Can routine physical examination detect HPV

Most routine physical examinations cannot detect HPV. Only if you actively add special HPV testing during physical examination can you get accurate infection results.

I have been in the gynecology clinic for almost 8 years and have encountered at least dozens of similar patients - the 34-year-old Ms. Zhou who was just admitted last week. The unit organizes routine physical examinations every year. The physical examination reports for three consecutive years have shown "no abnormality in gynecology." In the past two months, there has always been a small amount of brown bleeding after having sex. I came to the hospital for a check-up, HP V16 was positive and accompanied by low-grade intraepithelial lesions of the cervix. She took the previous physical examination report and asked us if we had misdiagnosed it. After looking through her previous physical examination items, she discovered that her routine physical examination only included basic vulvar inspection and leucorrhea routine, and did not even include TCT, let alone HPV testing.

In fact, this really cannot be blamed on the missed diagnosis by the previous physical examination institution. The basic items of the routine physical examination we usually talk about are mostly general items such as routine hematuria, liver and kidney function, chest X-ray, and abdominal color ultrasound. Even if a gynecological examination is provided, the default is mostly routine leucorrhea, ordinary gynecological palpation, and at most an abdominal B-ultrasound to check the uterine appendages. Targeted special screenings such as HPV testing will not be actively included. To use an inappropriate analogy, a routine physical examination is like a basic set meal you order, which only has rice and vegetables as standard ingredients. HPV testing is a special dish that requires extra money. If you don’t mention the extra dishes, the merchant will definitely not take the initiative to provide them to you.

Of course, there are very few exceptions. Some people add ordinary cervical scrapings (that is, traditional Pap smears) to their routine physical examinations. If koilocytes are found in the scrapings, the report may indicate "the possibility of HPV infection is not ruled out." However, in this case The missed diagnosis rate is particularly high. It can only be discovered when the infection lasts for a long time and has caused changes in cervical cell morphology. Early asymptomatic HPV infections are almost impossible to detect in this way, so the industry generally does not believe that routine physical examinations can cover HPV screening.

To be honest, many people now have too high expectations for routine physical examinations. They think that if you do it once a year, you can prevent all diseases. In fact, this is not true. For targeted screening like HPV, it is still recommended that sexually active women take the initiative to get HPV done every 2-3 years. +TCT combined screening, if you are a high-risk group with low immunity and multiple sexual partners, it is best to increase the frequency of screening to once a year. Don’t wait for routine physical examinations to “reveal” you. By the time routine physical examinations reveal problems, it has often been delayed for a long time.