Human papillomavirus (HPV) is usually detected during a routine gynecological examination during which a physician reviews a patient’s medical history and does a pelvic examination. HPV is sometimes diagnosed by the visual identification of genital warts in or around the vagina, on the vulva (opening to the vagina), cervix, groin, or in or around the anus.

It may also be diagnosed with a Pap smear, which is a screening test used to detect the presence of precancerous and cancerous cells. A Pap smear can reveal changes on the cervix caused by HPV infection. HPV is most often diagnosed with a Pap smear.

For the Pap smear, the physician inserts a speculum (an instrument for examination of canals) into the vagina to observe the cervix. Then, the physician removes cells from the cervix using a small spatula and a brush or cotton swab. The cells are placed on a glass slide or into a fluid-filled bottle and sent to a laboratory for examination.

However, it is possible that the results of a Pap smear can be normal even though the patient is infected with HPV. Changes on the cervix detected through a Pap smear may not appear immediately after infection or may never appear at all. Similarly, an abnormal Pap test does not necessarily indicate the presence of HPV infection.

If the warts are small or cannot be identified by visual inspection, a physician may perform a colposcopy (a test that uses a colposcope, an instrument with magnifying lenses, to view the cervix and vagina). The physician may also apply a vinegar solution which makes abnormal tissue turn white. This test is not painful and helps the physician identify warts or other abnormal tissue. If abnormalities are detected, a sample of tissue may be removed for analysis. A biopsy may be performed on the abnormal tissue to determine the presence or absence of precancerous changes.

For women over age 30 or those with mild Pap smear abnormalities, physicians may do an HPV test. This is a DNA test that detects most of the high-risk types of HPV. It is also a test for cervical cancer. Similar to the Pap test, the HPV test involves using a small soft brush to collect cells from the cervix. The results of HPV DNA testing can help physicians determine whether further tests or treatment is necessary. It should be noted that the HPV DNA test can be performed from a liquid based pap smear or as a separate swab.

No HPV tests are available for men.