HPV Testing

Testing for HPV (human papillomavirus) is recommended as part of cervical cancer screening. Screening tests for HPV are used to check for the virus in people who have no symptoms.

How are HPV tests and Pap tests different?

• An HPV test looks for cervical HPV infection. It detects high-risk types of HPV that are more likely to cause pre-cancers and cancers of the cervix. But an HPV test cannot detect pre-cancer or cancer itself.
• A Pap test is used to find cell changes or abnormal cells in the cervix. A Pap test cannot detect HPV.
• Both the HPV and Pap test are usually done during a speculum exam. Another option for the HPV test is for the person to use a kit to collect a vaginal sample themselves, while being supervised by a health care provider. This is called self-collection, and it doesn’t require a pelvic exam.
• An HPV test can be done either by itself (primary HPV testing) or at the same time as the Pap test (co-testing).
• If a Pap test is done by itself and the result is positive (abnormal), the same sample can be used to test for HPV.

If an HPV test is done by itself, and the result is positive (abnormal), the same sample can then be used to test for cell changes or abnormal cells.

What is mRNA E6/E7 detection?

E6 and E7 are proteins found on high-risk types of HPV viruses. Some HPV tests work by checking a sample for mRNA E6/E7, the instructions the virus uses to create these proteins. If the results of an HPV test say that mRNA E6/E7 was detected, it means the test is positive for HPV. Not all HPV tests look for these proteins. Some tests work by looking for the DNA of specific types of high-risk HPVs.

What does the American Cancer Society recommend about HPV testing?

The American Cancer Society (ACS) recommends HPV testing as part of a cervical cancer screening plan. ACS recommends:

• People aged 25 to 65 should have a primary HPV test every 5 years.
• If primary HPV testing is not available, screening may be done with either a co-test that combines an HPV test with a Pap test every 5 years, or a Pap test alone every 3 years. 
• People who have been vaccinated against HPV should still follow these guidelines for their age groups.

A primary HPV test is better at preventing cervical cancers than a Pap test that is done alone. Having a primary HPV test does not always add more unnecessary tests, which can happen when a co-test is done.

The most important thing to remember is to get screened regularly, no matter which test you get.

Learn more in The American Cancer Society Recommendations for the Prevention and Early Detection of Cervical Cancer Screening.

What about testing for HPV in other parts of the body?

The FDA has only approved tests to find HPV in the cervix. Any abnormal (positive) results are managed with extra testing and prompt treatment if the infection causes abnormal cell growth.

Research is still being done on HPV tests for other parts of the body. For example:

• There are commercially available oral HPV tests that are not yet FDA-approved or included in screening guidelines. However, some dentists use them.
• Doctors often recommend that high-risk men and some high-risk women get anal HPV testing.
• Research is being done on options for male genital testing for HPV.

There’s no useful test to find out a person’s “HPV status” because HPV can infect different parts of the body, and an HPV test result can change over a period of months or years.