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The highest-risk types are HPV 16 and 18; these are responsible for the vast majority of HPV-related cancers, including cancers of the cervix, vagina, vulva, penis, anus, and head and neck.
Another test is specific for DNA from HPV types 16 and 18, the two types that cause most HPV-associated cancers. A third test can detect DNA from several high-risk HPV types and can indicate whether HPV-16 or HPV-18 is present. A fourth test detects RNA from the most common high-risk HPV types.
Medicare Part B covers the costs of HPV testing. It provides coverage once every 5 years for people between the ages of 30 and 65 years without HPV symptoms.The HPV test is part of the Pap test ...
[10] [needs update] To combat this progression, HSIL is usually followed by an immediate colposcopy with biopsy to sample or remove the dysplastic tissue. This tissue is sent for pathology testing to assign a histologic classification that is more definitive than a Pap smear result (which is a cytologic finding).
The two screening methods available are the Pap smear and testing for HPV. CIN is usually discovered by a screening test, the Pap smear. The purpose of this test is to detect potentially precancerous changes through random sampling of the transformation zone. Pap smear results may be reported using the Bethesda system (see above).
The Pap test can be used as a screening test but produces a false negative in up to 50% of cases of cervical cancer. [58] [59] Another concern is the cost of doing Pap tests, which makes them unaffordable in many areas of the world. [60] Confirmation of the diagnosis of cervical cancer or precancer requires a biopsy of the cervix.
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Some people can have elevated levels of p16 but test negative for HPV and vice versa. This is known as discordant cancer. The 5-year survival for people who test positive for HPV and p16 is 81%, for discordant cancer it is 53 – 55%, and 40% for those who test negative for p16 and HPV. [208] [209]