Can routine physical examination detect HPV?

The answer is that most routine basic physical examinations cannot detect HPV. Only a physical examination package with special HPV testing can detect related infections.

A while ago, a 28-year-old Internet operator came to talk to me. He said that he had a routine physical examination with his employer every year, and all the reports were excellent. Last week, there was some light red blood in the same room. He was so scared that he went to the gynecology department to register. He was found to be positive for HPV16 and accompanied by low-grade squamous intraepithelial lesions. He squatted at the door of the clinic with the report and cried, saying, hadn’t all these years of physical examinations been in vain? I looked through her physical examination items in previous years. The unit bought her the most basic routine package. The gynecological items only included routine leucorrhea and abdominal B-ultrasound, not even a cervical scraping. Of course, HPV infection could not be detected.

What we usually call "routine physical examination" is actually a universal screening that covers the basic health status of the whole body. It is like an "entry-level security examination" for your entire body. It checks universal items such as blood routine, liver and kidney function, chest X-ray, and organ B-ultrasound. Even if you have a basic gynecological examination, at most you can add a traditional Pap smear. This kind of examination can only roughly screen for abnormalities in cervical cells. Even if a problem is found, it will not clearly indicate that it is HPV infection, but will only recommend that you undergo further special examinations.

Now there are different voices in the industry. One group thinks that HPV testing should be included in the routine physical examination of women aged 25-45. After all, persistent high-risk HPV infection is a clear cause of cervical cancer. Early screening can greatly reduce the risk of cancer.； The other group believes that there is no need for universal screening of all HPV. After all, 80% of HPV infections are transient and can be cleared by people with normal immunity in 1-2 years. Universal screening can easily add psychological burden to people who need not be anxious. I have met a 29-year-old girl before. She was found to be positive for low-risk HPV type 6 through self-examination. She did not have any lesions. She was still so frightened that she could not sleep all night and could not even attend class. It took more than half a year for her to recover after a follow-up test and she turned negative.

In fact, if you think of HPV testing as a "cervical targeted virus search", the security gate of a regular physical examination cannot detect this specific virus hidden in the cervical mucosa. You have to take the initiative to do this special examination, and the laboratory department will use special reagents to take samples for testing. Nowadays, the gynecological add-on of HPV combined with TCT in many medical examination institutions only costs 300 to 400 yuan. If you have had sexual intercourse for more than 3 years, have a history of high-risk contacts, or often stay up late and have low immunity, you can actually add it on your own initiative. It is not expensive and it is a good purchase.