HPV DNA Testing for Cervical Cancer Screening
Cervical cancer is a disease in which cancer cells grow in the cervix. Fortunately, cervical cancer can be prevented if precancerous cell changes are detected and treated early.
The human papillomavirus (HPV) is the primary cause of nearly all cases of cervical cancer. HPV can be passed from one person to another through sexual contact. In most cases, the HPV virus is harmless and causes no symptoms. In fact, many young women who become infected with HPV are able to clear the infection through their own immune systems. However, certain high-risk types of HPV can cause cervical lesions. Over time, these may develop into cancer if untreated.
The Pap smear is used detect cancerous and precancerous cervical lesions. Unfortunately, the Pap smear has been associated with false negative rates in some cases. In a false negative, the test indicates the pap smear is normal when, in fact, there is an abnormality. Women with abnormal results need further testing.
The HPV test can be used in conjunction with the Pap test. The test determines the presence or absence of HPV and whether or not the HPV type present is the type that is associated with cancer.
The HPV Test
The HPV test is collected similar to a Pap smear. A cervical brush or other collection device is inserted into the cervix to collect cells for testing. This sample is then sent to the lab for evaluation.
A negative result means that high-risk, cancer-causing types of HPV were not detected. Therefore, your risk of developing high-grade cervical disease before your next routine visit is extremely low.
A positive HPV result may mean an increased risk of developing cervical cancer if the precancerous type is present. In this case, further examination will be needed to determine whether your cervix shows pre-cancerous or cancerous changes. If no changes are detected, you will be closely monitored to make sure that any changes are detected as early as possible. If precancerous changes are detected, you should know that several highly effective treatment options are available.
General recommendations for cervical cancer screening:
- Screen women between the ages of 21-65 years
- Women ages 21-29 years—Pap smear every 3 years without HPV testing
- Women ages 30-65 years—Pap smear and HPV testing every 5 years or Pap smear alone every 3 years
- Stop screening women over 65 years old with normal testing in the past 10 years
Each woman has individual circumstances and risk factors. Talk to your doctor about how often you should be screened for cervical cancer.
Questions to Ask Your Doctor
To find out if HPV testing is right for you, be sure to ask your doctor the following questions on your next doctor visit:
- Am I a candidate for an HPV test as part of my cervical cancer screening program?
- Do you provide HPV testing as a follow-up to help clarify inconclusive Pap test results?
- If I have an inconclusive Pap test result, can you ask the lab to perform an automatic HPV test from the same Pap sample?
- Will my insurance cover the HPV test?
- Can I talk to you about questions I have about HPV and cervical cancer?
American Cancer Society
National Cancer Institute
Canadian Cancer Society
Society of Obstetricians and Gynaecologists of Canada
Cervical cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003042-pdf.pdf. Updated January 29, 2016. Accessed February 2, 2017.
Cervical cancer screening. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T116761/Cervical-cancer-screening. Updated October 6, 2016. Accessed February 2, 2017.
Cuzick J. Human papillomavirus testing for primary cervical cancer screening. JAMA. 2000;283(1):108-109.
Human papillomavirus (HPV) vaccines. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/prevention/HPV-vaccine. Updated November 2, 2016. Accessed February 2, 2017.
Kulasingam SL, Hughes JP, et al. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities. JAMA. 2002;288(14):1749-1757.
Manos MM, Kinney WK, et al. Identifying women with cervical neoplasia: Using human papillomavirus DNA testing for equivocal Papanicolaou results. JAMA. 199;281(17):1605-1610.
Pap and HPV testing. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/detection/Pap-HPV-testing. Updated September 9, 2014. Accessed February 2, 2017.
Schiffman M, Herrero R, et al. HPV DNA testing in cervical cancer screening: Results from women in a high-risk province of Costa Rica. JAMA. 2000;283(1):87-93.
What is HPV? Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/hpv/parents/whatishpv.html. Updated December 20, 2016. Accessed February 1, 2017.
What should I know about screening? Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/cancer/cervical/basic_info/screening.htm. Updated March 7, 2014. Accessed February 2, 2017.
Wright TC, Cox JT, et al. 2001 consensus guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002;287:2120-2129.
Wright TC, Denny L, et al. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA. 2000;283(1):81-86.
Last reviewed February 2017 by Michael Woods, MD, FAAP Last Updated: 2/10/2015