Human Papillomavirus (HPV) Testing

HPV at a Glance

Why get tested?

The HPV test can detect the risk of cervical cancer, one of the few types of cancer that can be prevented. Almost all cervical cancers – more than 99% – are associated with Human Papillomavirus (HPV). HPV infection does not mean you have cancer, but it can predict an increased risk of developing cervical cancer. Screening for HPV infection can help your healthcare provider provide the care you need.

What sample is required?

The HPV test uses the same procedure as a Pap test. A small sample of cells is taken from the cervical area during a pelvic exam using a swab or small brush. The sample is then placed into a bottle containing a special preservative and sent to the laboratory for analysis. The same sample of cells can be used for both the Pap smear and the HPV test.

Is any test preparation needed?

Follow any instructions given by your healthcare provider. For 24 hours before the test, it is recommended that you do not have sex. For 48 hours before the test, do not douche or use any vaginal products such as creams or gels, deodorants, or medications. Reschedule the test if you are having your period (menstruating). You may be asked to empty your bladder before the examination.


What is an HPV Test?

Human Papillomavirus (HPV) is a group of more than 200 related viruses. Of these, 14 types of HPV are considered high-risk because they can cause cancer. The HPV test detects the genetic material of high-risk HPV. Testing involves collecting cells of the cervix and using a very sensitive, specific nucleic acid amplification test to identify the presence of any high-risk HPV types.
 
The sample collection process is the same as for a regular Pap test; it is the testing method that differs. For a Pap test, the sample is examined under a microscope to reveal any abnormal cell changes. Compared to Pap testing, studies have shown that HPV testing is a more sensitive method of identifying at-risk individuals.
 
Many HPV infections resolve without treatment: the body can clear the infection by itself. Infections with high-risk HPV types that do not go away can lead to cervical cancer. Almost all cervical cancers are caused by long-lasting infections with high-risk HPV. Each year, nearly 1,400 Canadians develop cervical cancer, causing approximately 400 deaths annually.


Who should be tested?

Testing for HPV is appropriate for sexually active individuals with a cervix who are over 30 years of age. You may talk with your healthcare provider about adding HPV testing along with your routine Pap test screening.
 
Your healthcare provider may recommend HPV testing if a Pap test result is abnormal, such as detection of:

• Atypical squamous cells of undetermined significance (ASCUS) at age 30 or older.
• Low-grade squamous intraepithelial lesions (LSIL) at age 50 or older.
• High-grade squamous intraepithelial lesions (HSIL) at any age.

When is the test ordered?

You may request HPV testing at the same time as your routine cervical screen (Pap test). Alternatively, your healthcare provider may recommend HPV testing if your Pap test is abnormal.


Understanding your Results

HPV testing indicates whether or not any high-risk types were found in your sample. A negative HPV test means that the risk of cervical cancer is low at the time of sample collection, while a positive result suggests the presence of an infection with high-risk HPV. Your healthcare provider will discuss the results with you.

Detection of a high-risk infection does not mean you have cervical cancer, but it could indicate an increased risk of developing cervical cancer compared to individuals without HPV infection. Detection of one of the high-risk types of HPV infection can help to guide your healthcare provider as to the most appropriate next steps. More testing or a biopsy may be recommended depending on the details and your medical history.


Is there anything else I should know?

Most people who become infected with high-risk types of HPV never develop precancerous changes or cancer.

Although HPV is a type of sexually transmitted infection, being infected with HPV does not necessarily mean that your partner is having sex outside your relationship. The HPV virus can hide in cervical cells for many years; so, if either of you ever had sex with another partner in the past, it is possible to pass the infection to your current partner.
 
 

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How is HPV Treated?

There is no treatment for the virus itself, but your body's immune system is usually able to clear the infection within a few years. There are treatments, however, for the conditions the virus may cause. Precancerous growths on the cervix can be treated in several ways, such as cryosurgery that freezes and destroys abnormal cells, or surgical removal of abnormal tissue. Catching cervical changes early – when it is easier to treat – is the key to avoiding cervical cancer. At later stages, it is more difficult to treat.


How can HPV be prevented?

Vaccination

Vaccination may prevent most cancers and other health problems caused by HPV.
 
HPV2 (e.g., CERVARIX®), HPV4 (e.g., GARDASIL®), or HPV9 (e.g., GARDASIL®9) vaccine is recommended for both males and females ages 9 to less than 27 years of age for the prevention of vulvar, vaginal, anogenital, and cervical cancers and the precancerous changes they may cause. Vaccination also prevents genital warts.
 
The most common HPV-related cancer in women is cervical cancer (49%). Other types include cancers of the anus (18%), vulva (16%) and back of the throat (oropharynx) (11%). In men, the most common is cancer of the back of the throat (81%). Others include anus (12%) and penis (7%).
 
Currently, available HPV vaccines do not protect against all cervical cancers. Individuals who have been vaccinated against HPV should still undergo regular cervical cancer screening.
 

Safer sexual practices

Having sex with only one partner will not keep you from becoming infected with HPV if either of you has had sex in the past with someone who was infected. However, limiting your number of sex partners will reduce your overall risk of infection.
 
Using condoms may reduce the risk of spreading HPV, but only the skin and mucus membranes that are covered by the condom are protected from HPV. The virus can infect uncovered skin or mucus membranes on the genitals, groin, thighs, anus, rectum, and possibly in the mouth.


Download a requisiton for HPV testing, here.


References
 
https://cancer.ca/en/treatments/tests-and-procedures/human-papillomavirus-hpv-test
https://cancer.ca/en/cancer-information/find-cancer-early/get-screened-for-cervical-cancer/everything-you-ever-wanted-to-know-about-having-a-pap-test
https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-9-human-papillomavirus-vaccine.html#a5
https://www.canada.ca/en/public-health/services/publications/healthy-living/update-recommended-human-papillomavirus-vaccine-immunization-schedule.html