Molecular HPV reflex testing

Human papilloma viruses (HPV) are responsible for over 95% of cervical cancers. There are approximately 100 HPV subtypes, 13 of which are designated as "high risk". Of these, subtypes 16 and 18 alone account for more than 70% of cervical cancers. The HPV test measures all of the "high-risk" subtypes and specifically indicates whether subtypes 16 and/or 18 are present.

In contrast to the "stand alone" HPV molecular test, with the reflex HPV test, if any HPV other than 16 or 18 is present, liquid-based cytology is performed automatically from the same specimen.

According to the recommendations of the INESSS (January 2022), HPV testing is indicated every 5 years for women between 25 and 65 years of age. Before the age of 25, the presence of the virus is very common and the vast majority of infections heal spontaneously. In younger women, HPV testing should only be done following a gynecological cytology (PAP test) showing suggestive cellular abnormalities.

It should be noted that only a small percentage of chronic high-risk HPV infections will develop into cancer. However, a positive HPV infection, especially for subtypes 16 and/or 18, is an indication for colposcopy, even if the PAP test does not yet show a significant abnormality.