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Human papillomavirus (HPV) test

Human papillomavirus (HPV) is a group of more than 100 different types of related viruses. Certain types of HPV can cause abnormal changes to cells in the cervix. These types of HPV may also cause abnormal changes to cells of the oral cavity (mouth), pharynx (throat), vagina, vulva, penis or anus. An HPV test is a procedure that removes a small sample of cells and tests them for the DNA of high-risk types of HPV.

Research shows that HPV testing is most useful in screening for cervical cancer. But HPV infections are very common – there is no treatment for them and they usually go away on their own. For these reasons, HPV testing isn’t routinely used in provincial or territorial cervical cancer screening programs.

Find out more about human papillomavirus (HPV).

Why an HPV test is done

Some research shows that combining an HPV test with a Pap test may extend the time between cervical cancer screenings. HPV testing is most useful in screening for cervical cancer in women 30 years of age or older.

HPV testing may also be helpful in deciding the follow-up for women with certain abnormal Pap test results. It may be used for women who:

  • have atypical squamous cells – undetermined significance (ASC-US) and are 30 or older
  • have low-grade squamous intraepithelial lesion (LSIL) and are 50 or older
  • have been treated for high-grade squamous intraepithelial lesion (HSIL)

Find out more about abnormal Pap test results.

Who could benefit from an HPV test?

An HPV test may be used to help identify women who need further follow-up tests or treatment.

An HPV test may also be used with a Pap test to screen for cervical cancer in women 30 years of age or older. The HPV test helps identify women who have high-risk types of HPV. These women are more likely to have cervical abnormalities or precancerous changes that could develop into cervical cancer.

Who should not have an HPV test?

The HPV test is not currently used as a primary screening test for cervical cancer in Canada, but it may be available in individual cases. However, the following women will not benefit from having an HPV test.

Women younger than 30

HPV infection is very common in women under the age of 30. The HPV test is not used for women in this age group because most HPV infections will not lead to precancerous conditions of the cervix or cervical cancer. Women under the age of 30 are also more likely to fight off the HPV infection within a few years.

The best way to screen for precancerous conditions of the cervix or cervical cancer in women under the age of 30 is by having a Pap test. Women in this age group may have an HPV test as a follow-up test after treatment for HSIL.

Women who have had a total hysterectomy

Women who have had a total hysterectomy no longer have a cervix. If a woman hasn’t had a precancerous condition of the cervix or cervical cancer, there is no benefit to having an HPV test because she is no longer at risk of developing cervical cancer.

How an HPV test is done

Your Pap test sample may be tested for HPV if your doctor is using a liquid-based Pap test. HPV testing may also be done on a sample collected separately. The procedure is the same as a Pap test. The test only takes a few minutes. There may be some discomfort, pressure or cramping during the procedure, but it is not usually painful.

To do an HPV test, the doctor or nurse gently places a speculum in the vagina. A speculum is a clear plastic or metal device. It separates the walls of the vagina so the doctor or nurse can see the upper part of the vagina and cervix.

The doctor or nurse uses a small stick, or spatula, to gently scrape the surface of the lower part of the cervix to pick up cells. In some cases, a special brush (called a cytobrush or cytobroom) is used to collect cells from the inner part of the cervix, which leads into the uterus.

After collecting the cells, the doctor or nurse puts them into a container. The cells are treated with a special solution, called a fixative, that preserves the appearance of the cells. It is the same as the solution used in a liquid-based Pap test. The sample is sent to a lab where it is tested to see if it contains the DNA of high-risk types of HPV.

You may have some light vaginal bleeding for 1–2 days after an HPV test.

What the results mean

An HPV test will come back as either negative or positive.

A negative HPV test result means that you don’t have a type of HPV that is linked to precancerous changes in the cervix or cervical cancer.

A positive HPV test result means that you have a type of HPV that is linked to precancerous changes in the cervix or cervical cancer. It doesn’t mean that you have a precancerous change in the cervix or cervical cancer but you may need further testing.

What happens if an HPV test is positive

Your doctor will decide if you need more tests, such as colposcopy, biopsy or follow-up care.

deoxyribonucleic acid (DNA)

The molecules inside the cell that program genetic information. DNA determines the structure, function and behaviour of a cell.

colposcopy

A procedure that uses a colposcope (a lighted magnifying instrument) to examine the vulva, vagina and cervix.

Cells or tissue may be removed for examination under a microscope.

biopsy

The removal of cells or tissues for examination under a microscope.

Different types of biopsies include incisional biopsy, excisional biopsy and needle biopsy. Sometimes imaging techniques are used to guide the biopsy, as in ultrasound-guided biopsy and computed tomography (CT)–guided biopsy.

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