What Is the Cancer Risk for High-Risk HPV (Non 16/18)?

A result of “positive for other high-risk HPV” means you carry one of about a dozen virus types that can, over many years, cause cervical cancer. As a group, though, these types are clearly less dangerous than HPV16 and 18, which drive most cervical cancers. The result is less a cancer warning than a signal to keep up follow-up, because what matters most is whether the infection goes away.

How Likely Other High-Risk HPV Is to Lead to Precancer

Doctors track serious precancer: abnormal cells that are not yet cancer but can be removed before they become one. Your report may call it CIN3. Among women with a normal Pap and one of the “other” high-risk types, about 4 in 100 developed CIN3 or worse within 8 years.¹ With HPV16 the figure was about 22 in 100, and with HPV18 about 13 in 100.² The risk was similar for women under and over 30.³

Put the other way, about 96 of every 100 women with your result will not get serious precancer in 8 years. Cervical cancer typically takes 10 years or more to develop from infection, and regular screening is designed to catch the few cases that arise in that window.

The word “high-risk” is easy to misread. It names a family of viruses that can cause cancer, not your personal odds. Low-risk types cause warts, not cancer. Your own risk depends on the type, on whether the infection persists, and on your Pap results.

A normal Pap with a positive HPV test also sounds contradictory, but the two tests answer different questions. A Pap looks at how cells appear under a microscope, while the HPV test looks for the virus itself. Together they mean the virus is present but has not yet changed the cells in a way a lab can see. That is why this combination is treated as watch-and-retest rather than treatment.

These types turn up often in precancers but much less often in actual cancers.⁴ One reason may be that HPV16, 18 and 45 are more likely than other types to become part of the cell’s own DNA, a step linked to cancer.⁵ Precancer from other types is therefore more likely to stall or be caught along the way. They still appear in about half of serious precancers and cancers in some screening populations, so they are not harmless.⁶

Which Other High-Risk Types Carry More Risk

The “others” are not all alike. HPV31 and 33 each led to serious precancer in about 12 to 13 in 100 women with a normal Pap over 8 years, close to HPV18.⁷ Types 31, 33, 52 and 58 are consistently linked to serious precancer.⁸ HPV45 ranks next after 16 and 18 for presence in actual cancers.⁹

Other types look milder. Types such as 39 and 59 are found in cancers far less often relative to how common they are.¹⁰ HPV51 contributes very little to cancers.¹¹

Types such as 51 and 56 sit near the bottom, so a result naming one of them is more reassuring than the group average. For you, the type name matters more than the broad label.

The 4-in-100 figure blends riskier and milder types. Many tests report only 16, 18 and “other high-risk” as a group, while some labs use extended testing that names types like 31, 33, 45, 52 and 58. You can ask your clinician whether extended genotyping was done or is available.

African American women carry HPV35 more often, about 12% versus 5% in other groups.¹² They also have more HPV35-related precancers, about 7% versus 2%.¹³ So HPV35 deserves attention in Black women even though it often ranks low overall.

Most Infections Clear and Why Persistence Matters

About 69% of non-16 high-risk infections cleared within 18 months, versus 49% for HPV16.¹⁴ HPV31 cleared more slowly than the other non-16 types.¹⁵ Infections with several types at once cleared less often.¹⁶

Clearing happens without treatment. But 69% also means roughly 3 in 10 infections are still present at 18 months, so a single follow-up is not the end of the story for everyone. If the virus is still there at the retest, that moves you to closer follow-up, not straight to a cancer diagnosis.

A persistent infection is one where the same type is still there on repeat tests, commonly a year later. One positive test can’t tell you whether an infection is new or persistent, which is why the retest exists.

That is where the risk rises. With persistent HPV33, 18 or 31, about 1 in 3 developed serious precancer over 8 years.¹⁷ Persistent HPV56 carried only about a 3% risk.¹⁸

The same type again suggests persistence and closer follow-up. A different type may be a new infection. A negative repeat test is genuinely reassuring and usually returns you to routine screening.

Having several types roughly adds their separate risks rather than multiplying them.¹⁹ In a large study, most two-type combinations did not raise precancer rates over a single type.²⁰

You can help your body a little. Not smoking supports its ability to clear HPV. Condoms reduce new infections, though not fully. No supplement has proven to clear HPV.

What Happens Next After This Result

If the type is not 16 or 18 and the Pap is normal, a return test in 1 year is recommended in most cases.²¹ The risk in that situation is low enough to wait for the body to clear the virus. An abnormal Pap usually leads instead to colposcopy, a closer look at the cervix with a magnifying scope and sometimes a small biopsy.

Some programs go further. They refer women straight to a closer look if they have 31, 33, 52 or 58, while keeping others on yearly retesting.²² A stain test on the same sample, called dual stain, which you can ask about, missed fewer precancers than the Pap alone in women with other high-risk types.²³ It also sent fewer women for unneeded closer looks.²⁴

The plan can change before a year is up. New symptoms such as bleeding after sex are worth reporting right away rather than waiting for the scheduled retest.

A closer look at the cervix feels much like a Pap and lasts about 10 to 20 minutes. A vinegar solution highlights abnormal areas. If a biopsy is taken, it may cause brief cramping and light spotting. Results usually come back within one to two weeks.

The real risk is skipping the 1-year retest, which removes the safety net screening provides. Set a reminder, and rebook if the clinic does not call. Useful questions for your clinician: which type you have, if it was named; whether dual stain or extended typing is available; and when your next test is due and what result would change the plan.

Cancers Beyond the Cervix

These types can cause other cancers, though less often. Types 31, 33, 45, 52 and 58 cause about 8% of anal cancers in women and about 20% of vaginal cancers.²⁵ In HPV-related throat cancers, HPV16 accounts for about 93% and other types only a few percent.²⁶ A non-16/18 cervical result therefore adds little known risk for throat cancer.

There is no standard HPV screening test for the throat in people without symptoms, unlike the cervix. Awareness of symptoms is the main safeguard.

Worth reporting: persistent vaginal bleeding after sex or between periods; anal bleeding, lumps, or pain that doesn’t settle; and a sore throat or neck lump lasting more than three weeks. Most causes turn out to be harmless. Mention your HPV result so your clinician can read the symptom in context. Waiting for your next routine screening is not the right plan if a symptom persists.

Does the HPV Vaccine Protect Against These Types

The current 9-valent vaccine covers 31, 33, 45, 52 and 58 in addition to 16 and 18. In women aged 16 to 26 not already infected, it prevented about 97% of serious precancer from those five types.²⁷ Older vaccines targeting only 16/18 did not cause other types to take their place.²⁸

The “nine” is the number of HPV types it protects against. It does not cover every high-risk type, so some risk from uncovered types remains after vaccination. The vaccine is made from virus-like particles that cannot cause infection, so it cannot give you HPV.

After a positive test, vaccination can still make sense. You are very unlikely to carry every vaccine type at once, so it can protect against the ones you don’t have. Adults up to 45 may benefit after discussing it with a clinician, based on age and history. It does not replace screening, so follow-up testing stays on schedule.

Who Faces Higher Risk

Women with HIV more often carry non-16/18 high-risk types, and these tend to persist.²⁹ A weakened immune system can’t clear HPV as well,³⁰ so they face a higher risk of serious precancer.³¹ Women with HIV or on immune-suppressing drugs usually need more frequent screening. Even with effective HIV treatment, the schedule is set by their care team and is closer than average. Drugs given after an organ transplant or for autoimmune disease work in a similar way, because the immune system is what clears HPV.

Smoking also adds risk. Chemicals from tobacco reach cervical tissue and are thought to weaken local immunity. It is a factor you can change, and quitting is one of the few steps with a clear link to better clearance. Long gaps between screenings add risk too, because a persistent infection can go unnoticed.

Higher levels of one vaginal bacterium, L. iners, were linked to slower clearance in one study.³² This is not yet something to test for or treat.