Human Papillomavirus - HPV

Primary Author: Schlaberg, Robert, MD, MPH.

HPV Testing in Women

Screening guidelines

2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer Screening Tests and Cancer Precursors
Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance (Huh, 2015)
Do not perform low-risk HPV testing (Choosing Wisely: 15 Things Physicians and Patients Should Question, American Society of Clinical Pathology, 2016)
Comparison of screening guidelines for average-risk women (CDC, 2012)
ACP Best practice guidelines (ACP, 2015)
Cervical Cancer Screening Recommendations (ASCCP Powerpoint, 2012)
Updated disease management guidelines – algorithms and FAQs
ACS, ASCCP, ASCP Screening Guidelines for the Prevention and Early Detection of Cervical Cancer
Video – Spotlight on Test Utilization: Clinical Performance Comparison of FDA-Cleared HPV Tests (ARUP, Schlaberg, 2013)

Screening recommendations

Women under 21 years of age

HPV Screening Recommendations for Women <21 Years of Age
Screening method of choice	Management of screen results
No cervical cancer screening (cytology or HPV) regardless of risk factors	N/A

Women 21 to under 25 years

HPV Screening Recommendations for Women 21-<25 Years of Age

(Women 21 to under 25 years of age algorithm available)

Screening method of choice

Management of screen results

Cytology (cytology alone or cytology with reflex)

Note: SurePath cytology can be used only if Option 1 will be chosen for ASC-US cytology

Normal cytology

Repeat cytology in 3 years

ASC-US cytology

OPTION 1 – repeat cytology in 1 year
OPTION 2 – hrHPV testing (HPV TMA or HPV PCR)
- HPV negative – return to routine screening (choice of screening based on age; do not initiate next testing until 3 years from last normal or negative test)
- HPV positive – refer to ASCCP consensus guidelines (p. S10)

LSIL or more severe cytology

Refer to ASCCP consensus guidelines (p. S11)

Do not use HPV testing for screening in women <25 years. HPV testing is only appropriate in women <25 years for triaging those with abnormal cytology.

hrHPV = high-risk HPV; ASC-US = atypical squamous cells of undetermined significance; LSIL = low-grade squamous intraepithelial lesion

Women 25 to under 30 years of age

HPV Screening Recommendations for Women 25-<30 Years of Age

(Women 25 to under 30 years of age algorithm available)

Screening method of choice

Management of screen results

OPTION 1 – primary HPV testing (hrHPV with 16 and 18 genotype by PCR) for cervical cancer screening

Note: client should retain aliquot for cytology testing in case of hrHPV positivity

HPV type 16/18 positive – colposcopy

Any of other 12 hrHPV positive – cytology

≥ASC-US – colposcopy
Negative for intraepithelial lesion or malignancy (NILM) – repeat cytology in 1 year

HPV negative – routine screening (choice of screening based on age; do not initiate testing until 3 years from last normal or negative test)

OPTION 2 – cytology (cytology alone or cytology with reflex)

Note: SurePath cytology can be used only if Option 1 will be chosen for ASC-US cytology

Normal cytology – repeat cytology in 3 years

ASC-US cytology

OPTION 1 – repeat cytology in 1 year
- Normal – repeat cytology in 3 years
- ≥ASC-US – refer to ASCCP consensus guidelines (p. S9)
OPTION 2 – hrHPV testing (HPV TMA or HPV PCR)
- HPV negative – return to routine screening (choice of screening based on age; do not initiate next testing until 3 years from last normal or negative test)
- HPV positive – refer to ASCCP consensus guidelines (p. S9)

LSIL or more severe cytology

Refer to ASCCP consensus guidelines (p. S11)

hrHPV = high-risk HPV testing; ASC-US = atypical squamous cells of undetermined significance; NILM = negative for intraepithelial lesion or malignancy; LSIL = low-grade squamous intraepithelial lesion

Women 30 to 65 years of age

HPV Screening Recommendations for Women 30-65 Years of Age

(Women 30 to 65 years of age algorithm available)

Screening method of choice

Management of screen results

OPTION 1 – primary HPV testing (hrHPV with 16 and 18 genotype by PCR) for cervical cancer screening

Note: client should retain aliquot for cytology testing in case of hrHPV positivity

HPV type 16/18 positive – colposcopy

Any of other 12 hrHPV positive – cytology

≥ASC-US – colposcopy
Negative for intraepithelial lesion or malignancy (NILM) – repeat cytology in 1 year

HPV negative – routine screening (choice of screening based on age; do not initiate testing until 3 years from last normal or negative test)

OPTION 2 – co-testing (HPV and cytology)

Order co-testing bundled or cytology and HPV PCR testing individually

Normal cytology and HPV negative

Repeat screening of choice at 5 years

ASC-US cytology and HPV negative

Repeat screening of choice at 3 years

Normal cytology and HPV positive

OPTION 1 – repeat co-testing in 1 year
- If HPV negative – repeat co-testing in 3 years
- If HPV positive – refer to ASCCP consensus guidelines (p. S8)
OPTION 2 – hrHPV with 16 and 18 genotype by PCR
- HPV type 16 /18 positive – colposcopy
- Any of other 12 hrHPV positive – repeat co-testing in 1 year
- HPV negative – repeat co-testing in 1 year

ASC-US cytology and HPV positive

Refer to ASCCP consensus guidelines (p. S9)

LSIL or more severe cytology

Refer to ASCCP consensus guidelines (p. S11)

OPTION 3 – (cytology alone or cytology with reflex)

Note: SurePath cytology can be used only if Option 1 will be chosen for ASC-US cytology

Normal cytology

Repeat cytology in 3 years

ASC-US cytology

OPTION 1 – repeat cytology in 1 year
- Normal – repeat cytology in 3 years
- ≥ASC-US – refer to ASCCP consensus guidelines (p. S9)
OPTION 2 – hrHPV testing (HPV TMA or HPV PCR)
- HPV negative – return to routine screening (choice of screening based on age; do not initiate next testing until 3 years from last normal or negative test)
- HPV positive – refer to ASCCP consensus guidelines (p. S9)

LSIL or more severe cytology

Refer to ASCCP consensus guidelines (p. S11)

Women over 65 years of age

HPV Screening Recommendations for Women >65 Years of Age (Women over 65 years of age algorithm available)
Screening method of choice	Management of screen results
Prior screening was adequate and negative*	No further screening
Prior screening inadequate – perform co-testing (HPV and cytology) Order co-testing bundled or cytology and HPV PCR testing individually	Normal cytology and HPV negative Screen as per 30-65 year olds until adequate screening definition fulfilled ASC-US cytology and HPV negative Recommend additional surveillance with repeat screening in 1 year Preferred – co-testing Acceptable – cytology (cytology or cytology with reflex) OR HPV PCR Normal cytology and HPV positive OPTION 1 – repeat co-testing in 1 year If negative – repeat co-testing in 3 years If positive – refer to ASCCP consensus guidelines (p. S8) OPTION 2 – hrHPV with 16 and 18 genotype by PCR specific detection HPV type 16 /18 positive – colposcopy Any of other 12 hrHPV positive – repeat co-testing in 1 year HPV negative – repeat co-testing in 1 year ASC-US cytology and HPV positive Refer to ASCCP consensus guidelines (p. S9) LSIL or more severe cytology Refer to ASCCP consensus guidelines (p. S11)
History of ≥CIN2+	Use screening based on schedule for 30-65 year olds; screen for at least 20 years after positive CIN2 test
*Adequate screening: 3 consecutive negative cytology results or 2 consecutive negative co-testing results within the last 10 years; most recent of either tests must be within the past 5 years hrHPV = high-risk HPV testing; ASC-US = atypical squamous cells of undetermined significance; NILM = negative for intraepithelial lesion or malignancy

Post hysterectomy

Screening method of choice	Management of screen results
No history of CIN2+	No screening

Post HPV vaccination

Screening method of choice	Management of screen results
Use age-based screening recommendations in the tables above	Use age-based recommendations in the tables above

HPV screening algorithms

HPV Testing in Men

Summary of recommendations

Screening for anal cancer is not routinely recommended for men (CDC)
- HPV testing is not currently recommended for anal cancer screening
- No HPV test is approved by the FDA for testing of men
- Some experts recommend yearly anal cancer screening by cytology ("anal Pap") for homosexual, bisexual, and HIV-positive men (anal cancer is more common in these populations)
HPV is associated with the development of penile cancer
- Screening tests are not available for penile cancer

Indications for Testing

Refer to Key Points tab
Disease management guidelines available from the American Society for Colposcopy and Cervical Pathology (ASCCP)

Laboratory Testing

Refer to Key Points tab

Human Papillomavirus Screening Recommendations Women 21 to under 25 Years of Age Algorithm

Read more about Human Papillomavirus Screening Recommendations Women 21 to under 25 Years of Age Algorithm

Human Papillomavirus Screening Recommendations Women 25 to under 30 Years of Age Algorithm

Read more about Human Papillomavirus Screening Recommendations Women 25 to under 30 Years of Age Algorithm

Human Papillomavirus Screening Recommendations Women 30-65 Years of Age Algorithm

Read more about Human Papillomavirus Screening Recommendations Women 30-65 Years of Age Algorithm

Human Papillomavirus Screening Recommendations Women older than 65 Years of Age Algorithm

Read more about Human Papillomavirus Screening Recommendations Women older than 65 Years of Age Algorithm

Refer to Key Points tab

Human papillomavirus (HPV) is the most common sexually transmitted viral infection.

Epidemiology

Incidence – 20 million currently infected in the U.S.
Transmission – sexual contact (vaginal, oral, anal)

Organism

DNA virus
Multiple genotypes (>100) of varying infectivity
- >30 types are sexually transmitted
Etiologic agent for most cases of cervical cancer

Pathophysiology

Persistent infection with oncogenic (high-risk) HPV genotypes associated with increased risk for developing high-grade dysplasia and cervical, vulvar, or vaginal carcinoma
- Also a risk factor for anal, penile, and oropharyngeal carcinoma
Most women infected with high-risk genital HPV do not develop cancer; they clear the infection, usually within 2 years

Clinical Presentation

Frequently asymptomatic
Abnormal Pap smear
Complications – cervical, vaginal, vulvar carcinoma

Prevention

HPV vaccine – recommended for males and females 9-26 years in 3 doses

Tests generally appear in the order most useful for common clinical situations. Click on number for test-specific information in the ARUP Laboratory Test Directory.

Cytology, ThinPrep Pap Test and Human Papillomavirus (HPV), High Risk, E6/E7 mRNA by Transcription-Mediated Amplification (TMA) (for routine co-testing in women over 30) 2000136
Method: Microscopy/Qualitative Transcription-mediated Amplification

Recommended Use

Preferred FDA-approved test for 5-year interval testing (co-testing) in women ≥30 years

Triage women with equivocal and mildly abnormal cervical cytology

Limitations

Test has an inherent false-negative rate

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV), High Risk with 16 and 18 Genotype by PCR, ThinPrep 2011940
Method: Qualitative Polymerase Chain Reaction

Recommended Use

FDA-approved platform for primary HPV screening in women ≥ 25 years

FDA-approved test for routine cervical cancer screening in combination with cervical cytology (Pap smear) in women ≥ 30 years

Follow-up test for abnormal cytology results in women ≥ 21 years

Test amplifies DNA of HPV16, HPV18 and 12 other high-risk HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) associated with cervical cancer and its precursor lesions

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV), High Risk by Transcription-Mediated Amplification (TMA) with Reflex to HPV Genotypes 16 and 18/45 by TMA, ThinPrep 2007890
Method: Qualitative Transcription-Mediated Amplification

Recommended Use

FDA-approved test for routine cervical cancer screening in combination with cervical cytology (Pap smear) in women ≥30 years; genotyping performed for triaging women to colposcopy who are cytology-negative (NILM) and HPV-positive

Reflex pattern – if Human Papillomavirus (HPV), high risk is positive, then HPV genotypes 16, 18/45 will be added

Follow-up

Refer to Key Points tab

Cytology, ThinPrep Pap Test with Reflex to Human Papillomavirus (HPV), High Risk, E6/E7 mRNA by Transcription-Mediated Amplification (TMA) 2000138
Method: Microscopy/Qualitative Transcription-mediated Amplification

Recommended Use

Preferred FDA-approved test for routine cervical cancer screening in women 21-<25 years

An option for 3-year cervical cancer screening intervals in women 25-65 years

For preferred co-testing panel, refer to cytology ThinPrep Pap test and hrHPV by TMA

Reflex pattern – if the ThinPrep Pap test is interpreted as atypical squamous cells of undetermined significance (ASC-US), then Human Papillomavirus (HPV), high risk, E6/E7 mRNA by transcription-mediated amplification (TMA) will be added

Limitations

Test has an inherent false-negative rate

Follow-up

Refer to Key Points tab

Cytology, SurePath Liquid-Based Pap Test 2000134
Method: Microscopy

Recommended Use

May be used for routine 3-year interval cervical cancer screening test in all women

For 5-year interval testing (co-test) in women 30-65 years, order with HPV test (hrHPV PCR, SurePath or HPV 16 and 18 genotype PCR, SurePath)

Test does not include HPV testing

Limitations

Test has an inherent false-negative rate

Follow-up

Refer to Key Points tab

Cytology, ThinPrep Pap Test 2000137
Method: ThinPrep 2000 System/Routine Cytopathologic Evaluation

Recommended Use

May be used for routine 3-year interval cervical cancer screening test in all women ≥21 years

For 5-year interval testing (co-test) in women 30-65 years, order with HPV ThinPrep test (hrHPV PCR, ThinPrep or hrHPV by TMA, ThinPrep)

Limitations

Test has an inherent false-negative rate

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV), High Risk by Transcription-Mediated Amplification (TMA), ThinPrep 2007893
Method: Qualitative Transcription-Mediated Amplification

Recommended Use

FDA-approved test for routine cervical cancer screening in combination with cervical cytology (Pap smear) in women ≥30 years

Follow-up test for abnormal cytology results in women ≥21 years

Detects E6/E7 viral messenger RNA of the high-risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 associated with cervical cancer and its precursor lesions

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV), High Risk by PCR, ThinPrep 2011947
Method: Qualitative Polymerase Chain Reaction

Recommended Use

FDA-approved test for routine cervical cancer screening in combination with cervical cytology (Pap smear) for women ≥30 years

Follow-up test for abnormal cytology results in women ≥21 years

Follow up ASC-US cytology in women ≥30

Does not include reflex to genotype

Test amplifies DNA of 14 high-risk HPV types associated with cervical cancer and its precursor lesions (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68)

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV) Genotypes 16 and 18/45 by Transcription-Mediated Amplification (TMA), ThinPrep 2007894
Method: Qualitative Transcription-Mediated Amplification

Recommended Use

FDA-approved test for triaging women ≥30 years with negative cervical cytology (NILM Pap smear) and positive HPV test

Detects E6/E7 viral messenger RNA of the high-risk HPV types 16, 18, and 45 only

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV), High Risk with 16 and 18 Genotype by PCR, SurePath 2011933
Method: Qualitative Polymerase Chain Reaction

Recommended Use

FDA-approved test for routine cervical cancer screening in combination with cervical cytology (Pap smear) for women ≥ 30 years

Follow-up test for abnormal cytology results in women ≥ 21 years

Test amplifies DNA of HPV16, HPV18 and 12 other high-risk HPV types (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) associated with cervical cancer and its precursor lesions

Follow-up

Refer to Key Points tab

Human Papillomavirus (HPV), High Risk by PCR, SurePath 2011942
Method: Qualitative Polymerase Chain Reaction

Recommended Use

FDA-approved test for routine cervical cancer screening in combination with cervical cytology (Pap smear) for women ≥ 30 years

Follow-up test for abnormal cytology results in women ≥ 21 years

Test amplifies DNA of 14 high-risk HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) associated with cervical cancer and its precursor lesions

Follow-up

Refer to Key Points tab

Guidelines

Apgar BS, Kittendorf AL, Bettcher CM, Wong J, Kaufman AJ. Update on ASCCP consensus guidelines for abnormal cervical screening tests and cervical histology. Am Fam Physician. 2009; 80(2): 147-55. PubMed

Choosing Wisely. An initiative of the ABIM Foundation. [Accessed: Jan 2017]

Huh WK, Ault KA, Chelmow D, Davey DD, Goulart RA, Garcia FA, Kinney WK, Massad S, Mayeaux EJ, Saslow D, Schiffman M, Wentzensen N, Lawson HW, Einstein MH. Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance. Gynecol Oncol. 2015; 136(2): 178-82. PubMed

Manual for the Surveillance of Vaccine-Preventable Diseases . Centers for Disease Control and Prevention. Atlanta, GA [Last updated Apr 2014; Accessed: Feb 2017]

Massad S, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M, Solomon D, Wentzensen N, Lawson HW, 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol. 2013; 121(4): 829-46. PubMed

Moyer VA, U.S. Preventive Services Task Force. Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012; 156(12): 880-91, W312. PubMed

Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FA, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki A, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER, ACS-ASCCP-ASCP Cervical Cancer Guideline Committee. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2012; 62(3): 147-72. PubMed

Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FA, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS, Spitzer M, Moscicki A, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER, American Cancer Society, American Society for Colposcopy and Cervical Pathology, American Society for Clinical Pathology. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol. 2012; 137(4): 516-42. PubMed

Sawaya GF, Kulasingam S, Denberg TD, Qaseem A, Clinical Guidelines Committee of American College of Physicians. Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians. Ann Intern Med. 2015; 162(12): 851-9. PubMed

Smith RA, Manassaram-Baptiste D, Brooks D, Doroshenk M, Fedewa S, Saslow D, Brawley OW, Wender R. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening. CA Cancer J Clin. 2015; 65(1): 30-54. PubMed

Wright TC, Massad S, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D, 2006 American Society for Colposcopy and Cervical Pathology-sponsored Consensus Conference. 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests Am J Obstet Gynecol. 2007; 197(4): 346-55. PubMed

General References

Arbyn M, Roelens J, Cuschieri K, Cuzick J, Szarewski A, Ratnam S, Reuschenbach M, Belinson S, Belinson JL, Monsonego J. The APTIMA HPV assay versus the Hybrid Capture 2 test in triage of women with ASC-US or LSIL cervical cytology: a meta-analysis of the diagnostic accuracy. Int J Cancer. 2013; 132(1): 101-8. PubMed

Jarboe EA, Hunt JP, Layfield LJ. Cytomorphologic diagnosis and HPV testing of metastatic and primary oropharyngeal squamous cell carcinomas: a review and summary of the literature. Diagn Cytopathol. 2012; 40(6): 491-7. PubMed

Laudadio J. Human papillomavirus detection: testing methodologies and their clinical utility in cervical cancer screening. Adv Anat Pathol. 2013; 20(3): 158-67. PubMed

Pyne MT, Hamula CL, Tardif K, Law C, Schlaberg R. High-risk HPV detection and genotyping by APTIMA HPV using cervical samples. J Virol Methods. 2015; 221: 95-9. PubMed

Schiffman M, Solomon D. Clinical practice. Cervical-cancer screening with human papillomavirus and cytologic cotesting. N Engl J Med. 2013; 369(24): 2324-31. PubMed

Solomon D, Papillo JL, Davey DD, Cytopathology Education and Technology Consortium. Statement on HPV DNA test utilization. Am J Clin Pathol. 2009; 131(6): 768-9; discussion 770-3. PubMed

Wentzensen N, Doeberitz Mv. Biomarkers in cervical cancer screening. Dis Markers. 2007; 23(4): 315-30. PubMed

References from the ARUP Institute for Clinical and Experimental Pathology®

Erali M, Pattison DC, Wittwer CT, Petti CA. Human papillomavirus genotyping using an automated film-based chip array. J Mol Diagn. 2009; 11(5): 439-45. PubMed

Holladay B, Logan S, Arnold J, Knesel B, Smith D. A comparison of the clinical utility of p16(INK4a) immunolocalization with the presence of human papillomavirus by hybrid capture 2 for the detection of cervical dysplasia/neoplasia. Cancer. 2006; 108(6): 451-61. PubMed

Layfield LJ, Qureshi N. HPV DNA testing in the triage of atypical squamous cells of undetermined significance (ASCUS): cost comparison of two methods. Diagn Cytopathol. 2005; 33(2): 138-43. PubMed

Pyne MT, Hamula CL, Tardif K, Law C, Schlaberg R. High-risk HPV detection and genotyping by APTIMA HPV using cervical samples. J Virol Methods. 2015; 221: 95-9. PubMed

Pyne MT, Law C, Hillyard DR, Schlaberg R. Testing and genotyping of high-risk human papillomavirus by the cobas HPV Test and the Hybrid Capture 2 high-risk HPV DNA test using cervical and vaginal samples. J Clin Microbiol. 2014; 52(5): 1720-3. PubMed

Renshaw AA, Mody DR, Walsh M, Bentz JS, Colgan TJ, Cytopathology Resource Committee, College of American Pathologists. The significance of certification in liquid-based cytology and performance in the college of american pathologists interlaboratory comparison program in cervicovaginal cytopathology. Arch Pathol Lab Med. 2006; 130(9): 1269-72. PubMed

Rowe LR, Aldeen W, Bentz JS. Prevalence and typing of HPV DNA by hybrid capture II in women with ASCUS, ASC-H, LSIL, and AGC on ThinPrep Pap tests. Diagn Cytopathol. 2004; 30(6): 426-32. PubMed

Tardif KD, Pyne MT, Malmberg E, Lunt TC, Schlaberg R. Cervical Cytology Specimen Stability in Surepath Preservative and Analytical Sensitivity for HPV Testing with the cobas and Hybrid Capture 2 Tests. PLoS One. 2016; 11(2): e0149611. PubMed

Tardif KD, Simmon KE, Kommedal O, Pyne MT, Schlaberg R. Sequencing-based genotyping of mixed human papillomavirus infections by use of RipSeq software. J Clin Microbiol. 2013; 51(4): 1278-80. PubMed

Wilson AR, Welch RJ, Hashibe M, Greenwood J, Jackson B, She RC. Surveillance of human papilloma virus using reference laboratory data for the purpose of evaluating vaccine impact. Online J Public Health Inform. 2014; 6(3): e194. PubMed

Witt BL, Factor RE, Jarboe EA, Layfield LJ. Negative loop electrosurgical cone biopsy finding following a biopsy diagnosis of high-grade squamous intraepithelial lesion: frequency and clinical significance. Arch Pathol Lab Med. 2012; 136(10): 1259-61. PubMed

Medical Reviewers

Chadwick, Barbara E., MD, Medical Director, Cytology, and Staff Pathologist, Surgical Pathology at ARUP Laboratories; Assistant Professor of Anatomic Pathology, University of Utah

Gopez, Evelyn V., MD, Staff Cytopathologist at ARUP Laboratories; Associate Dean, Inclusion and Outreach, School of Medicine; Professor of Clinical Pathology, University of Utah

Schlaberg, Robert, MD, MPH, Medical Director, Microbial Amplified Detection, Virology, and Fecal Chemistry; and Assistant Medical Director, Virology and Molecular Infectious Disease at ARUP Laboratories; Assistant Professor of Clinical Pathology, University of Utah

Cervical Cancer

Head and Neck Cancer

Sexually Transmitted Infections

Treponema pallidum - Syphilis

Tumor Markers

HPV Testing for Cervical Cancer Screening -- Robert Schlaberg, MD, MPH (51 min)

Spotlight on Test Utilization: Clinical Performance Comparison of FDA-Cleared HPV Tests - Robert Schlaberg, MD, MPH (5 min)

Spotlight on Test Utilization: HPV Testing for Cervical Cancer Screening -- Robert Schlaberg, MD, MPH (4 min)

Schlaberg

Last Update: May 2017


	Chadwick B, Gopez E, Schlaberg R. Human Papillomavirus - HPV. ARUP Consult^©. Retrieved May 27, 2017, from: https://arupconsult.com/content/human-papillomavirus

Search form

Human Papillomavirus - HPV

HPV Testing in Women

Screening guidelines

Screening recommendations

HPV screening algorithms

HPV Testing in Men

Indications for Testing

Laboratory Testing

Human Papillomavirus Screening Recommendations Women 21 to under 25 Years of Age Algorithm

Human Papillomavirus Screening Recommendations Women 25 to under 30 Years of Age Algorithm

Human Papillomavirus Screening Recommendations Women 30-65 Years of Age Algorithm

Human Papillomavirus Screening Recommendations Women older than 65 Years of Age Algorithm

Epidemiology

Organism

Pathophysiology

Clinical Presentation

Prevention

Guidelines

General References

References from the ARUP Institute for Clinical and Experimental Pathology®

Medical Reviewers

Feedback