A positive HPV test does not mean you have cervical cancer. Here's what to know

Women Most human papillomavirus (HPV) infections clear naturally, but some strains can cause changes in cervical cells that may eventually lead to cancer. Doctors explain when an infection becomes a concern, who is at greater risk and why regular screening matters. HPV infections are common, but some strains carry a higher risk of cervical cancer than others – understanding the differences can help women make sense of their test results. (Photo: iStock/Natee Meepian) New: You can now listen to articles. This audio is generated by an AI tool. A positive human papillomavirus (HPV) test does not necessarily mean you have cervical cancer. It indicates that high-risk HPV has been detected, which may require further monitoring or testing.In Singapore, cervical cancer is the 10th most common cancer among women, according to the Singapore Cancer Registry Annual Report 2023. Cervical cancer is highly preventable because screening can detect precancerous changes before they develop into cancer.Dr Lee I Wuen, medical director and senior consultant, obstetrics and gynaecology, at Raffles Women’s Centre, told CNA Women that HPV is a group of over 150 related viruses, with more than 40 types or strains that can infect the genital area. HPV spreads through sexual intercourse and skin-to-skin contact.Cervical cancer screening is done through Pap smears or HPV tests. HPV tests check for the presence of the virus that could lead to genital warts, abnormal cervical cells or cervical cancer, while Pap smears detect cell changes that could be early signs of cervical cancer. Pap smears are recommended for women aged 25 to 29, and HPV tests for women aged 30 and above.Dr Quek Swee Chong, clinical director at ASC Clinic for Women, said that HPV is one of the most prevalent viral infections worldwide, and most sexually active women and men will be exposed to it at some point in their lives.HPV is much more prevalent in younger adults, and younger women will likely clear the infection without any untoward effects. “In women over 30, a positive HPV test is much more predictive of underlying precancer changes,” he said.“This is growing increasingly relevant in Singapore where one in 10 women are infected with HPV. National screening programmes use HPV testing to identify women at higher risk of developing cervical cancer,” he added.WHAT’S THE DIFFERENCE IN HPV STRAINS?Dr Quek explained that HPV tests in Singapore detect high-risk strains only. Routine testing for low-risk HPV strains is generally not recommended because these strains are associated with benign conditions such as genital warts, rather than cervical cancer. An HPV test result in Singapore tells you whether a high-risk human papillomavirus strain has been detected in your body. (Photo: iStock/Md Babul Hosen) He added that a positive high-risk HPV result indicates the presence of a strain associated with a higher risk of cervical cell changes over time.“For most women, the infection will clear naturally, but appropriate follow-up is important to determine whether the virus persists or whether further assessment is required,” he said.Dr Lee said that a woman may have low-risk HPV strains and have no symptoms – this will not affect her health. WHAT IF YOU HAVE PERSISTENT HIGH-RISK HPV INFECTIONS?Around 90 per cent of HPV infections are cleared naturally by the body’s immune system, often within one to two years, even after a person has tested positive, said Dr Quek.However, the concern is when a high-risk HPV infection persists over time, as this increases the likelihood of abnormal cervical cell changes. The body clears up most HPV infections on its own, although persistent high-risk HPV infections can increase the risk of cervical cancer. (Photo: iStock/Prostock-Studio) Dr Quek noted that cervical cancer is almost always associated with persistent infection by high-risk HPV types, particularly HPV types 16 and 18, which account for the majority of cervical cancer cases worldwide.He explained: “For women with persistent high-risk HPV infection, the progression from infection to precancerous cervical changes – and potentially to cervical cancer, if left undetected and untreated – is typically a slow process that can take 10 to 15 years, although it may occur more rapidly in individuals with weakened immune systems.”This is why regular screening is important, so doctors can monitor changes and intervene before more serious disease develops, said Dr Quek.TYPES OF CERVICAL LESIONSHPV infections may result in benign, precancerous or cancerous lesions, said Dr Lee.Precancerous lesions are known as cervical intraepithelial neoplasia (CIN). CIN is classified as mild (CIN 1), moderate (CIN 2) or severe (CIN 3). Dr Lee said that CIN typically develops one to three years or more after a persistent high-risk HPV infection.“CIN has no symptoms and is detected by screening,” Dr Lee added.She also noted that, other than cervical cancer, high-risk HPV can cause cancer of the vagina, vulva and anus.CAN HPV BE CURED?There is no antiviral medication that cures HPV, said Dr Lee. However, conditions caused by HPV can be treated. For example, genital warts are treated with topical medications, cryotherapy or a minor surgical procedure to remove them. Genital warts can be treated with topical medications or minor surgery to remove them; there is no antiviral medication that cures HPV. (Photo: iStock/suney munintrangkul) Dr Lee said that low-grade CIN (CIN 1) will usually regress on its own when the body’s immune system clears HPV; it often does not need to be treated but should be monitored until it clears.High-grade CIN (CIN 2 and CIN 3) requires treatment to prevent cervical cancer. Treatment involves destroying or excising the abnormal tissue through medical procedures.In Singapore, the Health Sciences Authority approved the use of a home-use medical device called Colpofix in the first quarter of 2026, and it has been available by doctor’s prescription since September 2026.Colpofix is a gel sprayed directly into the vagina via a disposable, single-use nozzle. The course of treatment ranges from three to six months.Dr Quek told CNA Women that Colpofix helps prevent and treat cervical lesions caused by HPV by supporting the local cervical environment. It does so by promoting wound healing as well as restoring the regrowth of the outer layers of the cervical lining. Additionally, it restores and maintains the vaginal microbiome.WHAT DOES THE HPV VACCINE DO? HPV vaccination is recommended for females in Singapore aged nine to 26 and protects them against the HPV strains with the highest risk of cervical cancer. (Photo: iStock/juststock) In Singapore, HPV vaccination is recommended under the National Childhood Immunisation Schedule and National Adult Immunisation Schedule for all females aged nine to 26.One common misconception is that getting the vaccine protects you completely from developing cervical cancer. Dr Quek said HPV vaccination remains one of the most effective ways to reduce the risk of HPV-related cancers, but it does not protect against every HPV type.“The vaccines target the HPV strains responsible for the majority of cervical cancers as well as several other high-risk types, depending on the specific vaccine used,” Dr Quek explained.Two vaccines are currently in use in Singapore, said Dr Quek. Cervarix protects against HPV 16 and 18, and Gardasil 9 protects against these two strains, plus seven other types. According to the Ministry of Health website, government subsidies and MediSave are not available for vaccination with Gardasil 9, but women can choose this vaccine at their own cost.“Because there are many HPV types, it is still possible for vaccinated individuals to acquire a strain that is not covered by the vaccine or to have been exposed to HPV before vaccination. This is why regular cervical screening remains essential, even for women who have been fully vaccinated,” said Dr Quek. CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg. Recent Searches Trending Topics