What does a positive HPV test mean, and does it automatically mean cervical cancer?
A positive human papillomavirus (HPV) test indicates that the genetic material (DNA) of HPV is present in the cervical epithelium, but this does not automatically mean cervical cancer. HPV infection is extremely common among the sexually active population, and in the vast majority of cases the immune system spontaneously eliminates the virus without causing neoplastic changes. The development of cervical cancer primarily requires a persistent, long-term infection with high-risk HPV types (especially HPV16 and HPV18), which over years or decades can give rise to precancerous conditions (dysplasia, e.g., CIN2/CIN3 lesions) before progressing to invasive cancer. In the case of a positive test, the condition of the epithelium and the necessary follow-up are determined by cytology or colposcopy.
In screening programs, a positive high-risk HPV (hrHPV) result is supplemented with triage tests, such as cytology (Pap test) or genotyping, to clarify whether any cytological or histological epithelial lesion has developed.
References
- A comparative analysis of cycle threshold (Ct) values from Cobas4800 and AmpFire HPV assay for triage of women with positive hrHPV results. PMID 37950154
- HPV-based screening for cervical cancer among women 55-59 years of age. PMID 31199811
- Understanding Patients' Perspectives and Information Needs Following a Positive Home Human Papillomavirus Self-Sampling Kit Result. PMID 30481121
- Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. PMID 29740819