There is no single universal HPV test for everyone. How you check for HPV depends on your sex, your age, and what part of the body you’re concerned about. For most people, HPV screening happens through a cervical sample collected during a pelvic exam, but genital warts are diagnosed visually, and anal screening is available for higher-risk groups. Here’s what each type of testing involves and who it’s for.
Cervical HPV Testing
The most widely used HPV test checks for the DNA of high-risk HPV strains in cells collected from the cervix. During the test, a healthcare provider inserts a speculum into the vagina and uses a soft brush to gently collect cells from the surface of the cervix. Those cells are sent to a lab, where they’re analyzed for the presence of HPV and, in many cases, which specific strain you carry. The procedure takes only a few minutes and feels similar to a Pap smear.
A Pap smear and an HPV test are related but look for different things. The Pap smear examines cervical cells under a microscope for abnormal changes that could eventually become cancer. The HPV test checks whether high-risk HPV strains are present in those cells at all. Your provider may order one or both, depending on your age and screening history.
Who Should Be Screened, and How Often
The U.S. Preventive Services Task Force recommends the following schedule for cervical cancer screening:
- Ages 21 to 29: Pap smear alone every 3 years.
- Ages 30 to 65: Pap smear alone every 3 years, HPV test alone every 5 years, or both tests together (co-testing) every 5 years.
For people 30 and older, evidence suggests that a 5-year interval using an HPV test alone or co-testing offers the best balance of catching problems early without leading to unnecessary follow-up procedures. Screening generally stops after age 65 if prior results have been consistently normal.
How to Prepare for a Cervical HPV Test
A few things can interfere with the accuracy of your results. For the two days before your appointment, avoid intercourse, douching, and any vaginal medicines or spermicidal foams, creams, or jellies. Try to schedule the test for a time when you’re not on your period. No other special preparation is needed.
At-Home HPV Test Kits
Self-collection HPV kits let you swab your own vaginal canal at home and mail the sample to a lab. A validation study comparing self-collected samples to clinician-collected ones found 98% sensitivity and 99.4% specificity, meaning the at-home kits caught nearly all HPV infections and almost never produced a false positive. Agreement between the two collection methods for HPV 16 and 18, the two strains responsible for most cervical cancers, was 98%.
These kits are a practical option if access to a clinic is difficult or if anxiety about pelvic exams has kept you from screening. They do not replace a Pap smear, though. If your at-home HPV result is positive, you’ll still need an in-office visit for further evaluation.
HPV Testing for Men
There is no clinically approved HPV test for men. The skin on the penis is too thick to reliably collect the type of cell sample needed for DNA testing, and studies have shown inconsistent results when the standard HPV test is used on men. In practice, HPV in men is detected through visual inspection: a healthcare provider examines the genital area for warts or other lesions.
The one exception is anal screening, which is discussed below. But for most men with no symptoms, there is currently no routine way to test for HPV.
Visual Diagnosis of Genital Warts
Genital warts caused by HPV are typically diagnosed by sight alone, without a lab test. They appear as flat, raised, or stalk-like growths on the genital skin or mucous membranes. They’re usually painless, though larger warts in certain locations can itch or cause discomfort.
If a growth looks unusual (pigmented, hard, bleeding, ulcerated, or stuck to deeper tissue), a provider may take a small biopsy to rule out other conditions. Some lesions can mimic genital warts but have entirely different causes. Condyloma lata, for instance, is a sign of secondary syphilis and requires a different blood test to diagnose. If you notice new bumps or growths in the genital area, a visual exam by a healthcare provider is the most straightforward way to check.
Anal HPV Screening
Anal screening uses a combination of tools: anal cytology (similar to a Pap smear but with cells collected from the anal canal), high-risk HPV testing, and a digital anal rectal exam, where a provider feels for abnormalities with a gloved finger. If results are abnormal, the next step is high-resolution anoscopy, a magnified visual examination of the anal canal that can detect and treat precancerous changes.
Anal screening is not recommended for the general population. It’s targeted at groups with a meaningfully higher risk of anal cancer:
- Highest risk (screening starting at age 35): Men who have sex with men and transgender women living with HIV.
- High risk (screening starting at age 45): Men and women with HIV who have sex with women, men who have sex with men without HIV, transgender women without HIV, people with a history of vulvar precancer or cancer, and solid organ transplant recipients ten or more years after transplant.
- Moderate risk (screening starting at age 45): People with a history of cervical or vaginal cancer, persistent cervical HPV 16, perianal warts, or autoimmune conditions like lupus, rheumatoid arthritis, or inflammatory bowel disease.
Oral HPV Screening
HPV can infect the throat and is linked to a growing number of oropharyngeal cancers, but there is no approved screening test for oral HPV in people without symptoms. Dentists and doctors may notice suspicious lesions during routine exams, but no swab or rinse test is currently recommended for screening the general population. If you have persistent symptoms like a sore throat, difficulty swallowing, or a lump in the neck that doesn’t resolve, bring it up with your provider.
What Happens After a Positive HPV Result
A positive cervical HPV test does not mean you have cancer. Most HPV infections clear on their own within a year or two. What happens next depends on several factors: which HPV strain was detected, whether your Pap results also showed abnormal cells, your previous screening history, and your age.
Based on your individual risk, your provider will typically recommend one of three paths. You may be asked to return in one or three years for a repeat HPV test or co-test. You may be referred for a colposcopy, a closer examination of the cervix using a magnified lens, which usually includes a small biopsy so the tissue can be examined under a microscope. Or, if higher-grade precancerous changes are found, you may be referred directly for treatment to remove the abnormal cells.
If your Pap came back with mildly abnormal cells but your HPV test is negative, the changes may be caused by something else entirely, like low hormone levels, and your provider might simply monitor you. If HPV is positive alongside those mildly abnormal cells, additional follow-up testing is the usual next step. More significantly abnormal Pap results, regardless of HPV status, almost always lead to a colposcopy.