Cervical Cancer Screening

By Dr. Sanjay Gupta

The human papillomavirus (HPV) test detects the presence of the human papillomavirus, a virus that can lead to the development of genital warts, abnormal cervical cells or cervical cancer.
HPV affects both men and women, but HPV test is available only for women at present. There is no test that can detect HPV in men. However, men can be infected with HPV and pass the virus along to their sex partners.

HPV test is a screening test for cervical cancer, though the test doesn’t detect that you have cancer. It detects the presence of HPV, the virus that causes cervical cancer eg. HPV 16 & HPV 18. When the test shows positive for virus, the patient is advised for next step of healthcare. Those steps might include follow-up monitoring, further testing, or treatment of abnormal or precancerous cells.

Routine use of the HPV test in women under age 30 isn’t recommended, nor is it very helpful. HPV spreads through sexual contact and is very common in young women, so, frequently, the test results will be positive. However, HPV infections often clear on their own within a year or two. Cervical changes that lead to cancer take several years — often 10 years or more — to develop. For these reasons, you might follow a course of watchful waiting instead of undergoing treatment for cervical changes resulting from an HPV infection.

As with other screening tests, HPV test has risk of both false positive and false negative result.

  • False-positive. A false-positive test result indicates that you have a high-risk type of HPV when you really don’t. A false-positive result could lead to an unnecessary follow-up procedure, such as colposcopy or biopsy, and undue anxiety over the test results.
  • False-negative. A false-negative test result means you really do have an HPV infection, but the test indicates that you don’t. This might cause a delay in appropriate follow-up tests or procedures.

HPV test is done at the same time when Pap test is done. An HPV test can be done using the same sample from the Pap test or by collecting a second sample from the cervical canal. Once the sample is collected, it is sent for examination. The result will be either Positive or Negative.

Depending upon the test result, following recommendation is done.

  • Normal monitoring. If you’re over age 30, your HPV test is negative and your Pap test is normal, you’ll follow the generally recommended schedule for repeating both tests in five years.
  • Colposcopy. In this follow-up procedure, your doctor uses a special magnifying lens (colposcope) to more closely examine your cervix.
  • Biopsy. In this procedure, sometimes done in conjunction with colposcopy, your doctor takes a sample of cervical cells (biopsy) to be examined more closely under a microscope.
  • Removal of abnormal cervical cells. To prevent abnormal cells from developing into cancerous cells, your doctor may suggest a procedure to remove the areas of tissue that contain the abnormal cells.
  • Seeing a specialist. If your Pap test or HPV test results are abnormal, your health care provider will probably refer you to a gynecologist for a colposcopic exam. If test results show that you might have cancer, you may be referred to a doctor who specializes in treating cancers of the female genital tract (gynecologic oncologist) for treatment.