Pap and HPV testing: What you need to know

Regular Pap tests, along with human papillomavirus (HPV) tests, can help your doctor catch cervical cancer early, when it’s most treatable.

But how are these two tests related, how are they different, and should you get both?

We talked with Pamela Soliman, M.D., professor in Gynecologic Oncology, about the Pap and HPV tests and why they are important in detecting and preventing cervical cancer. Here's what she had to say.

What screening exams does MD Anderson recommend for cervical cancer

MD Anderson recommends the following screening exams for cervical cancer:

• Age 21-29 – Pap test every three years
• Age 30-64 – Pap test and HPV test every five years

A Pap test can detect abnormalities in the cells of your cervix that are cancer or may become cancer. The HPV test looks for the presence of the HPV virus in your cervix. 

Almost all cervical dysplasia and cervical cancers are caused by the HPV virus.

“Doing the HPV screening lets us identify patients who may be at higher risk for cervical cancer, even if their Pap test shows only mild abnormalities or no abnormalities at all,” says Soliman. “The sooner we are alerted to their risk, the earlier we can catch cancer and the better our chances of treating it successfully.”

Starting at age 30, be sure to request an HPV (human papillomavirus) test in addition to your Pap test when scheduling your cervical screening exams.

“Don’t assume your doctor is going to perform both tests,” says Soliman. “Ask for both.”

What to expect at your cervical screening exam

During the exam, your doctor will ask you to lie on your back and put your legs in stirrups so he or she can examine your cervix.

“We look for lesions, masses or nodules. If something like that is spotted, we do a biopsy,” says Soliman. “If nothing is spotted, we take a scrape of cells from the cervix with a swab and put it in a vial of liquid to preserve the cells for testing.”

The cells are sent to a pathologist, who will look at them under a microscope for abnormalities that can’t be seen with the naked eye.

This test is called a Pap test or a Pap smear.

If your cervical cells look abnormal, your doctor may call you back in for a colposcopy. During this test, the doctor uses a lighted instrument to get a better view of your cervix. He or she may use a vinegar solution to highlight suspicious cells and take of biopsy of anything that looks abnormal.

For the HPV test, the same pathologist will test the sample cells for the HPV virus.

If HPV is detected, your doctor will recommend another cervical cancer screening, probably within a year, to ensure early detection if cancer develops. If HPV is still present, you will probably need to have more frequent screenings.

The HPV vaccine is your first defense against cervical cancer

Screening is important, but it’s not a substitute for the HPV vaccine, says Soliman.

“HPV is a virus, just like other viruses, and we know that it causes cancer,” she says. “The HPV vaccine is a cancer prevention vaccine.”

All males and females ages 9–26 should get the HPV vaccine. It is most effective when given at ages 11–12. Unvaccinated men and women ages 27–45 should talk to their doctor about the benefits of the vaccine.