Abnormal HPV Test: What to Ask Next

An abnormal HPV test means a high-risk type of HPV was found on your cervix. It does not mean you have cervical cancer. Most people with an abnormal result do not have cancer. What matters most now is understanding what type of follow-up you need and by when.

This page is educational. It is not medical advice and does not suggest a test or treatment.

HPV is extremely common. CDC says the immune system usually clears HPV within two years, without ever causing a problem. Screening exists to catch the smaller number of infections that stick around. Those can slowly cause cell changes. Left unwatched for years, those changes could eventually become cancer. Most abnormal results are an HPV infection or an early cell change. That is something to monitor or treat. It is not cancer itself.

An HPV test on its own has two possible outcomes. A negative result means high-risk HPV was not found. A positive result means a high-risk type was found. That calls for follow-up testing.

A Pap test result works differently. It can come back normal. It can come back unsatisfactory, meaning the sample was not good enough to read. That test needs to be repeated in two to four months. Or it can come back abnormal. Abnormal results range from monitoring to prompt treatment, depending on how serious the changes are. An abnormal Pap result means your cells do not look completely normal. It does not, by itself, say how serious that is.

Modern guidelines do not treat every abnormal result the same way. They weigh your HPV result, your Pap result, your past results, and your age together. The right next step for one combination is not the right step for another. Depending on your combination, your team may recommend:

• repeating HPV testing or cotesting in 1 or 3 years
• moving straight to a colposcopy
• treatment now, if your cells show higher-grade changes

Your own history and situation can change the interval and what is done, so ask how your case differs from the usual pattern.

So the interval that applies to you is the one written on your result letter, not one taken from a page. Ask the clinician who ordered the test for the date, and get it in writing.

A colposcopy uses a colposcope. That is an instrument with a bright light and a magnifying lens. It lets your provider look closely at your cervix for abnormal areas. Your provider may also take a biopsy to check the cells more closely. For high-grade changes, NCI says conization procedures such as LEEP or laser therapy may remove abnormal tissue before it becomes cancer.

Ask your care team:

• whether your result was HPV-positive, Pap-abnormal, or both. The combination is what drives the plan.
• what your prior results showed, if you have been tested before. Your history changes the calculation.
• whether the next step is repeat testing, colposcopy, or treatment.
• exactly when that needs to happen, and who will schedule it.

• What does this mean for my exact result, age, and screening history?
• After my HPV result, what needs to happen now, what can wait, and what should make me call sooner?
• Is there a written plan for my follow-up timing?
• Who do I contact after hours about my HPV result, and what should I have ready?

Do not skip follow-up because you feel fine. Most people who test positive do not have cancer, but your provider recommends follow-up steps so changes can be watched or treated early.

HPV results connect to your overall cervical screening schedule, vaccination history, and colposcopy planning. Related pages: Colonoscopy Prep Questions for Cancer Screening, Lung Screening Nodule Follow-Up Questions.

Your colposcopy or treatment service will give you its own discharge instructions with its own numbers to call. Those come first. Use the list below where you do not have them to hand.

• Call 911 or go to an emergency department if you have any of these after the procedure:

  • bleeding that soaks through a pad in an hour or less and keeps going
  • passing large clots
  • feeling faint, dizzy, or short of breath

  Bleeding at that rate is not something to wait on a clinic call for.

• Call your care team right away if you have any of these after a colposcopy, cervical biopsy or excision (MedlinePlus):

  • bleeding heavier than a period
  • a fever or other signs of infection
  • a foul-smelling discharge
  • new pain in your belly or pelvis

• Call your care team right away if bleeding after the procedure lasts longer than two weeks. Also call within a day or two if the follow-up test you were told to have has not been booked by the date you were given.

• National Cancer Institute — Understanding Abnormal HPV and Pap Test Results.
• MedlinePlus — Colposcopy-directed biopsy.
• Centers for Disease Control and Prevention — Basic Information About HPV and Cancer.