Routine HPV testing divides opinion amongst experts. There are over 100 subtypes of HPV and most do not cause significant disease in humans. However, there are 13 “high risk” types, which are to be found in 100% of cervical cancers thus confirming the pivotal role of the virus in the development of the disease. HPV testing can be carried out on the same sample as a liquid cytology smear. The result will often only state whether or not there is a high-risk HPV type present. Just as much as little is worked out about how to manage a positive result, even less is known about the long-term significance of a negative one. This is in part due to the fact that the expression of the virus depends on one’s immune system at any one point. Interpretation of the results should therefore be with care, as they can have social consequences beyond those envisaged! A decision on whether or not to have the test in addition to smears needs to be well informed. Further Reading www.cancerscreening.nhs.uk/cervical/hpv.html www.cancerscreening.nhs.uk/cervical/hpv-factsheets.pdf
