How Do I Get Tested For Human Papilloma Virus/HPV?

Human papilloma virus (HPV), coloured transmission electron micrograph (TEM). Science Photo Library - PASIEKA/Brand X Pictures/Getty Images

Question: How do I get tested for human papillomavirus/HPV?

Answer: It depends

  • For women: A swab from your cervix can be tested for HPV DNA, although this is not normally done unless you have an abnormal Pap smear. An HPV test can be useful in determining whether a borderline abnormal Pap smear is likely to be pre-cancerous. However, since most HPV infections resolve on their own without causing disease, and up to 40% of young women are infected with the virus at any given time, very few doctors advocate routine screening. Instead, yearly Pap smears are suggested to avoid the consequences of the virus.
     
  • For men: There is no HPV test currently available that can detect genital HPV infections in men. However, sometimes doctors will run an HPV test on an anal Pap smear. There are also tests for oral HPV that can be used in both men and women. However, they may be hard to find. Some dentists offices are offering them routinely, but they are the exception not the rule.

The FDA has approved several HPV vaccines. Gardasil protects against 4 of the most common types of the virus – the two strains that cause 70% of cervical cancers and the two that cause 90% of genital warts. Gardasil 9 protects against an additional 5 high-risk strains of HPV. Finally, Cervarix protects against the two most common high-risk strains. It does not directly protect against the strains associated with genital warts.

Should I Get an HPV Test?

One of the reasons that HPV tests are hard to access is that it's unclear whether everyone benefits from such testing.

Although a negative HPV test is a good indication that cervical cancer (or other HPV related cancers) won't develop, a positive test says less. The majority of HPV infections will go away within two years without causing any damage. Therefore, many doctors are concerned that testing will make people far more concerned than they need to be.

Sources:

Giorgi Rossi P, Baldacchini F, Ronco G. The Possible Effects on Socio-Economic Inequalities of Introducing HPV Testing as Primary Test in Cervical Cancer Screening Programs. Front Oncol. 2014 Feb 10;4:20. doi: 10.3389/fonc.2014.00020. eCollection 2014.

Mirghani H, Amen F, Moreau F, Guigay J, Ferchiou M, Melkane AE, Hartl DM, Lacau St Guily J. Human papilloma virus testing in oropharyngeal squamous cell carcinoma: what the clinician should know. Oral Oncol. 2014 Jan;50(1):1-9. doi: 10.1016/j.oraloncology.2013.10.008.

Moscicki AB, Schiffman M, Burchell A, Albero G, Giuliano AR, Goodman MT, Kjaer SK, Palefsky J. Updating the natural history of human papillomavirus and anogenital cancers. Vaccine. 2012 Nov 20;30 Suppl 5:F24-33. doi: 10.1016/j.vaccine.2012.05.089.

Pisano L, Tiradritti L, Zuccati G, Matucci M, Butera D, Foxi P, Confortini M. Pap smear in the prevention of HPV-related anal cancer: preliminary results of the study in a male population at risk. G Ital Dermatol Venereol. 2015 Jul 22. [Epub ahead of print]

Roka F, Roka J, Trost A, Schalk H, Zagler C, Kirnbauer R, Salat A. Anal human papillomavirus testing with Digene's hybrid capture 2 using two different sampling methods. Dis Colon Rectum. 2008 Jan;51(1):62-6.

Rositch AF, Koshiol J, Hudgens MG, Razzaghi H, Backes DM, Pimenta JM, Franco EL, Poole C, Smith JS. Patterns of persistent genital human papillomavirus infection among women worldwide: a literature review and meta-analysis. Int J Cancer. 2013 Sep 15;133(6):1271-85. doi: 10.1002/ijc.27828.

Thaxton L, Waxman AG. Cervical cancer prevention: immunization and screening 2015. Med Clin North Am. 2015 May;99(3):469-77. doi: 10.1016/j.mcna.2015.01.003.

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