Human Papillomavirus (HPV) Test


Sexual Health

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Test Quick Guide

Human papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the United States. Almost all sexually active people who do not receive an HPV vaccine will become infected with HPV at some point in their life.

An HPV test uses a sample of cells to determine whether the cells are infected with a high-risk strain of HPV. Such an infection, if long-lasting, can cause changes in cervical cells that could lead to cervical cancer.

An HPV test is primarily used to screen for the virus that causes cervical cancer but may also be used to plan treatment for patients diagnosed with oropharyngeal cancer, a type of cancer that affects the middle part of the throat.

About the Test

Purpose of the test

The purpose of an HPV test is to detect an infection with a high-risk strain of HPV. An HPV test may be performed in several situations:

HPV infections can cause several other types of cancer, including cancers of the anus, penis, vagina, and vulva. However, HPV testing on these parts of the body is uncommon in the United States and is typically only performed for research purposes.

What does the test measure?

An HPV test detects evidence of an infection with a high-risk strain of HPV. There are over 100 known strains of HPV, only some of which are spread through sexual contact. Sexually-transmitted HPV strains are separated into two categories:

HPV test measurements depend on the specific type of HPV test that was performed. Types of HPV tests generally fall into three categories:

When should I get an HPV test?

When used as a test to screen for cervical cancer, how often a person should get an HPV test depends on their age, health, and their history of cervical cancer screening. Cervical cancer screening may involve a Pap smear, an HPV test, or co-testing with both tests at the same time.

Professional medical organizations offer cervical cancer screening recommendations. For example, the U.S. Preventive Services Task Force recommends that most people with a cervix undergo regular cervical cancer screening between ages 21 and 65:

Patients should have a discussion with their health care provider about the pros and cons of different screening strategies in order to decide which approach is best for their situation.

Patients may need to be screened for cervical cancer more often if they have one of the following risk factors:

Other groups do not need regular cervical cancer screening. These include:

An HPV test may also be recommended as a follow-up test for patients who have had an abnormal Pap smear to help doctors understand if abnormal cell changes are related to an HPV infection and require additional follow-up.

In patients diagnosed with oropharyngeal cancer, HPV testing may be conducted on a tissue sample after a diagnosis of cancer is confirmed.

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Finding an HPV Test

How to get tested

An HPV test is typically ordered by a doctor. HPV testing is performed at hospitals and doctor’s offices, as well as clinics and community health programs. The analysis of cell samples is performed in a medical laboratory.

Can I take the test at home?

At-home HPV tests are available to detect high-risk HPV infections. At-home HPV testing allows users to collect samples that include both cervical and vaginal cells at home and mail them to a certified laboratory for testing.

If an at-home test comes back positive or if a patient has questions about cervical cancer screening, it’s important to contact a doctor. An at-home HPV test is not a substitute for regular cervical cancer screening overseen by a health care professional.

How much does the test cost?

The cost of an HPV test depends on where the test is taken and if the patient has insurance coverage. Costs of testing may include the office visit, the fee for the health care professional to conduct the HPV test, and the actual laboratory analysis.

Most health insurance plans cover HPV tests without requiring a copay or deductible. Local and federal health departments may offer financial assistance programs for HPV tests for people who don’t have insurance.

The cost of at-home HPV testing ranges from $50 to $90.

Taking an HPV Test

For cervical cancer screening and Pap smear follow-up, an HPV test requires a sample of cells from the opening of the cervix. These cells are obtained by gently scraping the cervix with a swab or small brush. At-home HPV testing provides a swab to collect a sample of cells from the vagina.

In patients diagnosed with oropharyngeal cancer, an HPV test is conducted on a sample of the tumor tissue and requires no additional medical procedures for the patient.

Before the test

Before taking an HPV test to screen for cervical cancer, it’s important for patients to keep several precautions in mind:

For people taking an at-home HPV test, it’s important to begin by reading all of the instructions contained in the testing kit and preparing the specimen collection container prior to collecting the sample.

During the test

An HPV test may be conducted during a pelvic examination. A pelvic examination involves lying on an exam table with the patient’s feet in stirrups while a health care provider examines the vulva, vagina, cervix, rectum, and pelvis.

During the HPV test, an instrument called a speculum is gently inserted into the patient’s vagina, allowing the health care provider to see the cervix. Once the provider can see the cervix, they obtain a small sample of cells by gently scraping the cervix with a brush, spatula, or scraper. This portion of the HPV test only takes a few seconds.

If a patient is also having a Pap smear as part of cervical cancer cotesting, the same sample may be used for both the HPV and Pap tests or, in some cases, a provider will obtain two samples.

Most patients experience little to no pain or discomfort during the collection of samples for an HPV test. Some may experience a feeling of pressure or temporary cramping similar to menstrual cramps. Patients may feel more comfortable if they urinate before an HPV test.

During an at-home HPV test, a swab is used to collect a sample of cells from the cervix and vagina. After collecting the sample, the swab is placed into a specimen container from the testing kit.

After the test

While patients may experience vaginal bleeding or discharge for a short time after an HPV test, there are no restrictions on activities after an HPV test is complete.

After an at-home HPV test is completed, the specimen container is packaged and sent to a laboratory for analysis.

HPV Test Results

Receiving test results

Results of HPV testing may be available within one to three weeks after completing the test. The results may be reported during a follow-up appointment with your doctor, over the phone, by mail, or through online medical charts.

It’s important to discuss HPV test results with a doctor, as a doctor can help you manage your risk for HPV and other STDs, answer questions about test results, and create a plan for cervical cancer screening.

At-home HPV test results may take additional time, as the samples must be sent to a laboratory by mail before testing can begin. Once the test is completed, results may be reported by phone or through a smartphone application associated with the company performing the testing.

Interpreting test results

A positive test result indicates that evidence of an infection with a high-risk strain of HPV was found in the sample of cervical cells. If HPV genotyping was performed, results may include the individual strain of HPV detected. HPV genotyping usually looks for HPV 16 and 18, the strains of HPV associated with the highest risk of cancer, but sometimes also includes testing for HPV 45.

A negative HPV test result means that there is no evidence of an infection with a high-risk strain of HPV at the time of the test.

Are test results accurate?

Although HPV testing is a routine aspect of cervical cancer screening, no test is 100% accurate. Both false positive and false negative results do occur. Doctors account for the risk of inaccurate results in several ways:

While researchers are still learning about the accuracy of at-home HPV testing, results of large studies are promising.

Do I need follow-up tests?

If an HPV test or cotest result is negative, the need for follow-up testing depends on the results of a patient’s past cervical cancer screening tests. In many cases, patients may be advised by their doctor to wait five years before being screened for cervical cancer again.

Similarly, follow-up testing after a positive HPV test depends on the results of a Pap smear (if cotesting) and a person’s history of Pap and HPV testing. Based on these factors, as well as a patient’s age and health history, doctors estimate a patient’s immediate and five-year risk of developing severely abnormal cervical cells.

Depending on a patient’s estimated risk level, a positive HPV test may signal the need for shorter intervals between HPV tests in the future, a follow-up Pap smear, or the need for expedited treatment to remove abnormal cervical cells. Additional considerations after a positive HPV test include:

Questions for your doctor about test results

A doctor can address detailed questions about HPV and your HPV test results. Some questions that you might wish to review with your doctor include:

Related Tests

How is an HPV test different from a Pap smear?

High-risk strains of HPV can cause abnormal cell changes that may develop into cervical cancer over time. An HPV test detects infections with high-risk strains of HPV, while a Pap smear detects abnormal cell changes that have already developed on the cervix.

Other related tests

Sources and Resources

These resources provide additional information about cervical cancer and screening tests:

American College of Obstetricians and Gynecologists: Abnormal Cervical Cancer Screening Test Results
CDC: Cervical Cancer
CDC: What Do My Cervical Cancer Screening Test Results Mean?
National Cancer Institute: Cervical Cancer Screening
National Cancer Institute: Understanding HPV and Pap Test Results
Sources

A.D.A.M. Medical Encyclopedia. HPV DNA test. Updated April 2, 2021. Accessed April 24, 2021. https://medlineplus.gov/ency/article/007534.htm

Centers for Disease Control and Prevention. HPV vaccine. Updated March 17, 2020. Accessed May 27, 2021. https://www.cdc.gov/vaccines/vpd/hpv/hcp/vaccines.html

Centers for Disease Control and Prevention. What should I know about screening? Updated January 12, 2021. Accessed April 24, 2021. https://www.cdc.gov/cancer/cervical/basic_info/screening.htm

Centers for Disease Control and Prevention. Genital HPV infection: Fact sheet. Updated January 19, 2021. Accessed April 24, 2021. https://www.cdc.gov/std/hpv/stdfact-hpv.htm

Centers for Disease Control and Prevention. Human papillomavirus (HPV) statistics. Updated April 5, 2021. Accessed May 27, 2021. https://www.cdc.gov/std/hpv/stats.htm

Centers for Disease Control and Prevention. Declines in prevalence of human papillomavirus vaccine-type infection among females after introduction of vaccine — United States, 2003–2018. Updated April 6, 2021. Accessed May 27, 2021. https://www.cdc.gov/mmwr/volumes/70/wr/mm7012a2.htm

Crum CP, Huh WK, Einstein MH. Cervical cancer screening: The cytology and human papillomavirus report. In: Goff B, ed. UpToDate. Updated April 7, 2021. Accessed April 24, 2021. https://www.uptodate.com/contents/cervical-cancer-screening-the-cytology-and-human-papillomavirus-report

Denny LD. Screening for cervical cancer in resource-limited settings. In: Goff B, ed. UpToDate. Updated February 1, 2021. Accessed April 24, 2021. https://www.uptodate.com/contents/screening-for-cervical-cancer-in-resource-limited-settings

Feldman S, Crum CP. Cervical cancer screening tests: Techniques for cervical cytology and human papillomavirus testing. In: Goff B, ed. UpToDate. Updated October 16, 2020. Accessed April 24, 2021. https://www.uptodate.com/contents/cervical-cancer-screening-tests-techniques-for-cervical-cytology-and-human-papillomavirus-testing

Goodman A, Huh WK, Einstein MH. Cervical cancer screening: Management of results. In: Goff B, ed. UpToDate. Updated April 7, 2021. Accessed April 24, 2021. https://www.uptodate.com/contents/cervical-cancer-screening-management-of-results

Haddad RI. Epidemiology, staging, and clinical presentation of human papillomavirus-associated head and neck cancer. In: Brockstein BE, Brizel DM, Fried MP, eds. UpToDate. Updated September 10, 2020. Accessed April 24, 2021. https://www.uptodate.com/contents/epidemiology-staging-and-clinical-presentation-of-human-papillomavirus-associated-head-and-neck-cancer

MedlinePlus: National Library of Medicine. Human papillomavirus (HPV) test. Updated April 15, 2018. Accessed April 24, 2021. https://medlineplus.gov/lab-tests/human-papillomavirus-hpv-test/

MedlinePlus: National Library of Medicine. Colposcopy. Published September 28, 2020. Accessed April 24, 2021. https://medlineplus.gov/lab-tests/colposcopy/

Morris SR. Human papillomavirus (HPV) infection. Merck Manual Consumer Edition. Updated January 2021. Accessed April 24, 2021. https://www.merckmanuals.com/home/infections/sexually-transmitted-diseases-stds/human-papillomavirus-hpv-infection

National Cancer Institute. CIN 3. Date unknown. Accessed April 24, 2021. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cin-3

National Cancer Institute. Low-risk HPV. Date unknown. Accessed April 24, 2021. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/low-risk-hpv

National Cancer Institute. HPV/Pap cotest. Date unknown. Accessed April 24, 2021. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/hpv-pap-cotest

National Cancer Institute. HPV and Pap testing. Updated December 20, 2019. Accessed April 24, 2021. https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet

National Cancer Institute. Next steps after an abnormal cervical cancer screening test: Understanding HPV and Pap test results. Updated January 13, 2021. Accessed April 24, 2021. https://www.cancer.gov/types/cervical/understanding-abnormal-hpv-and-pap-test-results

National Cancer Institute. Oropharyngeal cancer treatment (adult) (PDQ®)–patient version. Updated April 15, 2020. Accessed April 24, 2021. https://www.cancer.gov/types/head-and-neck/patient/adult/oropharyngeal-treatment-pdq

National Cancer Institute. HPV and cancer. Updated January 22, 2021. Accessed April 24, 2021. https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer

National Cancer Institute. Cancer screening overview (PDQ®)–patient version. Updated August 19, 2020. Accessed April 24, 2021. https://www.cancer.gov/about-cancer/screening/patient-screening-overview-pdq

Palefsky JM. Virology of human papillomavirus infections and the link to cancer. In: Dizon DS, Aboulafia DM, eds. UpToDate. Updated November 21, 2019. Accessed April 24, 2021. https://www.uptodate.com/contents/virology-of-human-papillomavirus-infections-and-the-link-to-cancer

Palefsky JM. Human papillomavirus infections: Epidemiology and disease associations. In: Hirsch MS, ed. UpToDate. Updated December 3, 2020. Accessed April 24, 2021. https://www.uptodate.com/contents/human-papillomavirus-infections-epidemiology-and-disease-associations

Polman NJ, Ebisch RMF, Heideman DAM, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncol. 2019;20(2):229-238. doi:10.1016/S1470-2045(18)30763-0

US Preventive Services Task Force. Cervical cancer: Screening. Published August 24, 2018. Accessed April 21, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening

US Department of Health and Human Services. Pap and HPV tests. Updated January 31, 2019. Accessed April 24, 2021. https://www.womenshealth.gov/a-z-topics/pap-hpv-tests

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