Positive HPV test — what happens next?

A positive HPV test means that genetic material of the human papillomavirus was found in the sample taken from your cervix. It is not a diagnosis of disease — most HPV infections clear on their own within a year or two. It is, however, a prompt to agree the next steps with a gynaecologist: usually a smear test, and in some situations a colposcopy.

What a positive HPV result means

HPV is a very common virus, passed on mainly through sexual contact. Most sexually active people come into contact with it at some point in their lives, often without knowing. The HPV test detects the virus in cells of the cervix — it does not tell you whether those cells have changed in any way.

Your result will usually say which type of virus was found:

• Types 16 and 18 — responsible for the majority of cervical cancers. Finding them is a reason for closer examination, even if your smear test is normal.
• Other high-risk types (such as 31, 33, 45, 52, 58) — less likely to lead to changes, but still need monitoring.
• Low-risk types (such as 6 and 11) — linked to genital warts, not to cervical cancer.

The test used at Sonar Clinic covers 14 high-risk genotypes, so the result tells you which type you are dealing with.

Is a positive HPV test something to worry about

A positive HPV test is not the same as cancer. For cancer to develop, the infection has to persist for many years and gradually cause pre-cancerous changes (described as CIN or SIL). These changes show up on smear tests and colposcopy long before cancer develops, so they can be treated before cancer appears.

In practice this means regular follow-up matters far more than immediate treatment. There is no drug that removes the virus — only changes on the cervix are treated, and only if they actually develop and are confirmed.

What usually happens next

Follow-up depends on the type of virus found, your smear result, your age and your previous results. The general principles are:

• HPV 16 or 18 — your doctor will usually refer you for colposcopy regardless of the smear result.
• Another high-risk type with a normal smear — a repeat HPV test and smear after about 12 months is often enough.
• Another high-risk type with an abnormal smear — colposcopy is usually recommended.
• No recent smear test — the first step is to have one, ideally as a liquid-based (LBC) smear.

This is a general outline, not a rule. Which step is right for you is decided by your doctor after reviewing the full result and your history. If your smear test was abnormal, you may also find the guide Abnormal smear test — what does it mean and what next? useful.

What colposcopy is and what it involves

Colposcopy is an examination of the cervix under magnification using a colposcope — an instrument similar to a microscope that stays outside the body. The procedure feels much like having a smear test:

• the doctor inserts a speculum, as in a routine gynaecological examination,
• the cervix is wiped with a weak acetic acid solution, and often with iodine solution — this highlights areas that look different from healthy tissue,
• the doctor examines the image and records the findings.

The examination usually takes 10–20 minutes. No anaesthetic is needed; some women feel a mild stinging from the solutions.

If the doctor sees an area that needs clarifying, a biopsy may be taken — a small piece of tissue sent for histopathology. It feels like a brief pinch or cramp. Light spotting is common for a few days afterwards. The histopathology result is usually ready in a few weeks, and only then can the doctor say whether the change needs treatment.

HPV vaccination

The vaccine protects against infection with the types it covers, but it does not treat an existing infection. Even so, your doctor may suggest vaccination after a positive result — it protects against other types and may reduce the risk of changes returning after treatment. In Poland, adolescents can be vaccinated free of charge through a national programme; adults can be vaccinated privately. It is worth raising this at your consultation.

When not to delay

Do not wait to book a consultation if:

• HPV type 16 or 18 was found,
• your smear test is abnormal at the same time,
• you have bleeding after sex, between periods or after the menopause,
• you have unusual discharge or pain in the lower abdomen,
• it has been several years since your last smear test.

Changes on the cervix develop slowly, so waiting a few weeks for an appointment is not a problem. Do not, however, put the follow-up off for a year or two.

How it works at Sonar Clinic

HPV results are discussed, and follow-up carried out, by Barbara Ossowska, MD — a doctor in gynaecology and obstetrics training. Within gynaecology and obstetrics she takes LBC smears and HPV tests and performs ultrasound scans.

A possible pathway:

1. Gynaecological consultation to discuss the result and agree a plan — 220 PLN.
2. If you have no recent smear: consultation + LBC smear — 350 PLN, or consultation + LBC + HPV test (14 genotypes) — 520 PLN.
3. Colposcopy — depending on the result and the doctor’s decision. Colposcopy will be available at Sonar Clinic soon; until then, the doctor will advise during the consultation where to have the examination.

Bring your HPV result and your most recent smear results. To book, call +48 880 018 703 or use online booking on the doctor’s profile. Sonar Clinic is at ul. Gubińska 8A, Wrocław. Consultations are held in Polish; please let us know when booking if you need language support.