HPV Testing

HPV (Human Papillomavirus) is one of the most common sexually transmitted infections, with experts estimating that over 20 million Americans are currently infected. This virus is recognized as a risk factor for the development of cervical cancer.

There are over 80 known types of HPV. Thirteen of these types or strains are called high-risk because they are associated with cervical cancer. A healthy immune system can suppress or control the virus from causing any damage. So immediately the first take home message here is stay healthy and don't partake in activities that compromise your immune system or your health, such as smoking and poor health habits. Most women with HPV will not develop cervical cancer. However, if an HPV infection remains over many years, there is a greater chance of developing cell changes that may lead to cervical cancer. These are called pre-cancerous cell changes.

There are no outward signs of high-risk HPV. However, an HPV infection may cause changes in the cervical cells, which are identified on your Pap test. If untreated, the most abnormal of these changes can lead to cervical cancer. Low-risk HPV can cause genital warts and the symptoms vary from a single small raised flesh colored wart on the genitals to a large area of multiple warts. The warts may be on the outer genital area as well as in the vaginal canal or on the cervix. These warts are non-cancer causing types of HPV.

Signs of HPV infections can appear weeks, months, or even decades after initial infection. So it is possible to become infected without being aware of it and carry the virus for many years before it appears as an abnormal Pap test. Thus it is possible for women who become infected in their teenage years to have normal Pap tests and not show cervical cell changes until their thirties or forties or later, or they may not develop any abnormality at all.

HPV is passed sexually through skin-to-skin contact. So anyone who has ever been sexually active may have gotten an HPV infection. Since there are 13 strains of high-risk HPV it is even possible to acquire other strains after you have been infected with one strain. The greater the number of strains the greater the risk of abnormal cells or pre-cancerous cells developing. Condom use is encouraged in any couple not in a long-term mutually monogamous relationship, but condoms are not completely effective in the prevention of transmission of HPV. Since the infection is spread by skin-to-skin contact it can be passed in areas where the condom does not protect. Since women can acquire the virus years before it appears on a HPV screen or causes cell damage, it may not be possible to track the person who transmitted the infection.

At this point high-risk HPV is not known to have any cancer causing effects in men. Low-risk HPV can cause genital warts on both men and women. Men can be carriers of the infection but are usually not treated or tested for high-risk HPV.

It is estimated that 75% of people will get an HPV infection at some point. Only in rare cases will HPV infection lead to cervical cancer. HPV cannot be cured or treated, although treatments do exist for the problems HPV can cause, such as cervical cell changes or genital warts.

ACOG Guidelines for Pap and HPV testing

Worldwide cervical cancer affects over 400,000 women and is second only to breast cancer in malignant cancers in women. In the United Sates, 12,200 women will develop and 4,100 women will die from cervical cancer this year alone. (American Cancer Society, Cancer Facts and Figures 2003). The good news is cervical cancer is very curable when found early, and thanks to the Pap test the number of women in the US who get cervical cancer has decreased.

Now there is a new test DNAwithPap that is available to help women to know their risk for cervical cancer. This new method of testing screens for both abnormal cell changes and the presence of HPV (Human Papillomavirus). HPV is a virus recognized as a risk factor for development of cervical cancer. For more info on HPV see our link on this topic.

A Pap Smear test is a method of sampling the cells of the cervix (the bottom part of the uterus) for abnormal cells changes that could lead to or be cervical cancer. HPV (Human Papillomavirus) screening can be done at the same time as the Pap test.

As of 2004 the American College of Gynecologist and Obstetricians recommends that women over 30 years of age and older have routine testing with the DNAwithPAP test in combination with a Pap test. Studies show that a negative HPV test and a normal Pap test result means that you most likely have a very low risk of having or getting cervical disease or cancer before your next regular screening test.

DNAwithPAP testing is recommend as routine testing for women over age 30 as HPV infection is much less common in this age group. After age 30 knowing whether or not HPV infection is present along with a Pap results gives your healthcare provider more meaningful information about your risk of developing cervical cancer.

A positive HPV infection in women over age 30 indicates that the infection may have been present for a long time. If a woman's Pap tests previous to 2004 were normal HPV testing was not done, and she would not know if she had the HPV virus. As of 2004 it is recommended for both the Pap test and the HPV screen-DNAwithPAP test be done at regular screening appointments.

A positive HPV result with a normal Pap result does not mean you will develop cervical cancer. However, following current cervical cancer screening guidelines, your healthcare provider will likely want to monitor you more frequently than a woman who is HPV-negative, as HPV increases the risk of cervical cancer.

Most insurance companies are paying for this new test, but we cannot guarantee all companies will cover this test. Please check with your insurance provider for coverage benefits.

In women under age 30 HPV screening or the DNAwithPAP test is done only if the Pap test is abnormal, as HPV is very common in women under age 30. HPV DNA testing is extremely helpful for women of all ages when their Pap tests are not normal. Each year, over two million women receive results known as ASCUS-US (atypical squamous cells of undetermined significance) that are not clear to their healthcare provider. According to major guidelines, when an HPV sample from the initial Pap visit is available for these women, HPV testing is the preferred method to help decide if more involved examination and testing may be necessary to rule out or confirm disease.