Human papillomavirus (HPV) is the cause of almost all cervical cancers. The new method for cervical cancer screening is to test for HPV DNA in the cervix, while the traditional cervical cell test (Pap smear) detects abnormal cell changes associated with cancer development.

Pap smear testing and HPV DNA test are helpful in detecting cervical problems early and treating them before they develop into cancer. The World Health Organization updated its guidelines in July 2021, to shift the global strategy to adopt HPV DNA test as a first-choice screening method among various screening methods.

What do Pap smear and HPV tests feel like?

Pa and HPV tests only take a few minutes, A nurse or doctor inserts a speculum into woman’s vagina. They use a small spatula or brush to collect a sample of cells from the surface of the cervix, which is then sent to the laboratory for testing. The process of both Pap and HPC DNA test is similar, and patients generally experience a similar sensation, although the content of the tests differs.

 What does HPV DNA tests check for?

Human papillomavirus (HPV) is the most common sexually transmitted virus. Most infections can be naturally cleared by the body’s immune system. However, a few types of HPV can cause cell changes and lead to cancer. These types are called “high-risk HPV.”

HPV DNA test has a high sensitivity and can detect pre-cancerous changes at an early stage. It also allows for longer testing intervals. The test can determine whether cervical cells are infected with high-risk HPV types. The test result will be reported as either “positive” or “negative.”

What does a Pap smear test check for?

A Pap smear test is used to detect abnormal changes in cervical cells. It can identify cell changes caused by high-risk HPV, but it does not directly detect HPV infection.

When should a Pap smear and/or HPV DNA test be done, and which test do I need?

According to the Hong Kong Centre for Health Protection, it is recommended that sexually active adult women undergo regular cervical cancer screening:

• Women aged 25-29: Pap smear test every 3 years.

• Women aged 30-64: HPV DNA test every 5 years, or Pap smear test every 3 years, or Pap smear test and HPV test (known as co-testing) every 5 years.

It takes several years for HPV to cause cell changes that can progress to cancer. Therefore, HPV DNA test can detect the presence of HPV before it potentially leads to cell changes, making it an earlier detection method compared to Pap smear testing, which detects cell changes that have already happened. This is why some doctors may recommend HPV DNA test over a Pap smear, and why you may need fewer testing intervals with HPV DNA test. However, both tests are important tools in preventing cervical cancer.

What happens if I get an abnormal Pap smear result or positive HPV DNA test result?

If a Pap smear detects abnormal cells on your cervix or if your HPV DNA test is positive, it does not mean that you have cancer. Most abnormal cells are caused by an HPV infection. You might need further investigation, such as a colposcopy, where a doctor will determine the extent and severity of the changes and provide appropriate treatment.

Do I still need Pap smear or HPV DNA tests if I got the HPV vaccine?

Yes, even if you have received the HPV vaccine, it is still recommended to undergo regular Pap smear or HPV DNA test. While the HPV vaccine is an excellent method for preventing HPV and cervical cancer, it does not protect against all types of HPV. Therefore, regular screening as advised by your doctor remains important.