HPV testing: clear indicator of potential risk

Molecular tests for the human papillomavirus (HPV) are widely available and used to varying degrees in cervical cancer screening programs throughout the world. HPV tests can be used as complementary or reflex tests with Pap cytology, and, in some cases, HPV testing is beginning to be used as the primary screen, supplanting the traditional Pap test.

In all cases, they are used to detect, or rule out, the presence of high-risk HPV genotypes (hrHPV) that are associated with cervical cancer. Tests are available that detect HPV DNA, typically based on a polymerase chain reaction (PCR) platform, while other tests target messenger RNA (mRNA). All of these tests detect the presence of a number of hrHPV genotypes, and some can also detect the presence of HPV 16 and 18 genotypes as either pooled or separate results.1,2

HPV testing provides information that can confirm suspicion or reduce concern about risk of cervical cancer. However, it does not provide information about potential malignant transformation.

Tests that are positive for hrHPV can sometimes predict who will develop high-grade cervical intraepithelial neoplasia (CIN 3+) over the next 5 to 15 years.3

Negative hrHPV findings may help allay initial concerns about equivocal cytology results. Here, women may return to routine screening intervals, with fewer office visits and less worry about results.3,4

If liquid-based cytology is used for a Pap sample, then HPV testing may be performed from the same vial. However, if a conventional Pap smear is collected, a second sample has to be collected to perform an HPV test.

Learn more about the role of hrHPV in cervical cancer

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