Human papillomavirus (HPV) is a widespread sexually-transmitted infection (STI). In fact, The Centers for Disease Control and Prevention (CDC) reports that HPV is the most common STI in the United States, with nearly 80 million people infected. The virus is easily transmitted through sexual contact and occasionally may be transmitted without sexual contact.
Anxiety and trepidation are normal reactions to any abnormal medical test result. However, as is the case with most viral infections, a healthy person’s immune system will usually eliminate HPV without the need for medical treatment. Therefore a positive HPV test is usually not linked to an ominous diagnosis. In the small minority of individuals with HPV infections that persist for many years, there is an increase in the risk of developing precursors to cervical cancer (dysplasia), which may eventually develop into cervical cancer.
A positive HPV result will usually call for further testing to better investigate your risk of cervical cancer. Here is what you can expect next if you have a positive HPV test result.
HPV Testing and Pap Smear Results
HPV testing typically occurs during cervical cancer screening, which consists of a pelvic examination, Pap test, and sometimes HPV testing. The HPV test is usually only given to women age 30 and older, or women who have had abnormal Pap test results. HPV testing in conjunction with Pap testing is more accurate at detecting cervical cancer than Pap testing alone in women over 30. HPV testing is not recommended in women under the age of 30 unless their pap smear is abnormal.
While the HPV test alone does not check for abnormal or cancerous cervical cells, a positive HPV test result indicates that you have at least one of the HPV strains that has been linked to cervical cancer. If your Pap smear is abnormal or you have two or more separate, positive HPV tests, your OB-GYN will likely recommend additional testing to check for cervical cancer.
If you pap smear is normal and your HPV test is positive, your OB-GYN will usually recommend simply repeating your Pap smear and HPV test in 12 and 24 months. If the repeated testing comes back without abnormalities, you can go back to a normal screening schedule. If the virus is still present on the repeated Pap test or there are changes present, patients will undergo additional tests.
If indicated, your OB-GYN may order further testing to rule out or confirm cervical cancer. If severe cell changes are detected or evidence of the HPV16 or HPV 18 strand is detected, a colposcopy procedure may be recommended. This is a procedure where your doctor uses a scope to examine your cervix and vagina internally. A colposcopy does not typically require hospitalization and can be done on an outpatient basis.
During the colposcopy, your OB-GYN will be searching for signs of cancer as well as other diseases. They will be looking for inflammation, warts, and anything else they deem suspicious. If your physician does find something concerning, they may elect to take a cervical biopsy. during which they will remove tissue for later analysis by a pathologist. The pathologist will look for abnormal cells or tissue changes that indicate cancer.
If further testing is negative for cervical cancer or your OB-GYN does not believe such testing is necessary in your case, they may recommend a strategy of watchful waiting. This means that you will need to continue your cervical cancer screening and other well-woman care, including regular HPV testing and Pap tests. Your OB-GYN may keep you on the routine schedule, or they may recommend an increase in testing frequency.
Points to Keep in Mind After a Positive HPV Test
Remember, HPV is the most common sexually transmitted infection in the U.S. and is especially prevalent among young adults. Approximately 80% of men and women who are sexually active will come into contact with HPV at some point during their lives. The HPV test is a tool to help assess cervical cancer risk, and a positive HPV test is not the same as a diagnosis of cervical cancer.
Your OB-GYN will want to investigate a positive HPV test result further out of caution. If cervical dysplasia is present, is can almost always be treated with minor procedures that will eliminate your risk of cancer without limiting your future fertility.
Please do not hesitate to ask your OB-GYN about what your test results mean, their treatment plan, and any other inquiries or concerns you have. Your doctor can help support you with their knowledge and experience as you face any health questions together.