No Routine HPV Screening Available for Men
There is no clinically validated screening test for HPV type 31 (or any HPV genotype) recommended for men in routine practice 1. The CDC explicitly states that HPV tests should not be used to screen men, partners of women with HPV, or for health conditions other than cervical cancer 1.
Why Men Cannot Be Routinely Screened
The fundamental issue is that no FDA-approved screening test exists for detecting HPV in men 2. While molecular testing techniques (PCR-based methods) can detect HPV DNA in male genital samples, these are research tools, not validated clinical screening tests. The 2010 CDC STD Treatment Guidelines—the authoritative guideline source provided—explicitly prohibits HPV testing in men for screening purposes 1.
Key Clinical Realities:
- Most HPV infections in men are asymptomatic and clear spontaneously without causing health problems 1
- HPV type 31 is a high-risk oncogenic genotype, but unlike cervical cancer screening in women, there is no established screening pathway for men
- The most common manifestation of HPV in men is genital warts (caused by types 6 and 11, not type 31), which are diagnosed by visual inspection 2, 1
What Can Be Done Instead
For Asymptomatic Men:
- No testing is indicated or recommended 1
- Focus on prevention through HPV vaccination (quadrivalent or 9-valent vaccines covering types 16,18,31,33,45,52,58 among others) for males aged 9-26 years 1
- Counsel on consistent condom use (though not fully protective as HPV infects areas not covered by condoms) 1
For High-Risk Populations:
While routine screening is not recommended, men who have sex with men (MSM) and HIV-positive men represent special populations where targeted surveillance may be considered in specialized settings 3, 4:
- Anal cytology and high-resolution anoscopy may be considered for MSM and HIV-positive men in centers with appropriate expertise 3, 4
- This is not routine screening but rather targeted surveillance in high-risk groups where anal cancer risk is substantially elevated
- Digital anorectal examination should be performed to detect suspicious lesions 3
- Biopsy any suspicious anal lesions to exclude invasive disease 3
For Men with Visible Lesions:
- Visual inspection and biopsy of any suspicious genital or anal lesions 3
- HPV typing of lesions is generally not clinically useful, as treatment is based on the lesion itself, not the viral genotype 1
Critical Pitfalls to Avoid
Do not order HPV testing on male partners of women with HPV 1—this is explicitly discouraged as it provides no clinical benefit and both partners in ongoing relationships typically share the same HPV types
Do not use research-based sampling methods (penile shaft swabs, urethral swabs, urine PCR testing) 5, 6, 7 in clinical practice—these are investigational tools without established clinical utility or validated interpretation guidelines
Do not assume HPV negativity means no infection—even research studies show HPV detection varies dramatically by anatomical site sampled (penile shaft 50%, glans 33%, urethra 10%, semen 5%) 5, making any single-site testing unreliable
Counseling Points for Men Concerned About HPV Type 31
- Most sexually active adults will acquire HPV at some point, often without knowing it 1
- HPV type 31 is oncogenic but causes no symptoms in men and typically clears spontaneously
- No screening test will change management for asymptomatic men
- Vaccination remains the primary prevention strategy for those eligible
- If a female partner has HPV 31, this does not indicate infidelity and the male partner likely already shares the infection 1
The evidence is unequivocal: routine HPV screening in men, including for type 31, is not recommended, not validated, and provides no demonstrated clinical benefit 1. The focus should remain on vaccination, risk reduction counseling, and clinical evaluation of any visible lesions.