How to Get the HPV Test

Women Under Age 30 Women Over Age 30

I was persistent and kept repeating that I wanted
the HPV test for "extra peace of mind."

Read Frances Masterman's story
So, you've decided that you want to take every step possible to make sure you do not get cervical cancer.

Most doctors will honor your wishes on issues such as this. If not, remember that you are the one who is ultimately responsible for your health. You need to decide how important it is to have a healthcare provider who partners with you.

Here are some tips to ensure you get the HPV test:

* Arm yourself with the facts about cervical cancer, HPV and the HPV test. Read the information in this Web site thoroughly. Doctors' offices are very tight on time these days, and they will be more receptive to your requests if they can tell you have "done your homework."
* Call your doctor's or nurse's office before your next exam to find out if the HPV test is offered as part of routine screening for cervical cancer, along with the Pap. Remember: Make sure the office understands that you want the HPV test no matter what the Pap shows. Some doctors and nurses only order an HPV test when your Pap results are inconclusive (called an "ASC-US" Pap).
* If your doctor or nurse says the office does not order HPV testing for all of its female patients who are 30 and older, indicate you'd like them to make an exception for you.
* If your doctor or nurse (or the office staff) responds by saying he/she doesn't think routine HPV testing is necessary, the simplest way to respond is to say that you would still like to have the test "for my extra peace of mind."
* Follow up on test results. Keep calling until you receive an answer regarding your test results.


Do you need to ask your doctor or nurse for the HPV test?

It's a good idea to ask your doctor or nurse for the HPV test. That's because some healthcare providers do not yet order the HPV test as part of routine cervical cancer screening, or offer it only if you ask for it. However, most laboratories can do the HPV test if your doctor or nurse requests it.
Why your doctor or nurse might not automatically order the HPV test for you – and what you should do about it …

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Unaware of approval of HPV test for routine screening.
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Thinks the Pap is good enough.
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Concerned the test will unnecessarily alarm you.
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Afraid you won't return for your annual visit if HPV testing shows you don't need yearly cervical cancer screening.
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Believes HPV testing might result in the need for unnecessary further procedures.

Some doctors and nurses are not aware that the U.S. Food and Drug Administration (FDA) has approved the HPV test for use along with the Pap for routine screening of women age 30 years and older. Some still believe that the HPV test should only be given to women if their Pap test results are unclear (called an "ASC-US" Pap). Still others simply aren't familiar with the data supporting the value of the HPV test for routine screening. Medical practice takes a while to change.

Share with your doctor or nurse the recent publication on HPV and HPV testing issued by the American Association of Reproductive Health Professionals.

Other healthcare professionals may actually recommend against routine HPV testing because they believe that although the Pap may not be perfect, it is good enough.

Respond that you know the Pap test catches many women with pre-cancerous cells, but that you would feel even more confident if you took an additional step and got the HPV test. You may want to refer your doctor or nurse to the April 2006 issue of the International Journal of Cancer ("Overview of the European and North American studies on HPV testing in primary cervical cancer screening"). This analysis of 11 studies involving more than 60,000 women documented that the HPV test is a more sensitive tool for cervical cancer screening than the Pap alone.

Your healthcare provider may worry that you will be unnecessarily anxious or alarmed if you find out you have a high-risk (potentially cancer–causing) type of the virus. After all, most women fight off the infection before it causes any problems.

Assure your doctor or nurse that you have researched the subject, and that you see the HPV test as a way to increase your peace of mind. Your healthcare provider will be more likely to feel comfortable ordering the test for you if he or she knows you already are educated on the virus and HPV testing. Show him or her the brochure (PDF) on HPV testing, available on this Web site, as evidence that you have educated yourself and know what to expect.

Some doctors and nurses fear that once women learn they do not have HPV, and thus only need another HPV and Pap test every three years, they will not come back for an annual office visit.

Communicate to your doctor or nurse that you understand the need for regular health checks – such as a breast exam – regardless of your HPV status. You can demonstrate this commitment by scheduling your next visit well in advance.

Some healthcare providers may believe the HPV test could result in the need for other, unnecessary procedures (such as a biopsy to remove cervical tissue for analysis).

Respond that you'd rather take the chance of having an extra exam that turns out to be normal, than to risk doing nothing until cervical cancer develops. You also might want to refer your doctor or nurse to an article in the October 2007 issue of the American Journal of Obstetrics & Gynecology titled "Consensus Guidelines for the Management of Women with Abnormal Cervical Cancer Screening Tests." One of the topics covered is how to manage the care of women who have HPV, but whose Pap results are normal or inconclusive. A short summary of these and other guidelines can be found in this brochure (PDF) on HPV testing. Following these guidelines should help assure that women with HPV do not have any more follow-up tests than when the Pap alone is used. Tell your doctor or nurse that you would like to get the HPV test for "extra peace of mind."