Human Papilloma Virus (HPV) belongs in a family of more than 150 viruses. Different types of the virus are distinguished with respect to the risk of carcinogenicity (low- or high-risk).
HPV test can detect both high- and low-risk types of the virus. Testing for high-risk types (HR-HPV) is clinically significant for evaluating pre-cancerous lesions of the uterine cervix.
- The HR-HPV test detects the presence of high-risk HPV and not of cell changes
- The HR-HPV test and the Papanicolaou test can be performed simultaneously (co-testing) or the HR-HPV test may be conducted in addition to the Papanicolaou test, in cases of abnormal findings.
When is ΗR-HPV test recommended?
The HR-HPV test is recommended in the following cases:
- Screening for women over 30 years of age
For screening purposes, the HR-HPV and the Papanicolaou test may be conducted together (co-testing), in order to increase the potential detection of pre-cancerous lesions. This is recommended for women over 30 years old.
For women below 30, HPV infections are very common and most of them resolve naturally by the immune system, without causing cervical lesions.
- Pathological Papanicolaou test (ASCUS)
Sometimes the result of the Papanicolaou test is referred as ASCUS (Atypical Squamous Cells of Undetermined Significance). In this case, the cells neither have a typical appearance nor they exhibit clear characteristics of pre-cancerous alterations, therefore being of undetermined significance.
The HR- HPV test contributes to determine whether high-risk HPV is responsible for these cellular changes. If the virus is detected, further tests are necessary to be taken (e.g. colposcopy).
- Following a treatment of pre-cancerous cervical lesions or cancer
In these cases, the HR-HPV test is used to detect persistent HR-HPV infection.
What is the meaning of the results?
- Negative HR-HPV test and normal Papanicolaou test
This result implies low risk for pre-cancerous lesions of the cervix. The patient may return to routine recall.
- Negative HR-HPV test and abnormal Papanicolaou test
No HR-HPV infection is detected and the reason of a pathological Papanicolaou test is undetermined. In this case a colposcopic examination is recommended.
- Positive HR-HPV test and normal Papanicolaou test
This result means that while an HR-HPV infection has occurred, there are no alterations in cervical cells. The available options include a repetition of both Papanicolaou and HR-HPV tests in 6-12 months, an mRNA HPV test, or colposcopy, depending on the history and the age of the woman.
- Positive HR-HPV test and abnormal Papanicolaou test
In this case, additional exams need to be undertaken (e.g. colposcopy) in order to determine the precise nature of alterations.