HPV and cervical cancer
Almost all cervical cancers are linked to persistent infection with high-risk types of human papillomavirus (HPV), which is sexually transmitted. HPV infection is very common and most clear within 1-2 years. The few persistent infections can cause pre-cancerous changes over years, which is why screening works.
Pap smear versus HPV test
- HPV test: detects high-risk HPV in cervical cells; highly sensitive, and a negative result gives long-term reassurance.
- Pap smear (cytology): examines cervical cells under the microscope for changes.
Both can be taken in the same examination within seconds.
Before the test
- Book outside your period, ideally a few days after it ends.
- Avoid douching, pessaries, creams and sex for 48 hours beforehand.
The examination usually causes only mild pressure. A study co-authored by Prof. Dr. İkbal Kaygusuz examined whether gel application reduces pain during speculum examination and how it affects smear results.
If the result is abnormal
An abnormal result does not mean cancer. Risk is calculated from HPV type, cytology and previous results, leading to a repeat test in a year, colposcopy or treatment. Colposcopy examines the cervix under magnification with biopsies from suspicious areas. High-grade changes are removed with small procedures such as LEEP or conisation.
Who should keep screening?
Vaccinated women should still be screened. After 65, screening can stop for women with consistently normal results. Immunosuppressed women need more frequent screening.
Frequently Asked Questions
My HPV test is positive. Do I have cancer?
Do women who have never had sex need screening?
Sources
- World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions, 2nd ed., 2021.
- Perkins RB, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines. J Low Genit Tract Dis, 2020.
- The role of gel application in decreasing pain during speculum examination and its effects on papanicolaou smear results. Archives of Gynecology and Obstetrics, 2014.
- Abnormal cervical cytology risk factors in the Western Black Sea Region and the importance of health insurance. Türk Patoloji Dergisi, 2014.
The information on this website is for general information only and does not replace a medical consultation.