An HPV test is a screening test that checks for the presence of high-risk strains of human papillomavirus in cells collected from the cervix. The test works by detecting DNA or RNA left behind by the virus, and its primary purpose is catching HPV infections that could eventually lead to cervical cancer. Unlike a Pap smear, which looks for abnormal cell changes that have already occurred, the HPV test identifies the virus itself, often years before any cellular changes develop.
What the Test Actually Detects
There are over 200 types of HPV, but only 12 are classified as high-risk for cancer: types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. The HPV test screens specifically for these high-risk strains. Two of them, types 16 and 18, are responsible for most HPV-related cancers, so many tests flag these two individually while grouping the others together.
A positive result means high-risk HPV DNA was found in your sample. It does not mean you have cancer or even precancerous cells. Most HPV infections clear on their own within one to two years. The test simply identifies who needs closer monitoring.
How the HPV Test Differs From a Pap Smear
A Pap smear and an HPV test are often confused because they’re collected in the same way, sometimes even from the same sample. But they answer different questions. A Pap smear examines cervical cells under a microscope to look for abnormalities that have already developed. An HPV test checks whether the virus causing those abnormalities is present in the first place.
The difference in accuracy is significant. In comparative studies, the HPV test detected about 94.6% of high-grade precancerous changes, while the Pap smear caught only 55.4%. The Pap smear was slightly more specific (96.8% vs. 94.1%), meaning it produced fewer false positives. But because the HPV test catches so many more true cases, clinical guidelines have increasingly shifted toward using it as the primary screening tool. Research across 13 large randomized trials over 15 years found that primary HPV screening is as effective at detecting serious precancerous changes as combining both tests together, with fewer total screenings needed over a lifetime.
What Happens During the Test
The sample collection is identical to a Pap smear and takes only a few minutes. You’ll lie on an exam table with your feet in stirrups. Your provider inserts a speculum to gently hold the vaginal walls apart, then uses a soft brush and a flat scraping tool called a spatula to collect cells from the surface of your cervix. The cells go into a small bottle of preserving solution and are sent to a lab. Many providers collect a single sample and run both the HPV test and Pap smear from it.
The procedure can feel mildly uncomfortable but is not typically painful. You can usually resume all normal activities immediately afterward.
Self-Collection Is Now an Option
The FDA has approved self-collected HPV tests for use both in clinical settings and at home. For the at-home version, a healthcare provider still needs to order the test and supply the collection device. You collect a vaginal sample yourself rather than having a clinician take cervical cells with a speculum. At-home self-collection is available to a limited number of people right now, though wider availability is expected in the near future.
When and How Often to Get Tested
The American Cancer Society recommends that people with a cervix at average risk start cervical cancer screening at age 25 and get a primary HPV test every five years through age 65. This is a shift from older guidelines that started screening at 21 with Pap smears alone.
The U.S. Preventive Services Task Force offers slightly different options depending on age. For those 21 to 29, a Pap smear every three years remains the recommended approach. Starting at 30, you can choose between a Pap every three years, an HPV test every five years, or both tests together (co-testing) every five years. Your provider can help you decide which approach makes sense based on your history and risk factors.
HPV testing is not recommended for people under 21, regardless of sexual history. Most HPV infections in younger people resolve without treatment, and testing would lead to unnecessary follow-up procedures.
What a Positive Result Means
A positive HPV test result means a high-risk strain was found, not that you have cancer. Follow-up depends on several factors: your specific test results, previous screening history, any past treatments for precancerous cervical changes, and your age. Based on your individual risk level, your provider may recommend one of several paths.
- Repeat testing in one or three years if your overall risk is low, to see whether the infection clears on its own.
- Colposcopy and biopsy if your risk is higher. A colposcopy uses a magnifying instrument to examine your cervix more closely, and a small tissue sample may be taken to check for precancerous changes.
- Treatment if precancerous cells are found. This typically involves removing or destroying the abnormal tissue in an outpatient procedure.
Current clinical guidelines take a personalized approach rather than applying the same follow-up to everyone with a positive result. Two people with the same HPV result may get different recommendations based on their screening history and other risk factors.
HPV Testing for Men
There is currently no approved routine HPV screening test for men. The CDC does not recommend HPV testing for men, adolescents, or women under 30. For men, there is no reliable way to determine overall “HPV status.” HPV-related health problems in men, such as genital warts or cancers of the throat, anus, or penis, are typically identified through physical examination or symptom evaluation rather than routine screening.
Cost and Insurance Coverage
HPV testing is classified as a preventive service, which means most insurance plans are required to cover it without any cost-sharing when performed according to recommended guidelines. This applies to non-grandfathered private health insurance plans, Medicare, Medicaid expansion plans, and traditional Medicaid plans. If you’re uninsured, community health centers and Title X family planning clinics often provide cervical cancer screening on a sliding fee scale.