The Human Papillomavirus (HPV) test is a medical procedure designed to screen for high-risk types of the virus responsible for nearly all cases of cervical cancer. The test identifies the genetic material, or DNA, of these specific high-risk HPV types in cells collected from the cervix. A positive result indicates the presence of a persistent infection, allowing healthcare providers to monitor for and treat precancerous changes before cancer develops. This screening is a powerful tool in preventative healthcare.
Screening Guidelines and Test Types
Current medical guidelines recommend cervical cancer screening begin at age 25 and continue until age 65 for individuals at average risk. Screening frequency varies, generally occurring every three or five years, depending on the specific method used.
Primary HPV Testing
This preferred method uses the HPV test alone to check for high-risk HPV types every five years.
Co-Testing
This combines the HPV test with a Pap test (cytology) to look for both the virus and any abnormal cells, typically done every five years.
Reflex Testing
This is performed only if a patient’s Pap test shows slightly abnormal cells. The HPV test serves as a follow-up to determine if the cellular changes are caused by a high-risk HPV infection.
Patient Preparation for the Appointment
Proper preparation helps ensure the accuracy of the sample collected for the HPV test. Patients should avoid scheduling the test during a menstrual period, as the presence of blood can interfere with laboratory analysis. However, testing may still be possible if bleeding is light.
To prevent obscuring the cells, patients must avoid inserting anything into the vagina for at least 48 hours before the procedure. This includes:
- Sexual intercourse
- Douching
- Vaginal creams, suppositories, or medications
Avoiding these substances prevents them from washing away or hiding the cervical cells, which could lead to an unsatisfactory result.
Step-by-Step Sample Collection
The HPV test is performed during a routine pelvic examination. The patient lies on an examination table with their feet in supportive stirrups, allowing the provider to access the cervix. The provider begins by gently inserting a medical instrument called a speculum into the vagina.
The speculum holds the vaginal walls apart, providing a clear view of the cervix. Providers may use different sizes and a small amount of lubricant for comfort. Once the cervix is visible, the provider uses a specialized collection device, typically a soft brush, to gather cells.
The instrument is gently rotated against the cervix to collect cells from the transformation zone, which is the area where most precancerous changes occur. This part of the procedure may cause a mild sensation of pressure or scraping, but it should not be painful. The collected sample is immediately placed into a vial containing a liquid preservation medium. This liquid-based method keeps the cells intact and prevents them from drying out, allowing for both the HPV and Pap tests to be performed on the same sample if needed. The sample is then labeled and sent to a specialized laboratory for molecular analysis.
Understanding the Results and Next Steps
The laboratory analyzes the collected cells for the DNA of high-risk HPV types, a process that can take up to three weeks. A negative result means no high-risk HPV was detected, indicating a low risk of developing cervical cancer. The next screening is usually recommended in five years.
A positive result means one or more high-risk HPV types were found, but this does not mean the patient has cancer. A positive result signals an infection that increases the risk of cellular changes over time.
If the HPV test is positive, the next step depends on the Pap test result. If the Pap test was normal, the patient returns for a repeat HPV test in 12 months to check if the immune system has cleared the virus. If both the HPV and Pap tests are abnormal, or if a positive HPV result persists, the patient is referred for a colposcopy. A colposcopy uses a magnifying device to examine the cervix closely and take biopsies to check for precancerous lesions.