I used to work in a microbiology lab where we processed and tested the samples for HPV cervical testing. If your pap smear comes back abnormal - an HPV test is now automatically ordered in almost all labs (i'm not sure if there are any labs out there that don't do this automatically anymore). I don't know how long this has been the case - but I don't think it was that way 7 years ago - as not nearly as much information was known at that time about HPV.

If your PAP SMEAR comes back normal - it DOES NOT mean you don't have HPV - it just means there have been no cellular changes yet that the smear detected. You can still have HPV.

Your doctor can also order the HPV test in addition to the pap smear so that you'll get both - regardless of the results of the smear. (Some insurances will pay for this and some won't - so you might get stuck with a bill if you are the latter.) However, the test will not tell you the specific strain you have - just that it is positive for one or more of a list of high risk strains. (I think the tumor testing is an entirely different test which can tell the exact strain of the virus.)

Also - if your HPV results come back negative - it doesn't mean you've always been negative - just that you currently are. You could have had it in the past and cleared it or it could be present in undetectable levels. However, as I understand it - the damage could have been started before you cleared it, so you can have an HPV related cancer - but cleared the virus at the time you were finally tested.

Also - there is no approved test for the oral region - so if your cervical sample tests negative - that doesn't mean you don't have it orally still.

So - in short, you can have:
Normal Pap, negative for high risk HPV
Normal Pap, Positive for high risk HPV
Abnormal Pap, negative for high risk HPV or
Abnormal Pap, Positive for high risk HPV

And as mentioned before - there is no way to determine if you have it orally unless your tumor tissue is tested and recent. If you test an old tissue sample - you may have cleared it by the time the tissue was tested.

Most of the people who get the HPV related cancers are thought to either not ever clear the virus - or just clear it much slower than most people - therefore more time for damage to occur and the cells to mutate into a cancer.