Table of ContentsView AllTable of ContentsTests for WomenTests for MenBiopsy of Genital WartsIf an HPV Test Is PositiveFrequently Asked QuestionsNext in HPV GuideHow to Build Your Immune System to Fight HPV
Table of ContentsView All
View All
Table of Contents
Tests for Women
Tests for Men
Biopsy of Genital Warts
If an HPV Test Is Positive
Frequently Asked Questions
Next in HPV Guide
Diagnosis ofhuman papillomavirus (HPV)involves not only detecting the virus, but determiningwhichof the more than 100 related viruses that make up HPV is present. Though most are relatively harmless, it’s especially important to find out if the infection involves one of the 14 identified high-risk strains that are strongly linked to cancer.
Doctors will use a Pap smear, HPV test, or biopsy—along with their clinical judgment—to form a diagnosis and hopefully catch any high-risk cases before they become a problem. How someone is screened and tested varies based on their gender, age, and even sexual orientation.
The challenge with diagnosis, however, is that HPV often doesn’t produce obvious signs of infection, which can prompt people to delay testing. In some cases, individuals may first be diagnosed with HPV when they are diagnosed with a related cancer.
Understanding Human Papillomavirus (HPV) Infection Symptoms
During a Pap smear, cells are gently scraped from the cervix and examined under a microscope to check for signs of dysplasia, which can result from HPV infection. A visual exam will also be performed to identifygenital warts(which typically have a cauliflower-like appearance, but can also be flat and flesh-colored). Remember, though, that the absence of warts does not mean you are clear of HPV.
Another test, called the HPV test, checks for the actual virus rather than for changes in cervical cells. It is used in women 30–65 years old, either in response to anabnormal Pap smearor as part of a routine screening.It can be performed at the same time—and even with the same swab—as the Pap smear (a practice known as co-testing).
HPV in Women
Recommendations
One of the greatest risk factors for cervical cancer is the absence of regular screening. To avoid complications of HPV, women should follow the above screening schedule and advise their doctors of any warts, lesions, or other abnormalities that have developed in the genitals or anus.
The anal Pap smear employs the same technology as a cervical Pap smear and is used to identify dysplasia in cells taken from the anus.The test can be an important tool for men who engage inreceptive anal sexsince internalized warts are often not felt.
Despite this, the Centers for Disease Control and Prevention (CDC) currently advises against routine anal Pap screening in men, as there is insufficient data available to recommend this type of anal cancer screening for those at risk.Moreover, unlike HPV tests used in women, there is no such test currently available to confirm either an anal or oral infection.
To this end, the CDC does acknowledge that some healthcare providers perform anal Pap smears in those who may be at increased risk—includingmen who have sex with men (MSM)who engage in receptive anal sex and men with HIV.MSM who are HIV-positive are especially at risk. This group has a 37-fold greater risk of anal cancer compared to the general population.
In the absence of screening guidelines, you need to be your own advocate and, if needed, seek care from a doctor or clinic specializing in men’s health or MSM-specific care.
If a wart looks suspicious or is hard to identify, the doctor may perform abiopsyto remove a sample of tissue to analyze in the lab. While the anesthetic injection used to numb the skin can be painful, the procedure itself is usually not.
Once removed, the tissue can be examined under the microscope. The lab will then either tell you that there are no abnormal cells (meaning that everything is fine) or that there are abnormal cells called koilocytes. Koilocytes will appear hollow or concave under the microscope and are characteristic of HPV infection.
A genital wart biopsy may be indicated if:
In the same way that the absence of warts does not mean you are clear of HPV, the presence of a genital wart does not mean you will get cancer.
Unless there is evidence of neoplasia (the uncontrolled, abnormal growth of cells), the doctor would consider a positive result of an HPV screen to be a “red flag” and continue to monitor the condition closely.
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While dysplasia may progress to cancer over time, the risk is highly variable. Low-grade dysplasia usually goes away on its own without treatment. By contrast, high-grade dysplasia without treatment may develop into an early form of cancer known ascarcinoma in situ (CIS).
In the unlikely event that cancer orprecanceris diagnosed, you would be referred to an oncologist to stage the disease and decide upon the appropriate course of treatment. Fortunately, early diagnosis almost always confers to greater treatment success.
Frequently Asked QuestionsHPV and Pap co-testing can result in higher false positive rates than the HPV test alone.Because this screening test is designed to detect high-risk HPV, a false-positive result usually means that the type of HPV present is not high-risk for developing cancer, which can lead to unnecessary worry and treatments.It can take years to show symptoms after HPV exposure, and some people never show symptoms. Others only find out they have HPV after more serious issues arise such as genital warts or cancer, which is why prevention is very important.There is no approved test to check for oral HPV (mouth or throat). However, concerning signs and symptoms may include an ulcer that does not resolve within three weeks, discoloration inside the mouth, difficulty swallowing, swollen tonsils, constant coughing or sore throat, and numbness in the mouth or on the lips.HPV is very common. According to the CDC, “About 13 million Americans, including teens, become infected each year”.
HPV and Pap co-testing can result in higher false positive rates than the HPV test alone.Because this screening test is designed to detect high-risk HPV, a false-positive result usually means that the type of HPV present is not high-risk for developing cancer, which can lead to unnecessary worry and treatments.
It can take years to show symptoms after HPV exposure, and some people never show symptoms. Others only find out they have HPV after more serious issues arise such as genital warts or cancer, which is why prevention is very important.
There is no approved test to check for oral HPV (mouth or throat). However, concerning signs and symptoms may include an ulcer that does not resolve within three weeks, discoloration inside the mouth, difficulty swallowing, swollen tonsils, constant coughing or sore throat, and numbness in the mouth or on the lips.
HPV is very common. According to the CDC, “About 13 million Americans, including teens, become infected each year”.
How Human Papillomavirus (HPV) Is Treated
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Human papillomavirus (HPV) and cervical cancer.Centers for Disease Control and Prevention.Gynecologic cancers.Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1American Cancer Society.Can anal cancer be found early?U.S. Centers for Disease Control and Prevention.Men who have sex with men.Colón-López V, Shiels MS, Machin M, et al.Anal cancer risk among people with HIV infection in the United States.J Clin Oncol. 2018;36(1):68-75. doi:10.1200/JCO.2017.74.9291Leeds, I, Fang S.Anal cancer and intraepithelial neoplasia screening: A review.World J Gastrointest Surg.2016;8(1):41-51. doi:10.4240/wjgs.v8.i1.41Andersson S, Mints M, Gyllensten U, et al.Uneven distribution of human papillomavirus 16 in cervical carcinoma and squamous cell carcinoma in older females: A retrospective database study.Oncol Lett. 2014;8(4):1528-1532. doi:10.3892/ol.2014.2347Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: Updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687. doi:10.1001/jama.2018.10400The Oral Cancer Foundation.HPV/Oral cancer facts.U.S. Centers for Disease Control and Prevention.About HPV.Additional ReadingCenters for Disease Control and Prevention.Human papillomavirus (HPV).
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Human papillomavirus (HPV) and cervical cancer.Centers for Disease Control and Prevention.Gynecologic cancers.Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1American Cancer Society.Can anal cancer be found early?U.S. Centers for Disease Control and Prevention.Men who have sex with men.Colón-López V, Shiels MS, Machin M, et al.Anal cancer risk among people with HIV infection in the United States.J Clin Oncol. 2018;36(1):68-75. doi:10.1200/JCO.2017.74.9291Leeds, I, Fang S.Anal cancer and intraepithelial neoplasia screening: A review.World J Gastrointest Surg.2016;8(1):41-51. doi:10.4240/wjgs.v8.i1.41Andersson S, Mints M, Gyllensten U, et al.Uneven distribution of human papillomavirus 16 in cervical carcinoma and squamous cell carcinoma in older females: A retrospective database study.Oncol Lett. 2014;8(4):1528-1532. doi:10.3892/ol.2014.2347Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: Updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687. doi:10.1001/jama.2018.10400The Oral Cancer Foundation.HPV/Oral cancer facts.U.S. Centers for Disease Control and Prevention.About HPV.Additional ReadingCenters for Disease Control and Prevention.Human papillomavirus (HPV).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
World Health Organization.Human papillomavirus (HPV) and cervical cancer.Centers for Disease Control and Prevention.Gynecologic cancers.Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1American Cancer Society.Can anal cancer be found early?U.S. Centers for Disease Control and Prevention.Men who have sex with men.Colón-López V, Shiels MS, Machin M, et al.Anal cancer risk among people with HIV infection in the United States.J Clin Oncol. 2018;36(1):68-75. doi:10.1200/JCO.2017.74.9291Leeds, I, Fang S.Anal cancer and intraepithelial neoplasia screening: A review.World J Gastrointest Surg.2016;8(1):41-51. doi:10.4240/wjgs.v8.i1.41Andersson S, Mints M, Gyllensten U, et al.Uneven distribution of human papillomavirus 16 in cervical carcinoma and squamous cell carcinoma in older females: A retrospective database study.Oncol Lett. 2014;8(4):1528-1532. doi:10.3892/ol.2014.2347Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: Updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687. doi:10.1001/jama.2018.10400The Oral Cancer Foundation.HPV/Oral cancer facts.U.S. Centers for Disease Control and Prevention.About HPV.
World Health Organization.Human papillomavirus (HPV) and cervical cancer.
Centers for Disease Control and Prevention.Gynecologic cancers.
Workowski KA, Bachmann LH, Chan PA, et al.Sexually transmitted infections treatment guidelines, 2021.MMWR Recomm Rep. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1
American Cancer Society.Can anal cancer be found early?
U.S. Centers for Disease Control and Prevention.Men who have sex with men.
Colón-López V, Shiels MS, Machin M, et al.Anal cancer risk among people with HIV infection in the United States.J Clin Oncol. 2018;36(1):68-75. doi:10.1200/JCO.2017.74.9291
Leeds, I, Fang S.Anal cancer and intraepithelial neoplasia screening: A review.World J Gastrointest Surg.2016;8(1):41-51. doi:10.4240/wjgs.v8.i1.41
Andersson S, Mints M, Gyllensten U, et al.Uneven distribution of human papillomavirus 16 in cervical carcinoma and squamous cell carcinoma in older females: A retrospective database study.Oncol Lett. 2014;8(4):1528-1532. doi:10.3892/ol.2014.2347
Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: Updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687. doi:10.1001/jama.2018.10400
The Oral Cancer Foundation.HPV/Oral cancer facts.
U.S. Centers for Disease Control and Prevention.About HPV.
Centers for Disease Control and Prevention.Human papillomavirus (HPV).
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