Understanding HPV test results

Screening tests first show whether you have HPV. These results are usually available within 1-2 weeks.

Around 90% of people screened will NOT have HPV found and can just continue to have regular screening. This will usually be 5-yearly (or 3-yearly if immune deficient).

About 10% of people screened will have HPV found. This does NOT mean you have cancer. It may mean there is a risk of already having or developing precancerous cell changes on your cervix, so further checks are important. 

The next steps will depend on what type of HPV is found. These follow up tests check for any cell changes on your cervix. 

Let’s look at what the results mean.

HPV not detected

If HPV isn't found in your sample, you won't need to have another screening test for 5 years (or 3 years if you are immune deficient). 

HPV 16 or HPV 18 

There are many different types of HPV. Some strains are more likely to persist and may lead to cervical cancer. If HPV types 16 or 18 are found (the 2 highest-risk types) you'll be referred for colposcopy to check for cell changes. 

This examination is done by a specialist colposcopist who uses a microscope to magnify and sometimes takes samples from your cervix. Most people who have HPV 16 or 18 will not have any cell changes, but it is important to check. 

HPV Other (type/number may be stated) 

If one of the 'Other' types of HPV is found, and your test was done as a vaginal swab, you will be asked to go back to your healthcare provider to have a cervical sample taken (previously known as a smear test). This will be sent to the laboratory and tested for any cell changes (cytology).

If you choose to have a cervical sample taken (rather than a swab test) you won't need to come back for this second appointment. The sample will be used to check for cell changes. 

Depending on what type of cell changes are found you may then be referred for colposcopy. 

Invalid or unsuitable for analysis

Very occasionally an HPV swab sample won't be able to be used for testing. You will be told if your test is unusable, so you can repeat it. 

Understanding Cytology test results 

Cytology screening (looking at cells under a microscope) looks for changes in the cells on the surface of the cervix. if you have a cervical cell sample taken and a cytology result is reported as well as HPV, the results are more complex. 

The cytology results that may be reported are: 

Normal cytology results (a negative result) 

No cell changes were detected. Future follow-up will depend on your screening history. 

Unsatisfactory results mean that the test could not be read at the laboratory because there were not enough cells in the sample, or blood or mucus hid most of the cells. You will need to have another test within three months. 

Inflammation or infection 

Occasionally your test result may show that inflammation or infection is present. 

Discuss this result with your healthcare provider. Often no treatment is required. 

Atypical changes 

This means it is difficult to be sure whether cell changes are starting to develop. mild atypical changes (called ASC-US or atypical squamous cell of undetermined significance) often clear up before your next test. 

Mild (low-grade) changes (LSIL)

This means the cells are beginning to show some mild changes. LSIL (or low-grade squamous intraepithelial lesions) are due to an HPV infection. 

These usually clear up on their own, so your next screening test may be normal. If it's not, you may be referred for colposcopy. This will depend on your age and how many times HPV has been detected in your screens. Your healthcare provider will discuss this with you and confirm if you need to have another screening test in 1 year, or be referred to a specialist. 

Moderate to severe (high-grade change (HSIL) 

High grade changes are cell changes that are more developed. They're called high-grade squamous intraepithelial lesions (HSIL). This doesn't mean cancer (most people will have cell changes that can be successfully treated), but you'll need colposcopy to check. 

Most cell changes are either LSIL or HSIL. Occasionally there are glandular cell changes, which are also regarded as a high-grade change requiring further investigation. 

You may be recommended for further tests or treatment following your cervical screening results. Your healthcare provider will explain why you need any follow-up procedures and what they will involve. 

Cancer 

If you smear test shows any changes suggestive of cervical cancer, you will be referred to a specialist within 1 week. The sooner this is treated, the better the chances of success. It's important for you to go to your appointment.