What is the difference between a Pap test and an HPV test? Do I need both?

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Q:

What is the difference between a Pap test and an HPV test? Do I need both?


A:

A Pap test evaluates a sample of cells from your cervix. This very quick, painless test is responsible for an 80 percent drop in the number of women diagnosed with cervical cancer in the past 50 years. This year, about 12,170 invasive cervical cancers will be diagnosed, far fewer than the 50,000 that would have occurred without screening. That's because the Pap test can identify very early cellular changes called dysplasia. Dysplasia is not cancer, but, depending on the type of dysplasia, could signify an increased risk of cancer. Removing these abnormal cells and following up with frequent Pap tests can help prevent cancer from occurring.

Screening guidelines for Pap tests currently vary slightly among leading medical organizations.

Leading medical organizations, including the American College of Obstetricians and Gynecologists (ACOG), the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF), recommend that screening for cervical cancer begin at age 21, regardless of sexual history. Women younger than age 21 are at very low risk of cancer. The benefits of cervical cancer screening for this age group do not outweigh the potential risks, such as unnecessary evaluation and possibly harmful treatment. Women of any age with risk factors for cervical cancer may need to be tested more frequently.

All three organizations recommend women ages 21 to 29 get a Pap test every three years. From age 30 to 65, the ACS and ACOG recommend a combined Pap test and HPV test every five years, but if the HPV test is not available, women in this age group may continue getting just the Pap test every three years. The USPSTF recommends either the three-year Pap schedule or the five-year combined schedule for women 30 to 65.

Because cervical cancer develops slowly and risk factors decrease with age, the organizations say that women over age 65 who have been screened previously with normal results and are not at high risk for cervical cancer should stop getting screened. Women with cervical precancer should continue to be screened.

All major organizations agree you can stop having Pap tests if your uterus and cervix were removed for noncancerous reasons; but if they were removed because of cancer, you still need the test.

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