How to screen for cervical cancer HPV

HPV screening for cervical cancer is mainly performed through a combination of HPV testing and cervical cytology (TCT). Screening methods mainly include HPV typing testing, thin-layer liquid-based cytology, colposcopy, cervical biopsy, acetic acid white test, etc.

1. HPV typing test

HPV typing testing collects cervical exfoliated cells to detect the presence of high-risk HPV infection. Persistent infection with high-risk HPV is the main cause of cervical cancer, and testing can identify the specific infection type. Commonly used methods include hybridization capture method and real-time fluorescence PCR method, which can distinguish high-risk subtypes such as type 16 and type 18. If the test result is positive, further evaluation needs to be combined with the TCT results.

2. Thin-layer liquid-based cytology examination

Thin-layer liquid-based cytology test, also known as TCT test, uses a special brush to collect cervical cells and prepare thin-layer specimens, and observe changes in cell morphology through a microscope. This examination can detect precancerous lesions such as cervical intraepithelial neoplasia, and its accuracy is higher than that of traditional Pap smears. When the test results are abnormal, the risk level must be determined based on the HPV test results.

3. Colposcopy

Colposcopy is suitable for those who are HPV-positive or have abnormal TCT. They can observe the cervical blood vessels and epithelial structure under magnification to identify suspicious lesion areas. During the examination, acetic acid solution and iodine solution will be used to assist in color development. Abnormal areas may show characteristics such as acetic acid white epithelium or punctate blood vessels. When suspicious lesions are found, localized biopsy can be performed simultaneously.

4. Cervical biopsy

Cervical biopsy is the gold standard for diagnosing cervical lesions. Suspicious tissues are usually removed for pathological examination under the guidance of a colposcope. Biopsy can clarify the extent of the disease and differentiate between low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, or invasive cancer. A small amount of bleeding may occur after surgery, and strenuous exercise and sexual life need to be avoided.

5. Acetic acid whitening test

The acetic acid whitening test is used as an auxiliary screening method to observe whether white lesions appear after applying acetic acid to the cervix. This method is simple to operate but has low specificity, and positive results need to be combined with other tests for comprehensive judgment. It is suitable for preliminary screening in resource-poor areas and cannot replace HPV or TCT testing.

It is recommended that women over 21 years old or who are sexually active undergo regular combined HPV and TCT screening, with the screening interval adjusted according to age and risk factors. Measures such as maintaining a single sexual partner, getting the HPV vaccine, and avoiding smoking can help reduce the risk of infection. If abnormal results are found during screening, follow-up or treatment should be carried out as directed by the doctor, and do not delay medical treatment.