Getting an HPV test, Which Test

We know that the Human Papilloma Virus (HPV) has almost 100 different types or "cousin" virus out there. And many are either completely harmless or virtually never seen in people. You can be tested for this virus.
Video Colposcopy at Women's Health Practice
There are tests, and there are new developing tests for this virus out there and deciding when to have the test is an important decision for women. Prior to 2006 there were some HPV tests but not specific HPV typing available. Now there are some HPV specific tests available. The company Quiagen has been testing for 13 different HR type of viruses. Now there is also a test for HPV 16 and 18. Their HC2 HPV test turns positive at about 5000 viral copies. Low levels of virus carrier rates aren't always able to be detected. So even if your prior positive tests have turned negative, it's tough to say you have really cleared the virus for all time, and it's harder still to say if you have developed enough immunity to then prevent picking up that virus again if you are someone who had HPV disease but then cleared. The National Cancer Institute estimates that about 1 in 5 women who test positive for HPV 16 or 18 will develop the severe dysplasia that is the step before invasive cancer. About 70-75% of all cervical cancers are caused by HPV 16 or 18, and many women are infected with both viruses. The HPV test is an important test. The HPV virus is the disease causing agent. A pap smear detects the disease. So we should be able to find women who still have a normal pap, but actually have disease in their cervix because they have HPV detected by testing. Whether you get an HPV test for just 16 and 18 vs an HPV test for the other types of viruses has been somewhat controversial. Most gynos will only repeat your pap test if just the test for only HR viruses is positive, but if you test positive for the 16 and 18 physicians recommend going to colposcopy (microscope check with biopsy of the cervix). So far GenPath Diagnostics is the newest company to offer HPV testing and their tests include HPV 6,11,31, 45, 16 and 18. Whether this will help your physician make that decision as to whether to do the colposcopy now or whether to schedule you for a follow up pap smear, is difficult to say as it's a new test that people are using.
Women under the age of 30 are not generally recommended to get these tests. When we pick treatment strategies we like to think that we are giving patients a permanent  cure, and we are trying to cure the precancerous changes. And if you are the patient it's natural to believe you have been cured.  So if you have been diagnosed with CIN III also known as carcinoma-in-situ, a pre-invasive cervical condition due to HPV what is the risk of not treating and what is your risk if you have been treated. In general we say there is about a 2% chance that the condition will progress to invasive cervical disease each year if you do not treat. If you treat, and have complete excision, the risk becomes almost negligible, but it's still there. It's about a 3-4/1000 chance (0.3-0.4%) that the disease will progress to invasive cancer. So essentially, the principal still holds, prevention is far superior to treatment. We lowere our risks considerably by getting the treatment. What we do not cure in all these cases is the actual infection with that inciting agent of the HPV (Human Papilloma Virus) , thus the risk persists if you are someone who still has infection after a treatment for dysplasia, such as a LEEP procedure. You may be someone who could benefit from being tested.

For more on how to know if you have the HPV virus, check older posts including: The Test and the Testiness.


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