What is high risk HPV?


HPV, or human papillomavirus, is a very common virus that can infect the skin and mucous membranes of the body. There are more than 100 different types of HPV. Some types are considered low-risk and cause conditions like genital warts. Others are called high-risk HPV because they can cause cancer.

High-risk HPV infections can affect the cervix, vagina, vulva, penis, anus, and throat. Most infections go away on their own, but some persist and lead to abnormal cell changes that can become cancer over time.

How do doctors test for high-risk HPV?

When doctors order an HPV test, it is usually designed to detect the high-risk types of HPV that are linked to cancer. The most important of these are HPV-16 and HPV-18, which together cause the majority of cervical cancers. Other high-risk types include HPV-31, 33, 45, 52, and 58.

How does high-risk HPV cause cancer?

High-risk HPV types produce proteins that interfere with the normal controls of cell growth. These viral proteins can turn off important tumor suppressor genes, such as p53 and Rb, which normally prevent cells from growing out of control. Over time, this can lead to precancerous changes and eventually cancer if the infection is not cleared.

Which cancers are associated with high-risk HPV?

High-risk HPV is linked to several cancers, including:

  • Cervical cancer (the most common HPV-related cancer).

  • Anal cancer.

  • Cancers of the vulva, vagina, and penis.

  • Head and neck cancers, especially oropharyngeal cancer in the throat and sinonasal tract.

Not everyone with high-risk HPV will develop cancer. In fact, most infections clear naturally. However, persistent infection increases the risk.

What is the risk of developing cancer with high-risk HPV?

Most people who get high-risk HPV will never develop cancer. In fact, the majority of infections are cleared by the immune system within one to two years. The risk comes from infections that do not go away and become persistent. These long-lasting infections can cause precancerous cell changes that, if left untreated, may develop into cancer over many years.

The exact risk depends on the type of HPV and other factors such as smoking, immune system health, and whether regular screening is performed. For example, persistent infection with HPV-16 or HPV-18 carries the highest risk for cervical cancer. This is why HPV testing and Pap tests are so important—they can detect problems before cancer develops.

How is high-risk HPV transmitted?

High-risk HPV is spread through intimate skin-to-skin contact, most often during sexual activity. The virus can be passed through vaginal, anal, or oral sex, even if there are no symptoms. Because HPV is very common, most sexually active people will be exposed at some point in their lives.

Condoms can reduce the risk of HPV transmission, but they do not completely prevent it because HPV can infect areas not covered by a condom. The HPV vaccine is the best way to protect against persistent infection from the most dangerous HPV types.

Who should be tested for high-risk HPV?

The HPV test is mainly used as a screening tool to help prevent cervical cancer. Screening means looking for a disease before there are any symptoms, with the goal of finding problems early, when treatment is most effective.

Guidelines for HPV testing vary by country and region, but in general:

  • Women aged 25 to 65 should undergo regular screening with either an HPV test, Pap test, or both together (co-testing), depending on local guidelines.

  • The HPV test may be recommended if a Pap test result is unclear or abnormal.

  • Routine HPV testing is not recommended for people under age 25 because infections are very common and usually temporary in younger age groups.

How is the test performed?

The test is usually done during a routine pelvic exam:

  • A small brush or swab is used to collect cells from the surface of the cervix.

  • The sample is sent to the laboratory where specialized techniques look for high-risk HPV DNA or RNA.

The test is quick and may cause mild discomfort but is generally well tolerated.

How are high-risk HPV results reported?

In your pathology report, results may be described as:

  • Negative for high-risk HPV: No high-risk HPV types were detected.

  • Positive for high-risk HPV: One or more high-risk HPV types were detected. The report may specify HPV-16, HPV-18, or another high-risk type.

  • Inconclusive or inadequate: The sample did not have enough cells to complete the test and may need to be repeated.

Can high-risk HPV be prevented?

Yes. The HPV vaccine is highly effective at preventing infection from the most dangerous HPV types, including HPV-16 and HPV-18. The vaccine works best when given before exposure to HPV, which is why it is recommended for children and young adults. Using condoms also lowers the risk of transmission, but it does not eliminate it completely.

Questions to ask your doctor

  • Was my HPV test positive for high-risk types?

  • Which type of HPV was found, and what does it mean for my risk of cancer?

  • Do I need a follow-up test, colposcopy, or treatment?

  • How often should I continue HPV or Pap testing?

  • Would the HPV vaccine still be helpful for me?

A+ A A-