No, doctors do not always test for human papillomavirus (HPV) during a Pap test; the necessity of an HPV test depends primarily on a person's age, medical history, and specific screening guidelines.
It detects high-risk types of HPV that are more likely to cause precancers and cancers of the cervix. But an HPV test cannot detect precancer or cancer itself. A Pap test is used to find cell changes or abnormal cells in the cervix. A Pap test cannot detect HPV.
Because HPV is common and often goes away on its own, it's not always necessary to test for it.
Early infections or resolving infections with HPV may not reveal any cellular abnormalities. The most common reason for a negative Pap test with a positive HPV result is that the patient has an HPV infection, but the infection is not causing any cellular abnormalities.
A note from Cleveland Clinic
If you have a cervix and are between the ages of 30 and 65, it's essential to get regular Pap smears, HPV tests or co-tests. Your provider can advise you on the tests you need. Remember, testing positive for HPV isn't something to be ashamed of. Many people have it at one point or another.
A Pap smear (now often called a Cervical Screening Test) primarily tests for the human papillomavirus (HPV), the common infection that causes nearly all cervical cancers, and looks for abnormal or precancerous cervical cells that HPV may cause, allowing for early detection and treatment to prevent cancer. It's a key screening tool for cervical cancer and can also find other infections or inflammation.
Human Papillomavirus (HPV) is a common sexually transmitted infection. More than 90 percent of sexually active men and 80 percent of sexually active women will be infected with HPV in their lifetime.
Symptoms
Sometimes, after several negative HPV tests, a woman may have a positive HPV test result. This is not necessarily a sign of a new HPV infection. Sometimes an HPV infection can become active again after many years. Some other viruses behave this way.
This is because HPV may remain dormant (“hidden”) in the cervical cells for months or even many years. While dormant, the virus is inactive; it won't be detected by testing and will not spread or cause any problems. However, the infection may then “re-emerge,” perhaps due to changes in the body's immune system.
An HPV test most often is done at the same time as a Pap test. A Pap test looks for cancer in cells from your cervix. An HPV test can be done using the sample from the Pap test. Or your healthcare professional can get a second sample from the cervical canal.
Most HPV infections do not cause any problems and are cleared by your body within 2 years. If HPV causes problems, such as genital warts or changes to cells in the cervix, you can have treatment for these.
The cervical cells are first of all tested for the HPV virus. If high risk HPV is found, the laboratory will test the sample for cell changes. You might also hear this test called a smear test. This was the test used before HPV testing.
If you test positive for HPV and your Pap test is normal, your doctor will most likely recommend repeating the Pap and HPV screening exams in one year. If your second HPV test comes back negative, continue regular Pap and HPV tests. If your second HPV test comes back positive, your doctor may recommend a colposcopy.
The primary HPV test is better at preventing cervical cancers than a Pap smear alone and does not add more unnecessary procedures, which can happen with a co-test. Compared to the Pap smear, HPV tests can also detect infections at earlier stages, before cancer has developed.
Women who are 21 to 29 should have a Pap test alone every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred. Women who are 30 to 65 have three options for testing. They can have a Pap test and an HPV test (co-testing) every 5 years.
Don't panic.
In most cases, your body is able to fight HPV on its own, and the virus will go away without causing any health problems in one or two years.
If you tested positive for HPV, but your cytology results were normal, you will be invited back for a test in a year. If in a year you still test positive for HPV, then you might be referred for a colposcopy.
In up to 90% of cases, the infection “clears” within 1 or 2 years, meaning that specific HPV types cannot be detected by polymerase chain reaction (PCR) assays of cervical or vaginal swab samples [1].
High-risk HPV doesn't have symptoms
In most cases, cervical cancer is preventable if your doctor catches the warning signs early. A Pap test, sometimes called a Pap smear, finds abnormal cells on your cervix caused by HPV — but it doesn't directly test for cancer or HPV.
Almost all cervical cancers are thought to be caused by HPV infections. While there are often no signs of early cervical cancer, some signs may include: Increased vaginal discharge, which may be pale, watery, pink, brown, bloody, or foul-smelling.
HPV Symptoms In Women
Genital warts can cause itching and discomfort, as well as bleeding with intercourse. The National Cancer Institute says long-term, high-risk HPV can infect cells and cause cancer of the cervix. It recommends regular cervical cancer screenings for early detection.
But high-risk strains of HPV infection can cause precancerous cell changes. These cell changes can eventually lead to cancer if they aren't managed. This process, though, can take years or decades to happen. Screenings, like Pap smears, can help detect these precancerous cells before they turn to cancer.
Stress itself doesn't directly cause warts—the human papillomavirus (HPV) is the actual cause. However, stress can significantly weaken your immune system through increased cortisol production, creating conditions where existing HPV infections can activate and manifest as warts.
Most people with HPV never develop symptoms or health problems from it. In most cases (9 out of 10), HPV goes away on its own within two years without health problems. When HPV does not go away, it can cause health problems like genital warts and cancer. The types of HPV that cause warts do not cause cancer.