Q: What is the difference between a Pap smear and an HPV test? Do I need both?
A: A Pap smear is a test that evaluates a sample of cells from your cervix. This very quick, painless test is responsible for an 80 percent drop in the number of women diagnosed with cervical cancer in the past 50 years. This year, about 10,800 cervical cancers will be diagnosed, far fewer than the 50,000 that would have occurred without screening. That's because the Pap smear can identify very early cellular changes called dysplasia. Dysplasia is not cancer, but, depending on the type of dysplasia, could signify an increased risk of cancer. Removing these abnormal cells and following up with frequent Pap smears can help prevent cancer from occurring.
Today most medical organizations, including the American College of Obstetrics and Gynecology (ACOG), the American Cancer Society (ACS) and the United States Preventive Services Task Force, recommend that women begin receiving Pap smears at age 21 or within three years of becoming sexually active. After that, you should have an annual Pap smear if your doctor uses the conventional Pap smear with a glass slide, or every two years if your doctor uses the newer, liquid-based Pap smear, which studies find is better at picking up cellular abnormalities.
After age 30, if your past three consecutive Paps were normal, you can talk to your health care professional about screening every two to three years. At age 70, if you've had three normal Pap smears and no abnormalities in the past 10 years, you can stop getting Pap smears. Also, you can stop having Pap smears if your uterus and cervix were removed for noncancerous reasons; but if they were removed because of cancer, you still need the test.
However, Pap smears aren't foolproof. Studies find that up to half of all women diagnosed with cervical cancer have had screenings, some with normal Pap smears. That's why the ACS and ACOG also recommend that women with abnormal cells on a Pap test, or women 30 and older (regardless of their Pap results) receive a high-risk HPV DNA test (Hybrid Capture 2) to identify any HPV infection. HPV, or human papillomavirus, is a sexually transmitted virus responsible for more than 90 percent of all cases of cervical cancer. The results of the Pap smear plus the HPV test help your doctor determine the next course of action. For instance, if you have abnormal results on both tests, your doctor may want to do a colposcopy to get a better look at your cervix and, possibly, take a sample of cervical tissue for a biopsy.
If you receive the HPV DNA test, ask your health care professional to use the high-risk HPV test, which tests for the viruses known to cause cervical cancer. About six to 10 percent of women older than 30 test positive for these high-risk viruses.
From the National Women's Health Resource Center's "Ask the Reproductive Health Expert" column
© 2007 National Women’s Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (toll-free). On the Web at: www.healthywomen.org.