Cervical Health 101: Pap Tests vs. HPV Tests

Pap tests and HPV tests are some of the best ways to prevent cervical cancer. These screenings can help find problems on the cervix early on, so you can treat them before they lead to cancer. Cervical cancer used to be the most frequent cause of cancer deaths in women, but thanks to Pap and HPV tests, along with the HPV vaccine, it’s now much less common in the U.S. — that’s why regular screenings are so important.

What do Pap and HPV tests feel like?

Pap and HPV tests only take a few minutes. A nurse or doctor uses a speculum to open your vagina. They gently rub your cervix with a small swab, brush, or spatula to get a tiny sample of cells, then they send that cell sample to a lab for testing. There may be some pressure when your doctor or nurse opens the speculum inside you, and you might also feel a light scratching or a small, mild cramp when they rub your cervix. It can sometimes be a little uncomfortable, but it usually doesn’t hurt and it’s over very quickly.

Pap and HPV tests use the same process and feel similar to the patient, but they test for different things.

What does the HPV test look for?

Human papillomavirus (HPV) is a really common sexually transmitted infection. Most of the time it’s not harmful, and your body naturally clears it over time. But a few types of HPV can cause cell changes that may eventually lead to cancer in some people — these types are called "high-risk HPV."

An HPV test looks for some of these high-risk types of HPV on your cervix. After your doctor sends your HPV test to the lab, the results will come back as “positive” or “negative.”

What does the Pap test look for?

Pap tests, sometimes called Pap smears, look for abnormal cells on your cervix that can possibly lead to cervical cancer. Pap tests find cell changes caused by high-risk HPV, but they don't test for HPV itself. 

After your doctor sends your Pap test to the lab, the results will come back as “normal” or “abnormal.”

Do the Pap and HPV tests find cancer?

Nope. Pap and HPV tests don’t find cancer directly. They're just screenings that tell your doctor whether you need more testing or treatment. 

When should I get a Pap test and/or HPV test, and which kind of test do I need?

How often you get tested depends on your age, medical history, and the results of your last Pap or HPV tests. In general:

• If you’re 21–24 years old: You can choose to get a Pap test every 3 years, or you can wait until you’re 25 to start getting tested.

• If you’re 25–65 years old: Get an HPV test every 5 years, or a Pap test and HPV test together (called co-testing) every 5 years. In some places where HPV tests are not as available, you may get only a Pap test every 3 years.

• If you’re older than 65: You may not need HPV/Pap tests anymore.

You can get both the Pap and HPV tests during your regular wellness exam. Your doctor can tell you which tests you need and when you need them based on your personal situation. If you have a history of HPV or abnormal Pap tests, your doctor may want to test you more often.

It takes years for HPV to cause cell changes, and for those cell changes to become cancer. So HPV tests catch problems a little earlier than Pap tests, because they find HPV before it may cause cell changes — Pap tests find cell changes after they’ve already happened. That’s why some doctors recommend HPV tests over Pap tests, and why you may need testing less often when you get HPV tests. But both tests are great tools for preventing cervical cancer.

Wait, every 3-5 years? Did the HPV and Pap test screening guidelines change?

Yep. Guidelines for keeping your cervix healthy might have changed since your last visit, and you may need testing less often than you used to. That’s because doctors and researchers have learned more about what causes cervical cancer, so testing has gotten better over time. They also learned that it takes several years for precancerous cell changes to develop. Getting tested more often than you need may cause you to have unnecessary procedures.  

Your doctor or nurse might still follow older guidelines, or want to test you more often based on your medical history. No matter what they recommend, you should feel comfortable with the amount of testing you’re getting. So if you have questions or concerns, talk with your doctor about a plan that makes sense for you.

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

If the lab finds abnormal cells on your cervix from a Pap test, or if your HPV test comes back positive, don’t panic  — it doesn’t mean you have cancer, it just means that you might need more testing and/or treatment. Your doctor may also just monitor your cervix to see if the issue goes away on its own (which is common).

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

Yes. The HPV vaccine is a great way to help prevent HPV and cervical cancer. But the HPV vaccine doesn’t protect against ALL types of HPV, so it's still important to get testing when your doctor recommends it.  

Where can I get an HPV or Pap test?

You can get Pap and HPV tests from a nurse or doctor, like the ones at your local Planned Parenthood health center. You may also be able to get them at some community health clinics or through the health department. Thanks to the Affordable Care Act (Obamacare), Pap or HPV tests are usually free with health insurance. If you don't have health insurance or you're worried about costs, contact your local Planned Parenthood health center to see if they can hook you up with affordable care.