Cervical

Pap smear and HPV test: what to expect

Cervical cancer starts in the cells of the cervix, the lower part of the uterus that connects to the vagina. Like other cancers, it causes no symptoms in its early stages, when it can only be found with screening. In countries with good screening programmes, deaths from cervical cancer have fallen dramatically, because screening finds precancerous cells before they turn into cancer.

The Pap smear

A Pap smear collects a sample of cells from the cervix to check them for cancerous or precancerous changes. A speculum is gently inserted into the vagina, and a small brush is used to take the sample. Most people don’t find it painful, although you may feel brief discomfort when the brush touches the cervix. The test takes a few minutes.

The HPV test

The HPV test looks for high-risk types of human papillomavirus in cells from the cervix. It doesn’t tell you whether you have cancer, but almost all cervical cancers are caused by HPV, so finding the virus is a reliable way to estimate your risk. The sample is taken in the same way as a Pap smear, and the two tests can be done together (a co-test).

Because HPV infection is very common in young people and usually clears on its own, the HPV test is used for screening from 30. Self-collected samples are now an option in some clinics, and one prescription at-home kit was approved by the FDA in 2025. Over-the-counter home kits are not a substitute for screening.

Before your appointment

• Try to book your test at least 5 days after your period ends.
• For 2 days before, avoid vaginal sex, creams, lubricants and douches.

When to be screened

The USPSTF recommends screening from 21 to 65: a Pap smear every 3 years until 29, then from 30 an HPV test every 5 years (preferred), a co-test every 5 years, or a Pap smear every 3 years. The American Cancer Society recommends starting at 25 with a primary HPV test every 5 years. You can stop after 65 only if you have been screened regularly for the previous 10 years with normal results; cervical cancer doesn’t become less common after 65.

If your HPV test is positive

Although HPV is fairly common in the general population and often clears on its own, a positive test should be followed up with further testing, such as a Pap smear or a colposcopy, as advised by your doctor. Cancer usually takes years to develop after an infection, which is why regular screening works so well.

This article gives general information and doesn’t replace advice from your physician. Want to know which screenings apply to you? Take the ScreenMe questionnaire.