What is an HPV test?

Human papillomavirus (HPV) is a group of more than 100 related viruses that can generally be grouped into two types. These are called low-risk HPV and high-risk HPV. Low-risk HPV can cause warts on or around your genitals, anus, mouth, or throat. High-risk HPV can cause:

• Cervical cancer.
• Anal cancer.
• Oropharyngeal cancer, a type of head and neck cancer, also called throat cancer.
• Vulvar cancer.
• Vaginal cancer.
• Penile cancer.

Most HPV types are harmless. However, it's important for your health care provider to check for high-risk HPV infections. They do this by looking for DNA left by the virus in your vagina or cervix (the lower part of the uterus). These infections can stay at the cervix for many years, leading to cell changes called precancer. If these changes are not screened for and treated, they may over time become cancer.

Nearly all cervical cancers are caused by high-risk HPV infections. Because of this, it is important to get routine testing for these viruses. If you do have an infection, your provider can decide how best to manage it. They may recommend that you have other tests and be tested more regularly to check for precancerous cells and cervical cancer.

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

What is it used for?

An HPV test screens for the infection that causes cervical precancer or cancer by examining a sample of cervical cells. The test is often done at the same time as a Pap test (sometimes called a Pap smear). A Pap test looks for abnormal changes in cervical cells before they become cancer. When an HPV test and a Pap test are done at the same time, it's called cotesting.

Because HPV causes cancer at other places in the body, an HPV test can be useful for other treatment decisions. This is especially the case in treatment for oropharyngeal (or throat) cancer. This cancer grows in the back of the throat, including the tonsils and the base of the tongue. In the United States, HPV causes most cases of oropharyngeal cancer. If you have an HPV test because you have oropharyngeal cancer, the test will use a sample of throat tissue collected during a biopsy.

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 test. An HPV test can show whether HPV caused the abnormal changes in your cervical cells.
• Are age 30 through 65. If you had an HPV test or an HPV/Pap cotest and had normal results, your provider may say that you can wait five years until your next test.

If you are between the ages of 21 and 29 and your last Pap test result was normal:

• You do not need additional HPV testing.
• Your provider may recommend that you wait three years until your next Pap test.

Most people have been exposed to HPV, usually through sexual contact. HPV is especially common in the 21-29 age group. However, these infections usually clear up on their own within a year or two without causing any health conditions. Some medical experts recommend starting HPV testing at age 25 and getting tested every 5 years if your last test was normal.

Cervical cancer is most common in people over age 30. If you have a high-risk HPV infection in your cervix, you're more likely to develop cervical cancer if you:

• Had an abnormal HPV test, Pap test, or cervical biopsy in the recent past.
• Have a weakened immune system because you:
  • Have a disease that harms your immune system, such as HIV.
  • Take medicine to control your immune system, such as certain medicines to treat cancer or autoimmune diseases.
• Have had cervical cancer or precancer.
• Smoke tobacco or breathe secondhand smoke.
• Use birth control pills or have given birth to many children.
• Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between 1940-1971, DES was sometimes prescribed to pregnant women 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.

What happens during an HPV test?

There are two ways to collect the sample needed for an HPV test. Your provider can collect the sample, or you can collect it yourself.

If your provider collects the sample:

• You will be asked to undress completely or from the waist down.
• You will lie on an exam table with your knees bent and your heels in footrests called stirrups.
• Your provider will gently insert a plastic or metal instrument called a speculum into your vagina. This helps to widen your vagina so that your cervix can be seen. This may cause a feeling of cramping or pressure.
• Your provider will then use a small, soft brush or swab to collect cells from the cervix. This doesn't usually hurt.
• The cell sample is sent to a lab for examination under a microscope.

If you collect the sample yourself:

• Your provider will give you a tube with the testing tools and explain the steps you will take.
• You will enter a private space in a health care setting.
• Open the tube and remove the swab or brush. Be sure not to touch the end that you will insert into your vagina.
• Insert the swab or brush into your vagina up to a point indicated on the handle. Once it is inserted, rotate the swab or brush around so that it can pick up cells from the walls of your vagina.
• Remove the swab or brush and put it back into the tube.
• Return your sample to your provider so that it can be 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, vulva, and vagina. 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 an HPV test to screen for cervical cancer, too.

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

If you're having an HPV test:

You don't need to do anything to prepare for an HPV test.

If you are having an HPV/Pap cotest:

Avoid the following during the 2-day window before your HPV/Pap cotest

• Having vaginal sex
• Douching (rinsing the vagina with water or other fluid)
• Using vaginal medicines or spermicidal foam, jelly, or cream

If you did have sex before the HPV/Pap cotest, or are having your period, let your provider know. They should still be able to carry out both the HPV and Pap tests.

Are there any risks to the test?

You may feel some mild discomfort when your provider collects cells from your cervix. Afterward, you may have some very light bleeding.

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 DNA from a high-risk HPV were found in your sample.

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

There's no treatment for an HPV infection. So, the next steps will depend on your risk for developing cervical precancer or 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 a colposcopy to check your cervical cells in greater detail. To do this procedure, your provider will use a lighted, magnifying device called a colposcope. They will place the device at the opening of your vagina. The device magnifies the normal view, allowing your provider to see problems that can't be seen by the eyes alone. 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?

There is a vaccine to prevent infection with the most high-risk types of HPV. The vaccine can also protect you against low-risk types that cause genital warts. The vaccine is safe and effective. It prevents cancers caused by HPV everywhere in the body, including in the cervix, throat, anus, vagina, vulva, and penis.

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, talk with your provider about the possible benefits of vaccination.