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Home Ask the Experts Ask the Experts Why is there no HPV test for men?

Why is there no HPV test for men?

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Why is there no HPV test for men?

HPV DNA testing is indeed approved for clinical use in women in two specific circumstances: 1) as follow up to an unclear Pap test result at any age and 2) or along with a Pap test as primary screening for women over age 30. It is not used as a general screening test for HPV infection. While HPV testing men for is commonly performed in research studies, a clinical HPV test for men is not yet available.

One reason the HPV test is not licensed for routine use in men is that we don’t yet know what a positive test in a man truly means for his current and future health, or the health of his sex partner(s). In women, depending on their age and Pap result, having a positive HPV test helps guide clinical decision-making. That is, based on a woman’s HPV result, her doctor can make better decisions about her risk for cancer, and what kind of evaluation or intervention she needs to prevent cervical cancer and pre-cancer. 

On the other hand, if a man has a positive HPV test, its significance is unclear. Most men with HPV will never develop visible skin lesions related to the virus, and associated health complications -such as cancer of the penis- are extremely rare in industrialized nations (and among circumcised men). So, from a health care provider’s perspective, a test that reveals that a man has HPV raises more questions than it answers, and doesn’t provide useful information for the patient’s health care.

Also consider that many people request HPV testing to answer questions such as, “Am I contagious?” “Do I still have the virus?” or, “Will I develop symptoms?” At this point, HPV DNA testing cannot definitively answer any of these questions. (While controversial and not performed in many locations, men who have sex with men might want to discuss with their provider the need for anal cancer screening, such as anal Pap tests. While anal cancer is relatively rare, it is more common in men who have sex with men and in immunosuppressed individuals, and is associated with HPV.)

Finally, there exists yet another reason why a clinical HPV test for men is not yet available. For one thing, we don’t yet know which part of the male genitals should be tested for the virus. Also, it is generally much more difficult to collect a good cell sample from male genital skin than from female genitals, because the male genitalia have tougher and thicker covering than does the cervix. Recent research studies have looked at ways of getting a better sample from men, such as using a fine-grade of sand paper to “exfoliate” the skin; yes, our reaction was the same as yours…