HPV Test

What is the human papillomavirus (HPV) test?

A human papillomavirus (HPV) test screens for the virus that can cause cervical cancer.

HPV is a sexually transmitted infection (STI) that you can catch or spread regardless of sex or gender. It’s transmitted through skin-to-skin contact. It’s also a common and complicated virus.

For example, there are over 100 strains of HPV. They’re responsible for nuisance growths, like warts on your hands, feet and face. About 30 strains can affect your genitals. Some harmless strains cause genital warts. Of all the strains of HPV, only a few “high-risk” strains cause cervical cancer. HPV tests check for these strains. These include the most common cancer-causing types, HPV 16 and HPV 18.

Healthy bodies can clear most HPV infections within a few years. Still, over time, high-risk strains can cause precancerous changes (cervical dysplasia) that eventually become cervical cancer. Almost all cases of cervical cancer arise from high-risk HPV infections. This is why screening for high-risk HPV using an HPV test is essential.

Currently, HPV tests can only detect HPV if you have a cervix. So, they’re only for people assigned female at birth (AFAB) with an intact cervix. There isn’t an HPV test for people assigned male at birth (AMAB).

When is an HPV test performed?

You may need an HPV test if:

• You’re a person with a cervix between ages 30 to 65. The American Cancer Society recommends regular screening with an HPV test for this age group.
• You had an abnormal pap smear. An HPV test can show if abnormal cells in your cervix (discovered during a routine Pap smear) are related to high-risk HPV infection.
• You have oropharyngeal cancer. High-risk HPV (especially HPV 16) is the most common cause of this type of throat cancer. It spreads through oral sex. Knowing that HPV is the cause helps your provider customize treatments. Oropharyngeal cancer associated with HPV has a better prognosis than oropharyngeal cancer that’s not associated with HPV.

If your HPV test results are normal, you should retest every five years. You may need more frequent screenings if you’ve tested positive for HPV in the past or if you have a condition that weakens your immune system, like HIV. A weakened immune system may be unable to fight infections (like HPV) as effectively.

How are you tested for HPV?

Many people think of an HPV test as a procedure in a gynecologist’s office, but it’s a lab test. A healthcare provider called a pathologist examines a sample of cells or tissue from your cervix for HPV DNA. They check to see if HPV is present and (if so) what type it is.

Procedures that allow healthcare providers to collect the sample include:

• Pap smear: A healthcare provider removes cells from your cervix to be tested for precancerous changes, HPV or both. Often, Pap smear visits include HPV tests. These are called HPV/Pap co-tests. This means the pathologist checks for precancerous cells or cancer cells (Pap test) and HPV DNA (HPV test).
• Cervical biopsy: You may need this procedure if you have abnormal Pap smear results. During a cervical biopsy, a provider removes cervical tissue to test it for high-risk HPV, precancerous cells or cancer. They may perform a cervical biopsy as part of a colposcopy. This procedure uses a special microscope to get a close-up view of your cervix to identify problem areas.

Many people are surprised to learn that standard STI tests don’t test for HPV. The most common procedure that collects a sample for an HPV test is a Pap smear.

How do I prepare for an HPV test?

Usually, you’ll follow the same guidelines you’d use to prepare for a Pap. You want to avoid doing things that risk interfering with the accuracy of your test results. To prepare:

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

You may need to take additional preparatory steps if your provider folds an HPV test into a biopsy. They’ll advise you on what to do.

What should I expect during the test?

The procedure is usually the same as a Pap. You’ll lie on your back on an exam table with your legs open and in stirrups. Your healthcare provider will:

• Gently insert a speculum into your vagina, widening it so they can see your cervix. You may feel some pressure when this happens. To reduce the risk of discomfort, ask your provider to use the smallest speculum possible that still allows them to widen your vagina.
• Use a small tool called a spatula and a soft brush to scrape and collect cells from your cervix.
• Prepare the sample to be sent to a lab for analysis.

There may be additional steps if you’re having a colposcopy or a biopsy, but the big steps are the same: a healthcare provider views your cervix and removes cells or tissue.

The actual test happens later when a pathologist examines the sample for HPV DNA in the lab.

What type of results do you get, and what do the results mean?

Your results will be either positive or negative. Your results will determine your next steps.

Positive HPV test

A positive HPV test means you have one of the strains of HPV that increases your risk of developing cervical cancer. So, testing positive for HPV is the same as testing positive for “high-risk” HPV.

This test result doesn’t mean you already have cervical cancer. It’s all about risk. You may have a high-risk strain and never develop cervical cancer. Your body may fight off the infection. Or HPV may cause healthy cells to transform into cancer.

Either way, a positive result tells your provider how often to test you and check for abnormal tissue. They can surgically remove tissue if they notice precancerous cell changes. This can prevent you from developing cervical cancer.

Next steps depend on your unique case. For example, your provider may recommend that you:

• Return for another test within a year to see if the infection’s cleared.
• Get additional tests, such as a colposcopy or cervical biopsy, to check for cancer cells.
• Take steps to protect your partner(s) from infection. (If your partner has a cervix, it’s a good idea for them to get tested, too.)

Negative HPV test

A negative HPV test means you don’t have a high-risk strain of HPV. Sometimes, this may mean you won’t need another HPV test for another five years. If you haven’t already done so, it may be a good idea to get the HPV vaccine. This series of shots can protect you from most high-risk strains of HPV (if you haven’t already been exposed).

Can my HPV test results change over time?

Yes. This is why it’s a good idea to have regular HPV tests. You may test positive, return for a retest a few years later, and test negative. This means that your body has successfully fought off the infection. Or you may test negative, return for a retest five years later, and test positive after exposure to the virus.

HPV is incredibly common. It’s important to keep tabs on your status to remain cancer-free.

Does HPV show up on an STD (STI) test?

No. Most routine STI screenings test blood or fluids for common STIs. HPV isn’t included in these screenings because the test requires examining the DNA of cells taken directly from your cervix.

The only way to know you have HPV is from an HPV test or a Pap/HPV co-test.

How do men test for HPV?

There aren’t any HPV tests for cisgender men. HPV-associated cancers that can affect people assigned male at birth (AMAB), like penile cancer and anal cancer, are much less common than cervical cancer. Still, people AMAB can transmit harmless and high-risk strains of HPV to partners of either sex.

Some providers offer anal Pap smears that can detect abnormal cells that may be signs of anal cancer or precancerous changes. If you think you may be at risk, talk to your provider about getting tested.

Can a man know if he has HPV?

Warts on any body part, including your penis and scrotum, are a sign of HPV. Currently, there aren’t any FDA-approved HPV tests that can check for HPV on any body part other than the cervix.

A note from Cleveland Clinic

HPV tests are key to detecting cancer before healthy cervical cells change to cancerous ones. If you have a cervix and are between the ages of 30 and 65, it’s essential to get regular Pap smears, HPV tests or co-tests. Your provider can advise you on the tests you need.

Remember, testing positive for HPV isn’t something to be ashamed of. Many people have it at one point or another. But not getting screened regularly can put your health at risk. Make HPV testing a part of your routine care and wellness plan.