A Pap test, or Pap smear, screens for cervical cancer and is recommended for women between 21 and 65. If your results are normal, you may not need to get screened again for another three to five years, depending on your age and the test you receive. But what happens when your results come back positive, abnormal, or unclear? Read on to learn more about the goal of cervical cancer screening, understand what HPV and Pap tests are, and what your results could mean.

Who needs to screen for cervical cancer, and why?

Cervical cancer starts in the cervix, the lower part of the uterus, where a baby grows during pregnancy. That means anyone with a cervix is at risk for cervical cancer and should screen regularly. Regular screenings can help find and treat precancerous, dysplastic lesions early. These are abnormal cells found on the surface of the cervix and are easier to treat before they become cancer. 

Do I need to get a Pap test or an HPV exam?

Two types of tests can be performed during cervical cancer exams: a Pap test and an HPV test. Your gynecologist may do one or both tests during your annual wellness exam. A Pap test looks for changes in cervical cells that could become cancer. In contrast, an HPV test looks for infection caused by high-risk human papillomaviruses (HPV), a virus commonly transmitted during sexual contact. Most HPV infections go away on their own without health problems, but if infections last for years, they can cause cervical cancer or other health problems.

How often should women screen for cervical cancer?

In general, women between 21 and 65 should have regular Pap smears. You may also need an HPV test after you turn 30. Women older than 65 who have not had any abnormal Pap smear testing history or have had normal Pap smears for 25 years may discontinue testing. Generally, you should have these tests at least every three years unless the results are unclear or abnormal. In cases where you had normal Pap and HPV test results, you could wait five years until your next test. Read on to learn more about what your test results may mean.

Do abnormal results mean I have cancer?

A Pap test can be normal (or “negative”), unclear, abnormal, or unsatisfactory. In contrast, an HPV test can be negative or positive. Even if a Pap test is negative, you still need a Pap exam every three years, as it’s possible for the cells in your cervix to change. An abnormal Pap test doesn't automatically mean you have cancer. It means your test results show changes in your cervix. Those could be minor changes that go back to normal on their own, or serious changes, often called “precancer.” While rare, an abnormal test can show that you may have cancer. An unsatisfactory Pap test result is one in which there aren’t enough cells in the sample to analyze, or in some cases, the cells are clumped together. It may not be a reason for concern. Your provider may ask you to return in a few months for another test.

HPV test results are more straightforward to understand. Your test is either negative or positive. A negative HPV test means precisely that: no HPV was found. You can usually wait another five years until your next test. Positive or abnormal test results suggest that high-risk HPV, the more serious type, was found. While hearing that your HPV test was positive can be discouraging, it doesn’t mean you have cancer. It means you are more likely to develop cervical cancer in the future. Your provider may ask for additional tests or monitor your condition. If your results are positive, it's important to test more regularly. It can take years for abnormal cervical cells to turn into cancer. If found early, abnormal cells can be treated before they become cancerous. It's much easier to prevent cervical cancer than to treat it once it develops.

The bottom line

In its early stages, cervical cancer usually has no symptoms, making it difficult to detect. When symptoms are present in the early stage, it’s common to experience vaginal bleeding, bleeding after intercourse, pelvic pain, or vaginal discharge with a strong odor. The best way to prevent cervical cancer is by getting regular Pap or HPV tests. You have more treatment options when detected early, which could save your life. 

Sources:

What Is Cervical Cancer? - NCI

Cervical Cancer Overview | Guide To Cervical Cancer

Cervical Cancer | HPV | Human Papillomavirus | MedlinePlus

Basic Information About Cervical Cancer | CDC

What Should I Know About Cervical Cancer Screening? | CDC

Pap Smear: MedlinePlus Medical Test

Human Papillomavirus (HPV) Test: MedlinePlus Medical Test