Who Should Get The HPV Test - Over 30

Q

Who should get the HPV test?

A

Young women over the age of 20 should have the HPV test if their Pap result is inconclusive, to help determine if further exams are needed. In addition, women 30 years of age or older can benefit from the added peace of mind offered by getting the HPV test along with their Pap, no matter what their Pap result.

Recommendations vary clearly among different countries. In the U.S. for example, the major women's health and cancer associations – the American College of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS) and American Society for Colposcopy and Cervical Pathology (ASCCP) – agree that routine screening for HPV, combined with a Pap test, may begin at age 30..

Even if you have been in a long-term relationship with one partner, it is important to be regularly screened with both the HPV and Pap tests. This is because it is possible for HPV to "hide" in the genital cells and thus go undetected long after you or your partner were first exposed. While it is dormant, the infection won't cause any problems and can't be spread to others. However, the HPV infection may "re-activate" later. That's why periodic re-testing is needed.



Q

Why shouldn't women younger than 30 get the HPV test routinely?

A

It's true that HPV infections are very common among young women. However, in the under-30 age group, HPV infections usually don't stay active for very long, since their immune systems are very strong. As a result, cervical cancer is relatively rare in young women.

As women grow older, HPV infections become less common and those that exist are more likely to be the long-term, persistent type most likely to cause cervical cancer. That's why it's recommended that women 30 and older be routinely tested for infection with high-risk types of HPV.

The rationale for recommending routine HPV testing only for older women is the same as that for mammography. Although some young women get breast cancer, it is not common enough to justify recommending regular mammograms for women younger than the permitted age.



Q

Will women still need the HPV test if they get the HPV vaccine?

A

Yes. The HPV vaccine is only fully effective in women who are immunized before being exposed to the targeted types of HPV through sexual contact. In addition, it protects against only two of about 15 types of HPV that can cause cervical cancer, so the protection it offers is not complete. Thus, continued screening with both the Pap and HPV tests is critical.



Q

Do you still need an HPV test if your cervix has been removed?

A

If you had a total hysterectomy (including removal of the cervix) for reasons other than cervical cancer, then you no longer need a Pap or HPV test. However, if you had the hysterectomy due to a diagnosis of cervical cancer, most experts say it is important to continue to get the Pap and HPV tests. That is because HPV also can infect the vagina and vulva, causing cancer in those areas. (There is some evidence that women who have had cervical cancer are at higher risk of these types of cancer.) This is what physicians are looking for when they continue to do a "Pap" smear following a hysterectomy. (It's not really a Pap test in its traditional sense – in which a sample of cervical cells is examined -- but rather a swab of the vaginal wall. Likewise, experts say the HPV test continues to be useful for the same reason, because it allows high-risk types of the virus to be detected in the "vaginal cuff" -- the top of the vagina.)



Q

Do insurance companies pay for the HPV test?

A

Whether insurance companies pay for HPV testing depends on local guidelines. Please ask your doctor or insurance about the conditions under which a reimbursement for HPV testing is available



Q

Is the HPV test only for women? Why isn't there a test for men?

A

There is currently no officially approved HPV test for males. Men also get HPV, which can in turn cause genital warts or cancer of the anus and penis. However, serious HPV-related problems such as cancers are rare in men, especially those with healthy immune systems. In addition, it is hard to get a good cell sample from men to test for HPV, and thus the virus would frequently be missed.

 
Remember, It's personal!


This is general information about screening. Every woman is different. It's a good idea to discuss your screening schedule and the benefits and risks with your doctor.

In addition, even if you do not have to be screened every year for cervical cancer, it is recommended that you still visit your doctor regularly to have breast, pelvic or other important exams. Discuss with him or her how often you should be seen and for which tests.