Key points
- The HPV test and the Pap test can help prevent cervical cancer or find it early.
- You should start getting Pap tests at age 21. If you are 30 years old or older, talk to your doctor about testing options.
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 precancers, cell 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 test, the doctor will use a plastic or metal instrument, called a speculum, to look inside your vagina. This helps the doctor examine the vagina and the cervix, and 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 test, the cells will be checked to see if they look normal.
- If you are getting an HPV test, the cells will be tested for HPV.
What is cervical precancer? When there are cervical cells that look abnormal but are not yet cancerous, it 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.
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"If I didn't go to that appointment, I might not be around for my kids," says Cindy. Her cervical cancer screening test found precancerous cells. She shares her story in this video.
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 normal, your 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 normal, your 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 normal, your doctor may tell you that you can wait five years until your next screening test.
- A Pap test only. If your result is normal, your 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 years, and the test results were normal or negative, and
- You have not had a cervical precancer in the past, or
- You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.
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How to prepare for your test
No special preparation is needed before you have an HPV test.
If you are getting a Pap test, you can take steps to make sure the test results are accurate. Avoid intercourse, douching, and using vaginal medicines or spermicidal foam for 2 days before the test. If you had sex before the test, go to the appointment as planned and let the doctor know.
If you have your period, don'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 normal, your 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 cancer, your doctor will let you know if you need to be treated. In most cases, treatment 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 normal, your 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 normal, unclear, abnormal, or 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 test, and the result is negative, your 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 result, like equivocal, inconclusive, or 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 pregnancy, menopause, or 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 time, minor 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 cancer, but they can turn into cancer over time. In rare cases, an abnormal Pap test can show that you may have cancer. You will need other tests to be sure. The earlier you find cervical cancer, the easier it is to treat.
- If there are not enough cells in the sample or the cells are clumped together, this 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.