Does a positive test for HPV mean I'll get cervical cancer?

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Question: Does a positive test for HPV mean I'll get cervical cancer?

It's probably a good thing HPV testing is becoming more common. However, there are now many women who are trying to understand what it means to be positive for HPV. Unsurprisingly, given the way the media discusses sciences, they are often quite worried about the diagnosis. They are concerned that a positive test for HPV means that they're definitely going to develop cervical cancer.

However, that's not the case at all. While it's possible that as many as 5 percent of all cancers are associated with HPV infection, very few people with HPV will ever be diagnosed with cancer. 

Answer: Being positive for HPV does not mean that cancer is on its way.

HPV infection is responsible for most, if not all, cervical cancer cases. It's also responsible for genital warts and other forms of cancer in both women and men. However, most women who are infected with HPV will never develop cervical cancer. In fact, more than 70 percent of women who receive a positive test for HPV will clear the infection and test negative again within two years. Of the remaining 30 percent who are HPV positive, most will eventually clear their infections. Only a small percentage of the rest will go on to develop a significant abnormal Pap smear result, let alone cervical cancer. Some factors that effect how long a woman remains infected with HPV include:

  • the type of HPV she is infected with,
  • whether she is on oral contraceptives,
  • whether she smokes.

A positive test for HPV mostly indicates that you should be conscientious about regular Pap smears. These screen for cervical dysplasia and early signs of cervical cancer. Keeping up to date on the screening is important because your risk is higher than women who have not been infected with HPV.

However, only a small fraction of even women with persistent HPV will ever develop cervical cancer. Furthermore, with regular screening and prompt treatment, most severe consequences of cervical cancer can be prevented.

If you're positive for HPV, it does indicate a need for follow-up. That's particularly true if that positive HPV test occurs in combination with an abnormal Pap smear. However, it does not indicate a need for panic. It may not even mean that you need a Pap smear more often than once a year. Your overall risk of getting cervical or other HPV cancers is higher than someone without an HPV infection, but it is still quite low. 

What About the HPV Vaccine?

There are currently multiple HPV vaccines available on the market. Completing the full vaccine series is one way to significantly reduce your risk of ever becoming infected with HPV. Although none of the vaccines protect against all type of HPV, they do focus on the ones that most commonly cause cancer in study populations. Furthermore, vaccine efficacy has been shown to last for 10 years or more, particularly when the vaccine is given to younger women. 

Sources:
de Sanjosé S, Brotons M, Pavón MA. The natural history of human papillomavirus infection. Best Pract Res Clin Obstet Gynaecol. 2017 Sep 6. pii: S1521-6934(17)30133-5. doi: 10.1016/j.bpobgyn.2017.08.015. 

Louvanto K, Rintala MA, Syrjänen KJ, Grénman SE, Syrjänen SM. Genotype-specific persistence of genital human papillomavirus (HPV) infections in women followed for 6 years in the Finnish Family HPV Study. J Infect Dis. 2010 Aug 15;202(3):436-44.

Nielsen A, Kjaer SK, Munk C, Osler M, Iftner T. Persistence of high-risk human papillomavirus infection in a population-based cohort of Danish women. J Med Virol. 2010 Apr;82(4):616-23.

Schwarz TF, Galaj A, Spaczynski M, Wysocki J, Kaufmann AM, Poncelet S, Suryakiran PV, Folschweiller N, Thomas F, Lin L, Struyf F. Ten-year immune persistence and safety of the HPV-16/18 AS04-adjuvanted vaccine in females vaccinated at 15-55 years of age. Cancer Med. 2017 Oct 5. doi: 10.1002/cam4.1155.

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