From the Guidelines
To check a male patient's HPV status, there is no FDA-approved routine HPV screening test specifically for men, and thus, the most reliable method involves a DNA-based test performed on a sample collected from potential infection sites, such as the penis, scrotum, or anal region, for those with symptoms or concerns. When considering HPV testing for men, it's crucial to understand that the primary method of detection is through visual examination for genital warts or DNA testing for high-risk HPV types, especially in individuals with symptoms or those who are at higher risk, such as men who have sex with men or are immunocompromised 1. The importance of HPV testing lies in its ability to identify infections that could lead to penile, anal, and oropharyngeal cancers, as well as genital warts, although the testing is not routine for men as it is for cervical cancer screening in women 1. Key points to consider include:
- HPV is very common and can infect both men and women, often without signs or symptoms 1.
- Most sexually active individuals will get HPV at some point, and while the immune system usually clears the infection, some cases can persist and lead to health issues 1.
- For men, especially those with symptoms or at higher risk, HPV DNA testing can be performed on samples from the genital area, but there's no standard screening test approved for routine use in men 1.
- Blood tests for HPV antibodies are not used clinically because they only indicate past exposure, not current infection 1.
- Certain groups, like men who have sex with men or are immunocompromised, might benefit from anal Pap tests as a form of screening similar to cervical screening in women, although this is not a standard practice for all men 1.
From the Research
Checking HPV Status in Male Patients
To check a male patient's HPV status, several methods can be considered, although none have been approved by the FDA for this specific purpose 2. The following are some approaches that have been studied:
- Urine testing: Urine can be used as a tool for HPV screening, with a higher chance of finding HPV-DNA in men with lesions in the urethra than outside the urethra 3.
- Swab samples: Swab samples can be obtained from different anatomic sites, such as the penile shaft, scrotum, coronal sulcus, and external urethral meatus, to detect HPV DNA by PCR testing 4.
- Genital wart biopsy: Genital wart biopsy can detect an average of 49.5% of total HPV types in a patient, and combining this with swab sampling of other sites can increase the detection rate 4.
- HPV DNA polymerase chain reaction (PCR) testing: This method can be used to detect HPV DNA in various samples, including swab samples and urine 4.
Considerations for HPV Screening in Men
Some key points to consider when screening men for HPV include:
- Risk factors: Men with a history of multiple sex partners, early initiation of sexual activity, and other sexually transmitted infections are at higher risk of persistent HPV infections 5.
- Vaccination: Vaccination is the primary method of prevention, and the nonavalent HPV vaccine is effective in preventing the development of high-grade precancerous cervical lesions in noninfected patients 5.
- Screening methods: While there is no golden standard for screening men for HPV, a combination of methods, such as swab sampling and genital wart biopsy, may be necessary to detect all HPV types present in a patient 4.