tests.

No one welcomes news they have a sexually transmitted infection, much less one that can cause cervical cancer. But just like Pap smears, HPV tests are key to detecting cancer before it can take root and spread. And an HPV test can keep you from spreading a virus to someone else. If you aren’t regularly tested for HPV, ask your healthcare provider to add the test to your regular screening tests. They’ll be glad to explain how HPV tests are done and when you should get yours.

Last reviewed by a Cleveland Clinic medical professional on 11/16/2021.

References

  • Center for Disease Control and Prevention. Cervical Cancer. What Do My Cervical Screening Test Results Mean? (https://www.cdc.gov/cancer/cervical/basic_info/test-results.htm) Accessed 11/16/2021.
  • Fontham, ETH, Wolf, AMD, Church, TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. (https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21628) CA: A Cancer Journal for Clinicians. Accessed 11/16/2021.
  • National Cancer Institute. HPV and Pap Testing. (https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet) Accessed 11/16/2021.
  • Merck Manual. Tests for Gynecologic Disorders. (https://www.merckmanuals.com/home/women-s-health-issues/diagnosis-of-gynecologic-disorders/tests-for-gynecologic-disorders) Accessed 11/16/2021.
  • Shiffman, Mark and de SanJose, Siliva. False Positive Cervical Screening Test Results. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514435/) Papillomavirus Res. Accessed 11/16/2021.
  • U.S. Department of Health and Human Services. Office on Women’s Health. Pap and HPV Tests. Accessed 11/16/2021.
  • Vives A, Cosentino M, Palou J. The role of human papilloma virus test in men: First exhaustive review of literature. (https://pubmed.ncbi.nlm.nih.gov/31874781/) Actas Urol Esp. Accessed 11/16/2021.

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