For a 26-year-old woman with a history of high-risk Human Papillomavirus (HPV) positive result in 2023, normal psychological evaluations in 2024 and 2025, and a negative HPV test in 2025, when should her next HPV test be done?

Next HPV Testing Timing After Clearance of High-Risk HPV

Your next HPV test should be done in 3 years (2028), as you have achieved HPV clearance with two consecutive negative tests 12 months apart, meeting discharge criteria from heightened surveillance.

Understanding Your Current Status

You have successfully cleared your high-risk HPV infection, which is excellent news. Here's how your timeline breaks down:

• 2023: High-risk HPV positive (non-16/18 types), normal cytology
• 2024: Normal cytology (HPV status unclear from your description)
• 2025: Normal cytology AND HPV negative

Evidence-Based Surveillance After HPV Clearance

The British Society of Colposcopy and Cervical Pathology (BSCP) and European Society of Gynaecologic Oncology 2025 guidelines provide clear discharge criteria: Two consecutive high-risk HPV negative tests 12 months apart are required to return to routine 3-year recall intervals 1.

Your Specific Pathway

Since you had one documented HPV-negative test in 2025, you need:

• One additional HPV test in 2026 (12 months after your 2025 negative test) 1
• If negative in 2026: You can be discharged to routine screening with the next test in 2029 (3 years after the second negative test) 1
• If positive in 2026: Immediate colposcopy is recommended regardless of cytology results, as you have a history of previous HPV positivity 1, 2

Risk Stratification Context

Your risk profile has improved significantly with HPV clearance:

• Women with negative HPV testing have a cumulative CIN3+ risk of only 0.31% over 10 years 2, 3
• However, women with prior HPV-positive results who subsequently clear still carry a residual 5-year CIN3+ risk of 0.54-2%, depending on initial abnormality severity 3
• The negative predictive value of combined negative HPV and normal cytology is excellent (CIN3+ risk 0.16-0.3% over 5 years) 3

Critical Pitfall to Avoid

Do not assume you can immediately return to 5-year screening intervals. The American Society for Colposcopy and Cervical Pathology emphasizes that HPV clearance doesn't automatically eliminate pre-existing dysplastic lesions that may have developed during the infection period 3. You must complete the two consecutive negative HPV tests 12 months apart before extending intervals 1.

If Any Future HPV Test Returns Positive

Should you test HPV-positive at any point during routine recall after discharge, immediate referral to colposcopy is mandatory, regardless of cytology results, because of your history of previous HPV positivity and the heightened risk this confers 1, 2.

Age-Appropriate Screening Considerations

At age 26, you fall into the younger screening cohort where:

• Co-testing (HPV + cytology) or HPV testing alone are both acceptable 2, 4
• The American Cancer Society recommends 5-year intervals for co-testing in women aged 30-65, but you must first complete your discharge criteria 2, 3