Management of High Risk HPV

Cervical screening is now primarily an HPV test. This test is for the high-risk HPV types which may lead to cell changes that could cause cancer. Most positive high-risk HPV tests never develop into cancer. 

What happens if I have a positive high-risk HPV test?

If HPV is detected following your cervical screening, you will need to undergo additional testing. However, for many people HPV infection is cleared by the body's own immune system within months to a few years. 

Many people who have HPV detected will not have any cell changes but it will still be necessary to have further investigation with cytology or colposcopy. The exact process depends on the type of HPV that is detected.

If HPV 16 or 18 is detected, you will be referred to a specialist clinic for further investigation using a procedure called colposcopy. A colposcope is like a pair of medical binoculars on a stand and it magnifies the cells on the cervix. Coploscopy shows where the abnormal cells are. A tiny piece of tissue may be removed (a biopsy) which may cause brief discomfort. The biopsy is sent to a laboratory to confirm if an abnormality is present. These procedures are simply and require only a short visit to a hospital clinic or private specialist. 

There are 12 other high-risk types of HPV that are tested for and if these are detected it is referred to as a positive test for HPV Other. Cytology testing (a cervical smear) will be used as a secondary test in these cases. If the cytology test is negative, you will be asked to return for another HPV test in 12 months.

If the cytology testing shows positive or definite high-grade changes then you will be referred to colposcopy. Treatment is generally only required if there are certain abnormal cell changes of the cervix. 

What about the future?

Most cervical cancers can be prevented by HPV vaccination, having regular cervical screening and following National Cervical Screening Programme (NCSP) recommended guidelines if any abnormalities are identified. There is no evidence that HPV affects the ability to have children.

Smoking decreases the immune system’s ability to deal with the HPV virus and therefore may increase the risk of developing abnormal cell changes. 

More information on cervical screening is available on www.timetoscreen.nz/cervical-screening/.