by Alicia M Prater PhD

Created on: December 03, 2011   Last Updated: April 27, 2012

Human papillomavirus (HPV) is a sexually transmitted virus that can cause cervical cancer in women and genital warts, or occasionally some other forms of cancer, in both men and women. A test is currently available to determine infection in women via samples from the cervix. In recent years, co-testing with Pap smears has been considered a useful method for detecting cervical cancer early, but new guidelines challenge this view.

HPV test overview

The Digene HPV test was approved by the FDA in 2003. It can detect the presence of HPV in the cervical cells taken during the Pap smear. In 2009, the FDA approved two new HPV tests, Cervista, that are capable of more specifically genotyping the high-risk HPV strains associated with cervical cancer. The tests are generally used in women over the age of 30 years because women who are younger than 30 tend to resolve HPV infections on their own (transient infection). Persistent HPV infections are associated with cervical cancer, and most infections do not result in cancer, so being positive for HPV, even the high risk strains, is not a clear cut certainty of cancer (the National Cancer Institute found that women infected with HPV 16 or 18, the high-risk strains for cervical cancer, only have a 20% risk of cancer progression over 10 years).

Co-testing and the old guidelines

Once the HPV genotyping test was available, women’s health groups and clinics (here is one example) began a policy of co-testing in women over 30 years of age. When a woman went to the doctor for her annual Pap smear, they would also run an HPV test. Women with positive results on both were considered to be at high risk of cervical cancer. If both tests were negative, the woman would not need another test for 3 years. If only the HPV test was positive, annual Pap smears were recommended. In 2006, the American Journal of Obstetrics & Gynecology (according to TheHPVTest) recommended specifics based on the age of the woman, including colposcopy (a process of the doctor viewing the cervix) to confirm positive results on both tests. The clinicians and doctors felt that this would aid in earlier detection, diagnosis, and intervention, as well as cut down on unnecessary Pap testing. However, these guidelines were based on expert consensus rather than scientific studies.

New HPV testing guidelines based on medical studies

In May 2011, the National Cancer Institute reported on a large-scale study that confirmed the 3-year interval guidelines for Pap

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