HPV DNA Testing for Cervical Cancer Screening
Cervical cancer is a disease in which cancer cells grow in the cervix. According to the American Cancer Society, an estimated 12,200 new cases of invasive cervical cancer will be diagnosed yearly and an estimated 4,100 women will die of the disease. Fortunately, cervical cancer is completely preventable if precancerous cell changes are detected and treated early.
The human papilloma virus (HPV) is the primary cause of nearly all cases of cervical cancer. Indeed, of the more than 100 types of HPV, over 30 may be passed from one person to another through sexual contact. In most cases, the HPV virus is harmless and causes no symptoms. In fact, many young women who become infected with HPV are able to clear the infection from their systems through their own immune systems. However, certain high-risk types of HPV cause cervical lesions, which, over a period of time, may develop into cancer if untreated.
For over 60 years, the Papanicolaou (Pap) smear has been a powerful tool for detecting cancerous and precancerous cervical lesions. Unfortunately, the Pap smear has been associated with false negative rates in 10% to 50% of cases. In a false negative the test indicates the pap smear is abnormal when in fact there is no abnormality. Women whose Paps return from the lab with the designation ASC-US (atypical squamous cells of undetermined significance) are then informed that their Pap tests are abnormal and that follow-up screening is required.
The HPV test (the DNA with PAP™ test by Digene Corporation) is used in conjunction with the Pap test. The test determines the presence or absence of HPV and whether or not the HPV type present is the precancerous type.
The HPV Test
The HPV test is collected very much like a Pap smear. A cervical brush or other collection device is inserted into the cervix to collect cells for testing. This sample is then sent to the lab for evaluation.
A negative result means that high-risk, cancer-causing types of HPV were not detected. Therefore, your risk of developing high-grade cervical disease before your next routine visit is extremely low.
A positive HPV result may mean an increased risk of developing cervical cancer if the precancerous type is present.. In this case, further examination will be needed in order to determine whether your cervix shows pre-cancerous or cancerous changes. If no changes are detected, you will be closely monitored to ensure that any subsequent changes are detected as early as possible. If precancerous changes are detected, you should know that several highly effective treatment options are available. When combined with the Pap test, HPV testing detects nearly all precancerous and cancer-causing HPV types.
Questions to Ask Your Doctor
To find out if HPV testing is right for you, be sure to ask your doctor the following questions on your next doctor visit:
- Am I a candidate for an HPV test as part of my cervical cancer screening program?
- Do you provide HPV testing as a follow-up to help clarify inconclusive (ASC-US) Pap test results?
- If I have an inconclusive Pap test result, can you ask the laboratory to perform an automatic HPV test from the same Pap sample?
- Will my insurance cover the HPV test?
- Can I talk to you about questions I may have regarding HPV and cervical cancer?
American Cancer Society
The American College of Obstetricians and Gynecologists
Centers for Disease Control and Prevention
National Cancer Institute
Canadian Cancer Society
The Society of Obstetricians and Gynaecologists of Canada
American Cancer Society. Cancer Facts & Figures. 2003;19-20.
Cancer Facts: Human papillomaviruses and cancer. National Cancer Institute website. Available at:
http://cis.nci.nih.gov/fact/3_20.htm. Accessed April 11, 2003.
Cuzick J. Human papillomavirus testing for primary cervical cancer screening. JAMA. 2000;283:108-109.
Kulasingam SL, Hughes JP, Kiviat NB, et al. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities. JAMA. 2002;288:1749-1757.
Manos MM, Kinney WK, Hurley LB, et al. Identifying women with cervical neoplasia: using human papillomavirus DNA testing for equivocal Papanicolaou results. JAMA. 199;281:1605-1610.
New testing strategy for cervical cancer: adding HPV test could improve accuracy. American Cancer Society website. Available at: http://www.cancer.org. Accessed April 11, 2003.
Schiffman M, Herrero R, Hildesheim A, et al. HPV DNA testing in cervical cancer screening: results from women in a high-risk province of Costa Rica. JAMA. 2000;283:87-93.
Wright TC, Cox JT, Massad LS, et al. 2001 consensus guidelines for the management of women with cervical cytological abnormalities. JAMA. 2002;287:2120-2129.
Wright TC, Denny L, Kuhn L et al. HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA. 2000;283:81-86.
Last reviewed May 2008 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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