Screening tests

The HPV test and the Pap test can help prevent cervical cancer or find it early.

• The HPV test looks for the virus (human papillomavirus) that can cause cell changes on the cervix.
• The Pap test (or Pap smear) looks for precancerscell changes on the cervix that might become cervical cancer if they are not treated appropriately.

Both tests can be done in a doctor's office or clinic. During the Pap testthe doctor will use a plastic or metal instrumentcalled a speculumto look inside your vagina. This helps the doctor examine the vagina and the cervixand collect a few cells and mucus from the cervix and the area around it. The cells are sent to a laboratory.

• If you are getting a Pap testthe cells will be checked to see if they look normal.
• If you are getting an HPV testthe cells will be tested for HPV.

What is cervical precancer? When there are cervical cells that look abnormal but are not yet cancerousit is called cervical precancer. These abnormal cells may be the first sign of cancer that develops years later. Cervical precancer usually doesn't cause pain or other symptoms. It is found with a Pap test.

Cindy's Story: Preventing Cervical Cancer

This video tells the story of Cindywho took action after precancerous cells were found during her routine cervical cancer screening. A 30-second version is also available: watch or download [1MB].

When to get screened

If you are 21 to 29 years old

You should start getting Pap tests at age 21. If your Pap test result is normalyour doctor may tell you that you can wait three years until your next Pap test.

If you are 30 to 65 years old

Talk to your doctor about which testing option is right for you:

• An HPV test only. This is called primary HPV testing. If your result is normalyour doctor may tell you that you can wait five years until your next screening test.
• An HPV test along with a Pap test. This is called co-testing. If both of your results are normalyour doctor may tell you that you can wait five years until your next screening test.
• A Pap test only. If your result is normalyour doctor may tell you that you can wait three years until your next Pap test.

If you are older than 65

Your doctor may tell you that you don't need to be screened anymore if:

• You have had at least three Pap tests or two HPV tests in the past 10 yearsand the test results were normal or negativeand
• You have not had a cervical precancer in the pastor
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditionslike fibroids.

How to prepare for your test

No special preparation is needed before you have an HPV test.

If you are getting a Pap testyou can take steps to make sure the test results are accurate. Avoid intercoursedouchingand using vaginal medicines or spermicidal foam for 2 days before the test. If you had sex before the testgo to the appointment as planned and let the doctor know.

If you have your perioddon't worry. Both tests can still be done at this time.

Test results

It can take as long as three weeks to receive your test results. If your test shows that something might not be normalyour doctor will contact you and figure out how best to follow up. There are many reasons why test results might not be normal. It usually does not mean you have cancer.

If your test results show cells that are not normal and may become canceryour doctor will let you know if you need to be treated. In most casestreatment prevents cervical cancer from developing. It is important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

If your test results are normalyour chance of getting cervical cancer in the next few years is very low. Your doctor may tell you that you can wait several years for your next cervical cancer screening test. But you should still go to the doctor regularly for a checkup.

Pap test result

A Pap test result can be normalunclearabnormalor unsatisfactory.

• A normal (or "negative") result means that no cell changes were found on your cervix. This is good news. But you still need to get Pap tests in the future. New cell changes can still form on your cervix. Your doctor may tell you that you can wait three years for your next screening test if you received a Pap test only. If you also received an HPV testand the result is negativeyour doctor may tell you that you can wait five years for your next screening test.
• It is common for test results to come back unclear. Your doctor may use other words to describe this resultlike equivocalinconclusiveor ASC-US. These all mean the same thing—that your cervical cells look like they could be abnormal. It is not clear if it's related to HPV. It could be related to life changes like pregnancymenopauseor an infection. The HPV test can help find out if your cell changes are related to HPV. Ask your doctor what to do next.
• An abnormal result means that cell changes were found on your cervix. This usually does not mean that you have cervical cancer. Abnormal changes on your cervix are likely caused by HPV. The changes may be minor (low-grade) or serious (high-grade). Most of the timeminor changes go back to normal on their own. But more serious changes can turn into cancer if they are not removed. The more serious changes are often called "precancer" because they are not yet cancerbut they can turn into cancer over time. In rare casesan abnormal Pap test can show that you may have cancer. You will need other tests to be sure. The earlier you find cervical cancerthe easier it is to treat.
• If there are not enough cells in the sample or the cells are clumped togetherthis is considered unsatisfactory. Your doctor may ask you to come back for another Pap test in a few months.

HPV test result

An HPV test result can be positive or negative.

• A negative HPV test means you do not have an HPV type that is linked to cervical cancer. Your doctor may tell you that you can wait five years for your next screening test.
• A positive HPV test means you do have an HPV type that may be linked to cervical cancer. This does not mean you have cervical cancer now. But it could be a warning. The specific HPV type may be identified to determine the next step.

Resource

• HPV and Pap Test Results: Next Steps after an Abnormal Cervical Cancer Screening Test (National Cancer Institute)