Cervical cancer is commonly associated with HPV infection. But some cases are found in people who test negative for HPV. There’s currently no clear definition for this type of cervical cancer.

Globally, cervical cancer is the fourth most common cancer in people assigned female at birth.

HPV-negative cervical cancer is much rarer, accounting for up to 11% of cervical cancer cases.

It’s unclear if all these cases are genuinely HPV-negative or if some people may have received a false negative when tested.

In fact, HPV-negative cervical cancer cases are dropping, which may result from better testing processes.

The symptoms of HPV-negative cervical cancer are similar to HPV-positive cervical cancer.

Be aware that early-stage cervical cancer usually has no symptoms.

When symptoms do appear, they tend to include pain and unusual vaginal bleeding or discharge.

If you’re experiencing any of these, consult with a doctor or other healthcare professional as soon as possible.

Researchers believe mutations in genes linked to tumors result in HPV-negative cervical cancer.

But they’re still working on finding a specific cause.

It’s tricky because some HPV-negative cancers may not actually be HPV-negative. Tests may not be sensitive enough to detect the presence of HPV, or the cancer may be misclassified as cervical primarily.

If you test negative for HPV, you have a very low risk of developing cervical cancer overall.

There are no specific risk factors for HPV-negative cervical cancer.

You may be more likely to develop cervical cancer if you:

As there’s no test for HPV-negative cervical cancer, symptoms like unusual vaginal bleeding usually start the diagnostic process.

If you have such symptoms, your doctor or a gynecologist will likely perform a pelvic exam.

They may perform a colposcopy to examine your cervix using an electric microscope.

If they notice anything unusual, they’ll take a biopsy and send the tissue to a lab for analysis.

Treatment for HPV-positive and HPV-negative cervical cancer is the same.

Your clinician may recommend a radical hysterectomy to remove the uterus and cervix, part of the top of the vaginal canal, tissues surrounding the uterus, and nearby lymph nodes.

Chemotherapy and radiotherapy may also be recommended.

It’s less likely that chemotherapy and radiotherapy will be used alone to treat cervical cancer.

People with HPV-negative cervical cancer may have a less favorable outlook than people with HPV-positive cervical cancer.

Overall survival and disease-free survival rates appear to be higher for those with HPV-positive cervical cancer, according to several studies.

This may be because HPV-negative cancer tends to be detected later when the cancer’s more advanced.

HPV-negative cervical cancer can’t be prevented through HPV vaccinations and may not be detected by screening tests. So prevention measures are limited.

But as more cervical cancer cases are HPV-positive, it’s essential to have regular cervical screenings.

Eating a balanced diet, avoiding smoking, and using barrier protection during partnered sexual activity can also help reduce your risk of developing cervical cancer.

Can you test negative for HPV and still have HPV?

Yes, it’s possible.

Standard tests may not be sensitive enough to detect some types of HPV. Or there may have been an error with the sample that was taken.

What does having an abnormal or unsatisfactory Pap smear result mean?

A Pap smear test detects cell changes in the cervix that may become cancerous later on.

An abnormal result means that some cells look different from how they’re expected to. But this doesn’t mean you have cancer or that these cells will turn into cancer.

Cell abnormalities can be due to infections like HPV, hormonal changes, growths, or even simple irritation.

In rare cases, cancerous cells may be found.

If your Pap test result comes back as unsatisfactory, this simply means that the lab was unable to properly analyze your sample.

Again, this could be for many reasons, including not enough cells or too much blood or mucus in the sample.

Can you test negative for HPV and have an abnormal or unsatisfactory Pap smear result?

Yes, you can.

While both tests act as a cervical cancer screening method, they look for different things so the results can differ.

The HPV test detects the HPV virus while the Pap test detects cellular changes that could become cancerous later on.

What follow-up tests or procedures are needed after an abnormal or unsatisfactory Pap smear result?

If your Pap smear comes back unsatisfactory, you’ll likely be asked to repeat the test.

Abnormal results may require further investigation but may also just be monitored more regularly.

Depending on factors like your age and previous test results, you may be asked to come back for another test in 1 or 3 years’ time.

Alternatively, your clinician may recommend a colposcopy and take a biopsy for further testing.

A pathologist will check a biopsy and give the abnormal cells a grade. Low-grade cells often go away by themselves, moderate-grade ones tend to be removed, and high-grade cells require more immediate treatment as they’re more likely to become cancerous.

To remove the abnormal cells, a piece of tissue is often taken from the cervix —this is called conization.

Other treatments like laser therapy or a hysterectomy may be needed, too.

HPV-negative cervical cancer is relatively rare. And it’s possible that some cases are, in fact, HPV-positive but weren’t detected by an HPV test.

Regardless of the type, the diagnostic and treatment process is essentially the same for both cervical cancers.

Regular cervical screenings are a good way to detect and monitor any changes in your cervix. If you notice unusual symptoms, such as abnormal bleeding or pain, consult a doctor or other healthcare professional.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraine attacks, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.