The HPV Test - An Overview

What is the HPV Test?

The HPV test examines a sample of cells, collected from the cervix, to check whether the DNA of the human papillomavirus is present. The cells are examined in a pathology laboratory under a microscope. The HPV test is not the same as a Pap test although the HPV test can be carried out on the same sample that was taken for the Pap test. At the present time, HPV testing is only for women; there is no HPV test yet developed for men.

Why is the HPV test done?

Testing for HPV is done to identify high-risk HPV strains that can lead to cancer. The HPV test screens for the possibility of cervical cancer. It is known that at least 2 HPV strains, 16 and 18, are precursors to cervical cancer, so determining if HPV is present is an early-warning sign of the possibility that cervical cancer may develop.

Not all women who have been infected with HPV-16 or -18 will develop cervical cancer, but being infected with these strains does increase that risk to high. An HPV test might also be done to check whether there are abnormal cells present after the woman has received treatment for high risk HPV.

Women over the age of 30 years are advised to be routinely tested, often at the same time as their regular Pap test, because the changes to the cervix that lead to cervical cancer take several years to develop, up to 10 years or more. So even if younger women are tested and prove positive to HPV-16 or -18, it is unlikely that the precancerous cells will have developed yet. In many cases, HPV is cleared by the body's immune system without any intervention; it is mainly women who have had recurring HPV over a number of years who are at the greatest risk of developing cervical cancer.

Because the high-risk strains of HPV don't have any noticeable symptoms, the HPV test isn't confined only to those women who have HPV symptoms like genital warts. Genital warts do not lead to cancer.

What are the risks associated with HPV testing?

The risks are involved in the results – that the results may not be an accurate assessment of the situation. A false positive gives the result as testing positive to the HPV strains but you actually haven't been infected. A false negative result tells you that you don't have the high-risk strains whereas you really are infected. These false results can cause unnecessary worry or lead to a delay in getting treatment. This is why routine testing is recommended, as your next test would probably be correct.

What is involved in having an HPV test?

The HPV test is carried out in the same way as your regular Pap test and may be done at the same time as the Pap test, using the same sample of cervical cells. It can be done by your doctor, gynecologist or other trained medical professional.

You will be asked not to use any vaginal preparations for 48 hours or more before the test, including tampons, deodorants or douches. For your comfort, you will be asked to have emptied your bladder immediately prior to the test. You will lie on your back on the examination couch, undressed below the waist; your feet may be placed in stirrups.

The doctor will insert a speculum (medical instrument) gently into your vagina to open up the vagina for easier examination. A sample of cells is then taken from your cervix using a swab or special brush; the sample is then put into the collection tube for delivery to the pathology lab to be tested for HPV.

You might feel some discomfort as the speculum is inserted but it doesn't last very long. While it seems like a big ask, it will be easier if you can relax – try taking deep breathes, focus on your breathing or think about something other than what is happening. After the test, you might have a little vaginal discharge or bleeding but not for long.

What do the HPV test results mean?

The HPV test is a very reliable test. If your HPV test comes back normal, no high-risk strains of HPV were found. If the test comes back as abnormal, don't immediately think the worst and start to panic. This result does NOT mean you have cancer; it simply means that some high-risk HPV was found in your sample.

This means that you are in the high-risk category for developing precancerous changes to the cells of your cervix. Your doctor will advise you, but this might mean a repeat HPV test, a colposcopy or a cervical biopsy or other test. The next step will be determined by the exact results of your HPV test as well as your medical history.

The HPV test is not used to diagnose genital warts which have no link to cervical cancer; they are caused by different strains of HPV. The HPV test is used to check for cervical cell changes that may indicate a high risk of precancerous cells developing.