Pap Test vs. HPV Test: Cervical Cancer Screening Explained

What does a Pap test look for?

A Pap test—also called cervical cytology or a Pap smear—collects cells from the cervix. A laboratory examines those cells for changes that may be precancerous. The test may also show inflammation or other findings, but its screening purpose is to identify cervical cell changes that need the appropriate follow-up.

A normal result means the laboratory did not find abnormal cervical cell changes in the sample. An unclear, abnormal, or unsatisfactory result does not automatically mean cancer. The result needs to be interpreted with the person’s age, HPV findings, prior screening, and health history.

What does an HPV test look for?

An HPV test looks for high-risk types of human papillomavirus that can cause cervical cell changes. HPV is common, and many infections are controlled by the body. A positive high-risk HPV result is not a cervical cancer diagnosis, but it may change the recommended follow-up.

Some HPV tests identify whether specific higher-risk types are present. The laboratory result and previous screening history help the clinician determine whether repeat testing, cytology, genotyping, colposcopy, or another step may be appropriate. Patients should not try to choose that step from a single result without clinical review.

What is cotesting?

Cotesting means an HPV test and a Pap test are performed together. The same cervical sample may be used to look for both high-risk HPV and cervical cell changes. For average-risk patients ages 30 to 65, current guidance includes several accepted strategies, and the available options can depend on the clinical setting and guideline being followed.

More testing is not automatically better. Screening too frequently can lead to additional procedures and anxiety without improving benefit for every average-risk patient. Follow the interval recommended after a review of your age, history, prior results, and test type.

What are the current age and interval recommendations?

Guidelines are updated over time and do not always change on the same schedule. The CDC summarizes current U.S. options for average-risk screening as follows:

• Ages 21 to 29: Pap testing beginning at age 21; after a normal result, the usual interval may be three years.
• Ages 30 to 65: primary HPV testing every five years, HPV/Pap cotesting every five years, or Pap testing every three years may be options.
• Older than 65: some people may stop after adequate prior negative screening and without a history that calls for continued surveillance; others may still need screening.

HRSA announced an updated Women’s Preventive Services guideline in January 2026. Beginning with plan years starting in 2027, it identifies primary high-risk HPV testing every five years as the preferred strategy for average-risk women ages 30 to 65, while retaining cotesting every five years and Pap testing every three years when primary HPV testing is unavailable. The clinical choice and insurance implementation should be confirmed rather than assumed.

Who may need a different screening plan?

Average-risk schedules do not apply to everyone. A clinician may recommend a different plan for people with a history of abnormal cervical screening or biopsy results, cervical precancer or cancer, HIV, another condition that weakens the immune system, or prenatal exposure to diethylstilbestrol (DES).

Hysterectomy history matters too. A total hysterectomy removes the uterus and cervix; a supracervical or partial hysterectomy leaves the cervix in place. Whether screening is still needed also depends on the reason for surgery and any prior cervical precancer or cancer. Confirm what was removed and review the operative history with a clinician.

Does HPV vaccination replace screening?

No. HPV vaccination helps prevent infection with important HPV types, but it does not cover every high-risk type. The National Cancer Institute advises vaccinated people with a cervix to continue following cervical cancer screening recommendations.

Bring your vaccination dates if you have them, but do not delay a screening conversation because the record is incomplete. Your clinician can review age, prior doses, screening history, and other factors separately.

What happens during cervical screening?

Clinician-collected cervical screening is usually done during a pelvic examination. The clinician uses a speculum to see the cervix and a soft brush or small collection device to obtain the sample. The sample is sent to a laboratory for the ordered Pap test, HPV test, or cotest.

Tell the clinician if you have pain, anxiety about the examination, a history of trauma, mobility needs, or questions about positioning. You can ask the clinician to explain each step, use your preferred name and language, pause when requested, and discuss what may make the examination more comfortable.

How should you prepare?

CDC states that no special preparation is needed for an HPV test. For a Pap test, CDC advises avoiding intercourse, douching, and vaginal medicines or spermicidal foam for two days beforehand to support an accurate sample. If you already had intercourse or your period starts, keep the appointment unless the clinic tells you otherwise and let the clinician know.

Before the visit, gather the date and result of your last Pap or HPV test, any history of colposcopy or cervical treatment, the type of hysterectomy if applicable, current symptoms, medicines, allergies, pregnancy status, and questions. Ask whether screening is being done at the visit and whether laboratory charges are separate.

What about self-collected HPV testing?

In 2024, the FDA approved certain self-collected vaginal samples for primary HPV testing in healthcare settings. NCI reports that expert guidance considers self-collection acceptable for asymptomatic, average-risk individuals when an approved process is used. People with prior abnormal screening, colposcopy, or treatment generally need clinician-collected cervical specimens because evidence for self-collection in surveillance is limited.

HRSA’s updated guideline adds patient-collected high-risk HPV testing as an option for average-risk women ages 30 to 65 beginning with plan years starting in 2027. Availability is not universal. Ask which approved test is offered, where the sample is collected, how results are communicated, and what additional clinician-collected testing may be required.

What do abnormal results mean?

An abnormal Pap result means cervical cell changes were found; a positive HPV result means a high-risk HPV type was detected. Neither result by itself proves cervical cancer. Some changes are minor and may resolve, while others require closer evaluation.

The next step depends on the exact result and clinical history. Ask for a copy of the laboratory report, the recommended follow-up, the time frame, and who will arrange it. Screening only protects health when recommended follow-up is completed.

Screening is not the same as evaluating symptoms

Screening is intended for people without symptoms. Unexpected vaginal bleeding, bleeding after sex, unusual discharge, or pelvic pain should be discussed with a clinician rather than waiting for the next routine screening date. These symptoms can have many causes and require individualized evaluation.

Seek urgent care based on the severity of symptoms, pregnancy status, bleeding, pain, weakness, or other concerning changes. This article cannot determine the cause or the right level of care for an individual symptom.

Questions to ask at your appointment

• Am I due for cervical cancer screening based on my age and prior results?
• Which test are you recommending: Pap, primary HPV, or cotesting?
• What interval applies if this result is normal?
• Does my history change the routine screening schedule?
• How and when will I receive the laboratory result?
• What follow-up would be needed after an abnormal or positive result?
• Is self-collected HPV testing available and appropriate here?
• Are the visit, laboratory, and possible follow-up services billed separately?