HPV Test: PCR, Genotyping of Types 16 and 18 and Co-Testing

Human papillomavirus (HPV) is one of the most common infections: most sexually active people encounter it at some point, and in most cases the body clears the virus on its own within 1–2 years. The HPV test is not there to scare you but to catch in time the types that, with long persistence, raise the risk of cervical cancer. Let's sort out how this test works, what genotyping and co-testing are, and how to read the result.

What the HPV Test Shows

The main HPV test is a PCR that finds the virus's DNA in a sample from the cervical canal (in women) or the urethra. There are over 200 HPV types; some cause skin warts and papillomas (low oncogenic risk), while about 14 types are high-risk — and it is these the doctor cares about in cervical cancer screening. So the modern test looks not for "the virus in general" but for a specific group of dangerous types. More on the virus itself, its types and prevention is in the article on HPV and cancer risk.

PCR and Genotyping: Why 16 and 18 Are Singled Out

A simple qualitative test answers "is high-risk HPV present or not". The extended option — genotyping — shows which types exactly were found. Types 16 and 18 are almost always singled out, because they account for about 70% of cervical cancers. Knowing the specific type changes the approach: with 16 or 18 monitoring is usually stricter than with other high-risk types. A quantitative (viral load) version helps track the trend on repeat testing.

Co-Testing: HPV Together With Cytology

The most informative screening approach is co-testing: high-risk HPV is taken together with cytology (a Pap test or liquid-based cytology), which assesses the cervical cells themselves. The logic is simple: the HPV test shows the presence of a risk-factor virus, while cytology shows whether cell changes are already there. Their combination is more accurate than either test alone and allows less frequent but more reliable monitoring of cervical health. Screening intervals after a negative co-test are usually longer than with cytology alone.

What a Positive Result Means

A positive high-risk HPV is not a cancer diagnosis and not even necessarily pre-cancer. It means a risk-factor virus was found and the cervix needs monitoring. With normal cytology and high-risk HPV, a repeat in 6–12 months is usually advised — often the virus clears on its own by then. With types 16/18 or abnormal cytology the doctor arranges colposcopy. There is no need to panic over a positive result, but it should not be ignored either — monitoring matters.

How and When to Test

For women HPV screening usually begins at a certain age and is repeated on a schedule set by the gynaecologist; the sample is taken from the cervical canal, preferably not during menstruation. Men are not routinely HPV-screened, but the test may be ordered for anogenital warts or as part of a couple's work-up. HPV is often tested as part of a panel of sexually transmitted infections — HIV and hepatitis are checked alongside, and the overall STI picture is covered in the article on STI symptoms and tests.

What to Do Next

If the result is unclear, you can upload the report for decoding — the service explains what the detected types and cytology mean in plain language. But the plan — the monitoring interval, the need for colposcopy — is always set by a doctor based on the combination of HPV test and cytology. Vaccination helps lower the risk of infection with high-risk types: how it works and at what age it is effective is covered in the material on the HPV vaccine.

This article is for informational purposes only and does not replace a doctor's consultation. HPV test and cytology results are interpreted by a specialist in the context of the virus type and clinical picture.