Positive HPV test on cervical screening: what it means

A positive HPV test on cervical screening means a high-risk type of human papillomavirus was found in the sample. It does not mean you have cancer or abnormal cells. HPV is very common and most infections clear on their own within about two years. In Spain the next step is a smear (cytology) and, if that is normal, a repeat HPV test in one year.

This guide, by Dr. Pedro Yelamo Vera, a GP licensed in Spain, explains what the result means and what happens next.

How common is cervical cancer?

The World Health Organization reports around 660,000 new cases of cervical cancer and around 350,000 deaths worldwide in 2022, making it the fourth most common cancer in women. Almost all cases are caused by persistent high-risk HPV, which is why screening looks for the virus first.

What is HPV?

Human papillomavirus is a group of viruses passed on by intimate skin-to-skin contact. Most sexually active people get it at some point. A few high-risk types, especially HPV 16 and 18, cause about 76% of cervical cancers, according to the World Health Organization. Cancer develops only when infection persists for many years.

Why is HPV tested in Spain's screening?

Spain's cervical screening programme uses a high-risk HPV test every 5 years for women aged 30 to 65. Detecting the virus first identifies the women who need a closer look, and lets those with a negative test wait longer between checks.

What happens after a positive result?

1. Cytology (triage): the sample is checked for abnormal cells.
2. If cytology is normal: the HPV test is repeated in one year to see whether the virus has cleared.
3. If cytology shows abnormal cells, or HPV persists: you are referred for a colposcopy, a closer look at the cervix with a magnifying instrument, sometimes with a small biopsy.
4. If high-grade changes are found: a small procedure removes the abnormal area. It is very effective.

What can you do?

• Stop smoking: it makes it harder for the body to clear HPV.
• Go to every follow-up appointment, even if you feel well.
• Use condoms to reduce the spread of HPV, although they do not remove the risk.
• Ask whether the HPV vaccine could protect you against other types.

When should you see a doctor sooner?

See a doctor if you have bleeding between periods, after sex or after menopause, unusual discharge or pelvic pain, whatever your last screening result.

How can an online GP help?

1. Pedro Yelamo Vera can explain your HPV and cytology report in English or Spanish, check when your next test is due and write a referral when it is clinically appropriate. Send your results by eConsult or book a video visit. Related: genital warts and HPV in Spain. Examinations and colposcopy are done in person.

This service is for urgent, non-emergency care. In an emergency, call 112.

This article is general information and does not replace an individual medical assessment. Written by Dr. Pedro Yelamo Vera, GP licensed in Spain (Colegiado No. 484814280). Related: sexual health and HPV.

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