Pap Smears and HPV Testing: What to Expect

What is the difference between a Pap test and an HPV test?

A Pap test (also called a Pap smear) collects cells from the cervix to look for abnormal changes that could, if left untreated, develop into cervical cancer over time. An HPV test checks for the high-risk types of human papillomavirus that cause nearly all cervical cancers. Because HPV is common and most infections clear on their own, a positive HPV test does not mean you have cancer; it means you and your provider should follow the recommended next steps.

When should screening start and how often should it happen?

The USPSTF and ACOG recommend starting cervical cancer screening at age 21, while the American Cancer Society recommends starting at age 25. In your 20s, a Pap test alone every three years is the standard approach. From ages 30 to 65, three options are considered equally effective: a Pap test every three years, an HPV test every five years, or a combined Pap and HPV test (co-testing) every five years.

• Ages 21 to 29: Pap test every three years.
• Ages 30 to 65: Pap every three years, HPV every five years, or co-testing every five years.
• Screening can stop at 65 with an adequate history of normal results.
• After a hysterectomy or with certain histories, screening needs differ; your provider can advise you.

Does screening stop at a certain age?

Guidelines generally agree that screening can stop at age 65 if you have had adequate prior screening with normal results and are not at higher risk. Women with a history of high-grade cervical changes, an immune condition, or certain other risk factors are usually advised to continue screening beyond 65. The decision is individualized, which is a good reason to review it with your provider rather than assume it applies to you.

• Screening usually ends at 65 with adequate prior normal results.
• Higher-risk women may continue screening past 65.
• A provider can tailor the plan to your history.

How should I prepare for a Pap test?

Your provider may ask you to avoid scheduling the Pap during your period, since heavy bleeding can make the sample harder to read. You do not need to stop using birth control, but some providers ask you to avoid intercourse, douching, or vaginal medicines for about two days before the visit because they can wash away or dilute the cells being sampled. The test itself takes only a few minutes: a small brush and spatula gently collect cells from the cervix while you lie on the exam table.

What if my results are abnormal?

An abnormal Pap or a positive HPV result is common and does not mean you have cancer. Most abnormal results are mild and resolve on their own. Depending on the result, your provider may recommend repeating the test in a year, adding an HPV test, or moving to a follow-up test called a colposcopy. TruHealth can explain what your result means, arrange appropriate follow-up, and refer you to gynecologic care when specialized procedures are needed.

• Many abnormal results resolve without treatment.
• Follow-up depends on the specific finding and your HPV status.
• Colposcopy and biopsy are performed by specialists when indicated.
• Staying on schedule with screening is what matters most.