Screening for cervical cancer is an important part of every woman’s health routine. For many years, the primary test for cervical cancer was the Pap test or Pap smear. In recent years, testing for high-risk types of human papillomavirus (HPV) has been added as a second option.
Which test is right for you? The answer may be both.
The cervix is the part of a woman’s reproductive system that is the opening to the womb. Cervical cancer is a typically slow-growing cancer that may take 10 to 15 years to develop.
Many women with cervical cancer do not have any symptoms until their cancer is in an advanced stage. With regular testing that can provide early detection and treatment, cervical cancer is the most preventable type of female cancer.(2)
A Pap test or Pap smear looks at cells from the cervix to see if cancer cells are present. During your annual exam, your gynecologist will remove a small number of cells from your cervix and send them to the lab to be tested.
According to the Centers for Disease Control and Prevention, all women should get regular Pap tests beginning at age 21.
The HPV test also looks at cells that your doctor has removed from your cervix. But instead of looking for actual cancer cells, the HPV test looks for the human papillomavirus. If HPV is present, it can cause changes in the cells of your cervix that could turn into cancer.
The HPV test is recommended for women over age 30. For those women, a positive HPV test may mean you are at higher risk for developing cervical cancer.
HPV is very common in younger women. In most cases, the body fights off HPV just like it fights off many other types of viruses. So HPV in younger women is not considered very likely to cause them future health problems.
Some researchers question the accuracy of the HPV test, stating that the test is too new. They also cite concerns that the availability of the HPV vaccine will dramatically reduce the number of women who have HPV in the future, making the test less relevant. These researchers believe that the current standard Pap test is still the better option. (3)
Other researchers believe the Pap test is less accurate and should be replaced by the HVP test as the primary screening method for cervical cancer.
They cite potential errors with Pap tests because some versions of the test require a person to physically look for cancerous cells, which may be hidden among many healthy cells. These people believe that the HPV test should replace the Pap as the primary method of testing for cervical cancer.(3)
In 2014, the U.S. Food and Drug Administration approved the use of one particular HPV test as a primary cervical cancer test for women age 25 and older.
This approval was based on findings from the ATHENA clinical trial that tested more than 47,000 women and concluded that the HPV test was more accurate.(1)
An additional cohort study that included more than a million women showed an extremely low risk of cervical cancer for women who test negative for HPV.)(1)
If you are 30 or older, your doctor may recommend that you have both the HPV and Pap test at the same time. Using two different methods to evaluate your health can give your doctor better insight into your risk of cervical cancer.
If your HVP test is positive, you have the HPV virus. But that does not guarantee that you will develop cervical cancer. Most women’s bodies are able to fight off the HPV virus within two years experiencing no harmful results.
The most important decision you can make is to have regular exams to check for cervical cancer. You and your doctor can decide which test is best for you or if you would benefit from having both tests.
If you have questions about the HPV test, the Pap test or your risk for cervical cancer, talk to your health care provider.
Reviewed October 12, 2016
by Michele Blacksberg RN
Edited by Jody Smith