Pap smear and HPV test

Both tests use cells taken from the cervix, the lower part of the womb. A Pap smear (Pap test) looks at the cells under a microscope for early changes, called precancer, that could turn into cancer if left untreated. An HPV test looks for high risk types of the human papillomavirus, the infection that can cause these changes.

Screening looks for changes before they cause symptoms, as early changes rarely do, so that they can be treated before they become cancer. An HPV test may also follow an abnormal Pap smear. The World Health Organization suggests screening from age 30 (25 for women living with HIV, who are screened more often), repeated every 5 to 10 years. Schedules differ between countries and tests, so ask your doctor.

Tell the clinic if you may be on your period on the day. Some clinics ask you to wait until it has ended, and others go ahead.

1. You undress from the waist down behind a screen and are given a sheet to cover yourself.
2. You lie back with your knees bent and apart.
3. The nurse or doctor gently puts a speculum, which holds the vaginal walls apart, into your vagina, sometimes with a little lubricant, so that the cervix can be seen.
4. A soft brush collects a small sample of cells.
5. The speculum is removed and you get dressed. The sample goes to a laboratory.

In some places you can collect the HPV sample yourself with a swab, in private. Ask whether this is offered.

You may have light bleeding or spotting, which should stop within a few hours, and mild cramping. See a doctor if you have heavy bleeding or if spotting does not stop after a few hours. Results can take up to about 3 weeks, so ask how you will be told. If you have not heard, call and ask.

The tests carry very little risk: mild discomfort, cramping or light bleeding. Like all screening tests they are not perfect. A result can be abnormal when nothing is wrong (a false positive), or normal when a problem is present (a false negative). That is why you should still see a doctor about new symptoms.

A Pap smear can be normal; unsatisfactory (too few cells, so it is repeated in a few months); unclear (cells look abnormal but the cause is uncertain, such as HPV, pregnancy, menopause or infection); or abnormal. Abnormal usually does not mean cancer, and small changes often go away. Serious changes can become cancer if untreated, so follow-up matters.

An HPV test is negative if no high risk HPV is found, and your doctor will say when to be tested again. Positive means high risk HPV was found. It does not mean precancer or cancer, and there is no treatment for the infection itself. Next steps depend on your age and risk, and may include colposcopy, a magnified look at the cervix, or more frequent testing.

What these tests cannot show: a Pap smear does not diagnose cancer. If results are concerning, your doctor will explain what further examination or treatment is needed.