• Cancer

    Women’s Wellness: Could the HPV test replace the Pap smear?

Doctor and worried female patient at office during consultation
Not yet, according to Dr. Margaret Long, a Mayo Clinic OB-GYN. But she said the study published in JAMA raises the question of whether it might make sense to replace the Pap smear test with the HPV test in the future.

“The HPV test could potentially replace Pap testing for most women. It’s a better first test than a Pap test,” says Dr. Long, who is not associated with the study. “If your HPV test is negative, the chances of you developing cervical cancer is profoundly low for a long time.”

What is HPV?

HPV is a common virus and can lead to the development of genital warts, abnormal cervical cells or cervical cancer. Nearly 80 million Americans are infected with it, making it the most common sexually transmitted infection in the U.S., according to the Centers for Disease Control and Prevention (CDC).

For most women infected with HPV, the immune system helps prevent the virus from doing harm. But the infection can lead to the development of cancerous cells on the surface of the cervix for a small number of women.

“Virtually everybody that gets cervical cancer has human papillomavirus and, specifically, some high-risk types of human papillomavirus,” Dr. Long says.

Watch: Dr. Margaret Long discusses testing for cervical cancer.

Journalists: Broadcast-quality sound bites with Dr. Long are in the downloads.

How is the HPV test different than a Pap smear?

There is little difference when it comes to the process for collecting an HPV test and a Pap smear, according to Dr. Long. Both tests involve collecting samples of cervical cells using a soft brush and a flat paddle called a "spatula." What’s different is how these samples are tested.

A positive HPV test doesn’t necessarily mean a woman has cervical cancer. It means she has a high-risk form of the virus that can cause cervical cancer.

“If the test is positive, then we would do more testing to find out for sure if there is a risk for cervical cancer or not,” Dr. Long says.

Should women ask for the HPV test?

It is common for women who are getting a Pap test to be given an HPV test at the same time. If you are 30 or older, it is worth asking your health care provider about getting an HPV test in addition to a Pap test, according to Dr. Long.

a medical illustration of cervical cancer

“I think asking about HPV testing for cervical cancer screening would be a good choice,” Dr. Long says. “If the test is negative, it is very reassuring. If the test is positive, then you have additional testing.”

One benefit of getting the HPV test in addition to the Pap smear is potentially fewer visits to your health care provider. Under current recommendations, women who are age 30 and older who get a Pap test and an HPV test at the same time only need to be tested every five years. For women who only get Pap smears, the recommendations call for testing every three years.

The HPV test is not recommended for women younger than 30 because the potential for cervical cancer is much less and the rates of HPV are much higher. The current recommendation is that women under 30 get a Pap smear every three years.

Why are cervical cancer screenings so important?

Thanks to screenings, the number of women dying every year of cervical cancer has dropped significantly in recent decades.

“With cervical cancer screening, the rates have plummeted and they’re tremendously less than they were before. At this point in time in the United States, most everybody that dies of cervical cancer did not have screenings at all or they didn’t have screening for the last five to 10 years,” Dr. Long says.

Still, an estimated 13,240 cases of invasive cervical cancer are diagnosed every year. About 4,170 women will die from the cancer, according to the American Cancer Society.

Another effective way to prevent cervical cancer is for adolescents and young adults to get the HPV vaccine, Dr. Long says. The CDC recommends routine HPV vaccination at ages 11 or 12. Vaccines can be given to children as young as 9. The HPV vaccine is also recommend for females ages 13 through 26 who have not been adequately vaccinated and males age 13 through 21.

“Pretty much all cervical cancer is caused by high-risk HPV. And even more important than doing screenings is to prevent the HPV infection in the first place. And one of the best ways to do that is for adolescents and young adults is to get the HPV vaccine,” Dr. Long says.Women's Wellness logo