Human papillomavirus (HPV) test

Human papillomavirus (HPV) is a group of more than 100 different types of related viruses. It spreads by intimate skin-to-skin contact during vaginal, oral or anal sexual activity. HPV infections are very common. There is no treatment for HPV and most HPV infections will go away on their own, especially in younger people.

HPV can cause abnormal changes to cells in the oral cavity (mouth), pharynx (throat), cervix, vagina, vulva, penis or anus. High-risk types of HPV can cause precancerous cells or cancers in these areas. Low-risk types of HPV can cause external genital warts or mild precancerous cells.

An HPV test looks at a small sample of cells that have been collected and tests them for the DNA or mRNA of high-risk types of HPV.

HPV can cause changes to the cells in different parts of the body, including the mouth, throat, cervix, vagina, vulva, penis or anus. But HPV testing is currently only used as part of screening for cervical cancer.

Some research shows that using HPV testing with a Pap test may mean that there can be more time between cervical cancer screenings. HPV testing is most useful for screening in people with a cervix who are 30 years of age or older.

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

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

HPV tests aren't currently use to screen for changes in the cells of the mouth, throat, anus or penis.

Find out more about abnormal Pap test results.

An HPV test may be used to help identify people who have high-risk types of HPV and so need further follow-up tests or treatment.

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

The HPV test is not yet currently used as a primary screening test for cervical cancer in Canada. But it may be used in certain cases once abnormal cervical cells have been found. The following people will not benefit from having an HPV test.

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

In Canada, the Pap test is currently the best way to screen for precancerous conditions of the cervix or cervical cancer in people with a cervix who are under the age of 30. People in this age group may also have an HPV test as a follow-up test after treatment for high-grade precancerous cells of the cervix.

People who have had a total hysterectomy no longer have a cervix. If you have had a hysterectomy for a non-cancerous (benign) or precancerous condition, you aren't at risk for cervical cancer and don't need to be screened for it.

HPV testing can be done on the sample taken during a Pap test. It can also be done on a separate sample, but it will be collected in the same way as a Pap test. There may be some discomfort, pressure or cramping during the procedure, but it is not usually painful.

To collect a sample, 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 brush (called a cytobrush or cytobroom) to gently collect cells from the cervix, which leads into the uterus.

After collecting the cells, the doctor or nurse puts them into a container. The sample is sent to a lab where it is tested to see if it contains the DNA or mRNA of high-risk types of HPV.

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

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

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

A positive HPV test result means that you have one or more high-risk types of HPV that increase the risk of developing precancerous changes in the cervix or cervical cancer. It doesn't mean that you have a precancerous change or cancer, but you may need further testing and closer follow–up.

Your healthcare team will decide if you need more tests. This might include doing another Pap test or referring you to a specialist in colposcopy for a biopsy or treatment.