HPV, or human papillomavirus, is one of the most common sexually transmitted infections in the United States. In fact, it's so common that experts from the Centers for Disease Control and Prevention state that nearly every sexually active man and woman will contract the viral infection at some point in their lives. In the United States, around 14 million new cases of HPV are diagnosed annually, and nearly 80 million men and women are living with an active HPV infection at any given point in time, according to the American Sexual Health Association.
- 1 The CDC estimates that nearly every sexually active man and woman will contract HPV at some point in their lives.
- 2 In the U.S., around 14 million new HPV cases are diagnosed annually.
- 3 Over 20,000 cases of cancer are linked to HPV in women each year.
- 4 There is a vaccine available and recommended for boys and girls ages 11-12 years of age.
Published April 10, 2020
Written by Leigh Morgan
The high number of HPV cases is concerning because certain strains of the virus can cause abnormal cell changes in the throat and genitals. In some cases, these changes lead to cancer of the anus, cervix, vagina, penis, vulva, or back of the throat. Each year, 20,700 cases of cancer are linked to HPV in women, and about 14,000 cases of cancer are linked to HPV in men.
This guide provides an overview of the HPV testing process, including why the test is performed, and when it should be done. It also contains in-depth information about the symptoms of HPV and the treatment options available for HPV infections.
|Formal Name||Human papillomavirus|
|Other Commonly Used Names||Cancer gun, larnelled, warts|
|Testing Collection Method||Swab sample from cervix cells in women|
|Transmission/Risk||Skin-to-skin contact during sexual acts, including the genitals, back of the throat, and anus||Prevention||Abstinence, latex condoms|
Overview of HPV Testing
The Purpose of an HPV Test
The purpose of the HPV test is to detect active HPV infections in women. Although both men and women can be infected with HPV, no test is available to check for active infections in men. Therefore, it’s possible for a man with HPV to pass the virus to his sexual partners because he’s unaware he has it.
When You Should Get Tested
According to experts from the Mayo Clinic, a woman should have the HPV test under the following conditions:
- Her Pap smear shows abnormal cell changes in the cervix. These changes are referred to as atypical squamous cells of undetermined significance (ASCUS).
- She is at least 30 years old. Because HPV is so common in young women, the test isn’t as useful in women under the age of 30.
What Type of Sample is Required?
To test for HPV, a medical professional collects a sample of cells directly from the cervix, the opening that connects the vagina to the uterus.
What You Need to Do to Prepare
Before an HPV test, it’s important to avoid douching or having sexual intercourse for at least 48 hours. Spermicide and medications administered vaginally should also be avoided, as they can interfere with the test. If possible, the test should not be scheduled when a woman is menstruating, as the presence of menstrual blood makes it more difficult to collect an adequate sample of cervical cells.
How an HPV Infection Works
The HPV infection can spread any time the vulva, cervix, vagina, anus, or penis comes into contact with an infected person’s throat or genitals. Because the virus lives on the genitals and in the back of the throat, it can spread even if full penetration doesn’t occur. Skin-to-skin contact is all that’s necessary for an infected person to spread HPV to his or her partner.
More than 150 types of HPV have been identified. These strains are classified as low-risk HPV or high-risk HPV. Low-risk strains may cause genital warts, but they aren’t linked to cancer. Once the body builds an immunity to one of these strains, the infection usually goes away on its own. High-risk strains of HPV are associated with the cellular changes that can eventually develop into cancer. Although 12 high-risk strains have been identified, type 16 and type 18 cause most HPV-related cancers, according to NYU Langone Health.
The Symptoms of HPV
The HPV infection doesn’t cause any symptoms, which is why it’s spread so easily. In some people, HPV can cause genital warts, which are small bumps that appear on or around the penis, scrotum, vagina, cervix, or anus. These bumps may be white or flesh-colored, and they typically have the appearance of small pieces of cauliflower. Although genital warts can cause itching, they aren’t usually painful.
In some cases, HPV causes abnormal cell changes that can turn into cervical cancer. At first, cervical cancer may not cause any symptoms. As it progresses, the following symptoms may develop:
- Abnormal vaginal discharge
- Bleeding between periods
- Bleeding after sexual intercourse
- Painful intercourse
- Pelvic pain
- Bloody urine
- Difficulty urinating
Testing for HPV
The HPV test doesn’t check for abnormal cell changes or other signs of cervical cancer. Instead, it looks only for the virus. This test is usually performed at the same time as a Pap smear, a procedure involving the collection of cells from the cervix. In some cases, the same swab is used to collect a sample for the Pap smear and the HPV test; in other cases, separate swabs are used to collect each sample.
Before a sample is collected, the woman lies back on an exam table and places her feet in stirrups. This helps keep her legs apart so that a medical professional can insert a speculum into the vagina. A speculum is a medical tool used to hold the walls of the vagina apart. Once the speculum is in place, a swab is inserted into the vagina and used to take a sample of cells from the cervix. Finally, the cell sample is sent to a laboratory to be analyzed.
Although the test is usually performed in a medical office, at-home test kits are available to women who want to test for HPV in the privacy of their own homes. A home kit typically includes a vaginal swab and instructions for using the swab to obtain a cell sample. Although these kits are convenient, it’s important to understand that they don’t necessarily test for every strain of HPV that has been identified. For example, the at-home HPV test kit offered by Everlywell only tests for 14 types of HPV.
Treatment for HPV
Medications and surgical procedures may be used to treat HPV, especially if it’s a strain that causes genital warts. Salicylic acid, a common ingredient in anti-acne medications, can be used to remove genital warts. It doesn’t remove all the warts in a single treatment; instead, it removes each wart layer by layer. Trichloroacetic acid is stronger than salicylic acid, so it can be used to burn off warts. It’s most effective when an individual has just a few warts, rather than an advanced case of genital warts. Trichloroacetic acid is typically applied several times over a four- to six-week period to ensure the warts are removed successfully.
Podofilox is another medication used to destroy genital warts. This medicine is available as a liquid solution or a gel, so it can be used on the penis, vulva, or area between the genitals and anus. An individual who uses podofilox must be careful to apply it only to genital warts, not normal skin, as the medication can cause severe skin irritation. Imiquimod doesn’t directly destroy genital warts; instead, it enhances the body’s immunity to make it easier to fight HPV.
If topical medications don’t work, surgical procedures may be used to destroy warts and prevent them from coming back. During a procedure known as cryotherapy, the warts are frozen. Electrocautery uses a low-voltage probe to deliver electricity to warts, which burns them off. Laser surgery and other forms of surgical removal may be used to treat severe cases of genital warts. A medical professional will conduct an examination to determine which type of treatment is likely to be the most effective and produce the fewest side effects.
Although there’s no treatment for the high-risk HPV strains, the doctor and patient can work together to establish cancer prevention strategies and frequent check-ups to assist in early cancer diagnosis.
Vaccine for HPV
Fortunately, there’s a vaccine available for HPV. The American College of Obstetricians and Gynecologists recommends that parents should have both boys and girls vaccinated between 11-12 years of age, with a catch-up range of up to 26 years old. Depending upon the timing of the vaccine, two or three doses may be required. Most studies don’t see the benefit of vaccination for individuals over the age of 26.
Frequently Asked Questions
How is an HPV test used?
An HPV test is used to determine if an individual has HPV, which has been linked to several types of cancer. If the test is positive for a high-risk strain of HPV, a woman and her doctor can work together to watch for precancerous changes, and take quick action if any symptoms of cervical cancer appear. Therefore, the test is important for determining a woman’s risk of developing cervical cancer.
How can I order an HPV test?
A woman in need of an HPV test typically visits a medical professional, such as a doctor or nurse practitioner, to discuss her concerns and request a test. However, for women who want to preserve their privacy, it’s possible to order a home test kit online. Several companies offer these kits, so it’s important to follow the ordering instructions offered by each provider.
What does a positive result for HPV mean?
A positive HPV result indicates that a woman has one of the high-risk strains of HPV that have been linked to cervical cancer. She should make an appointment with her doctor to discuss prevention strategies. It doesn’t mean that a woman has cervical cancer or precancerous changes in the cervix.
What does a negative result for HPV mean?
A negative result means that a woman isn’t infected with a high-risk strain of HPV; however, it’s possible for a woman to receive a false negative result on the HPV test. A false negative is when the test comes back negative even though the woman has a high-risk strain of HPV. False negatives are more common in older women than younger women.
What’s important to know about HPV?
The most important thing to know about HPV is that some strains of the virus can cause cervical cancer, which is the most common type of cancer in women. HPV is the most significant risk factor for cervical cancer, but other risk factors exist, including HIV infection, smoking, using oral contraceptives for more than five years, having multiple sexual partners, and having three or more children. Early diagnosis of cervical cancer makes it possible to start treatment quickly and prevent the cancer from spreading to the pelvic organs, which is why it’s so important for women to have the HPV test.
If cervical cancer isn’t treated early, it can spread to other parts of the body, making it more difficult to treat, and making it more likely that a woman will develop complications. At stage 0, abnormal cells have been identified in the inner lining of the cervix. If these cells spread to the outer layers of the cervix, the cancer has progressed to stage 1. Cervical cancer is classified as stage II if it has spread beyond the uterus, but has not advanced into the lower third of the vagina or the pelvic sidewall. If the cancer spreads to the lower third of the vagina or the pelvic sidewall, it has advanced to stage III cervical cancer. The most advanced stage of cervical cancer, stage IV, is characterized by the spread of cancerous cells into the bladder or the rectal mucosa. Once cervical cancer spreads, it can cause kidney complications and other problems, making the early detection of this cancer extremely important.
How long does it take to get results from an HPV test?
It may take anywhere from one to three weeks to receive the results of an HPV test. This is because it takes time for the laboratory to analyze the cervical sample and report the results to the ordering physician.
- Sources [-]
https://www.cdc.gov/std/hpv/stats.htm. Accessed March 2020
https://www.cdc.gov/hpv/parents/cancer.html. Accessed March 2020
https://www.mayoclinic.org/tests-procedures/hpv-test/about/pac-20394355. Accessed March 2020
https://nyulangone.org/conditions/human-papillomavirus-in-adults/types>. Accessed March 2020
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366864/. Accessed March 2020
https://www.cdc.gov/cancer/cervical/basic_info/risk_factors.htm. Accessed March 2020
https://www.nccc-online.org/hpvcervical-cancer/stages-of-cervical-cancer/. Accessed March 2020