Cervıcal Screenıng Test
What Is a Cervical Screening Test? Pap Smear and HPV Test
A cervical screening test is an important screening method that helps detect cervical cancer and precancerous cellular changes at an early stage. One of the best-known screening methods in medicine is the Pap Smear Test. The Pap Smear test is performed by examining a cell sample taken from the cervix under a microscope.
Cervical cancer usually develops over many years. Therefore, the goal is not only to diagnose cancer, but also to detect cellular changes that appear before cancer develops and treat them appropriately. According to the CDC, the Pap test and HPV test can help prevent cervical cancer or detect it early (1).
“ Cervical screening is not done to wait for cancer; it is done to catch warning cellular changes before cancer develops. ”
Why Is a Cervical Screening Test Performed?
The main purpose of a cervical screening test is to detect precancerous cellular changes in the cervix at an early stage. These changes often do not cause symptoms. If regular screening is not performed, they may go unnoticed and may turn into cervical cancer over the years.
The World Health Organization states that cervical cancer is largely associated with persistent high-risk HPV infection and that screening programs can reduce the disease burden by detecting precancerous lesions (2).
A cervical screening test is performed for the following purposes:
- To detect precancerous cellular changes in the cervix,
- To detect cervical cancer at an early stage,
- To evaluate high-risk HPV types,
- To monitor abnormal cellular changes,
- To plan further evaluations such as colposcopy or biopsy when necessary.
What Is a Pap Smear Test?
The Pap Smear Test is the process of taking a cell sample from the cervix with the help of a soft brush or spatula. The collected cells are examined in a pathology laboratory to evaluate whether there are abnormal cellular changes in the cervix.
According to ACOG, the Pap test is generally recommended every 3 years for women aged 21-29. Between the ages of 30-65, Pap test, HPV test, or co-testing options using both tests together may be evaluated according to the individual (3).
What Is an HPV Test?
The HPV test is a test that investigates the presence of high-risk HPV types associated with cervical cancer. While the Pap Smear test shows cellular changes, the HPV test helps detect high-risk HPV types that may cause these changes.
The National Cancer Institute states that in cervical cancer screening, the HPV test can be used together with the Pap test or alone in certain age groups (4). Especially in women aged 30 and over, the HPV test may be an important part of the screening plan.
Who Should Have a Cervical Screening Test?
Cervical screening is recommended for people who have a cervix, according to their age and risk status. The CDC recommends starting Pap testing at age 21 and advises people aged 30 and over to discuss testing options with their doctor (1).
The general screening approach is as follows:
- Ages 21-29: A Pap Smear test can generally be performed every 3 years.
- Ages 30-65: Pap test every 3 years, HPV test every 5 years, or Pap Smear + HPV co-test every 5 years may be evaluated.
- After age 65: If previous screening results have been regular and normal, stopping screening may be considered; the decision should be made with a physician.
- High-risk groups: More frequent follow-up may be required in people with a suppressed immune system, a history of high-grade lesions, or a history of abnormal results.
Screening frequency may vary depending on age, previous test results, HPV status, immune system, pregnancy history, and whether the person has previously received treatment for a cervical lesion.
What Should Be Considered Before a Cervical Screening Test?
Proper preparation before the test may help the sample be evaluated more accurately. If possible, it is preferred that the test be performed when there is no menstrual bleeding.
- Sexual intercourse should be avoided within 24-48 hours before the test.
- Vaginal douching should not be performed.
- Tampons should not be used.
- Vaginal creams, suppositories, or medications should not be used.
- If there is an active vaginal infection or heavy discharge, evaluation and treatment may be needed first.
- If pregnancy exists or there is a possibility of pregnancy, the physician should be informed.
“ Avoiding vaginal products before smear and HPV testing improves sample quality and helps reduce the risk of incorrect evaluation. ”
How Is a Cervical Screening Test Performed?
A cervical screening test is a short, generally painless procedure that can be performed during a routine gynecological examination. The patient is placed in the gynecological examination position. A speculum is inserted into the vagina to make the cervix visible.
Then, a cell sample is taken from the cervix with the help of a soft brush or spatula. Depending on the method used, the sample may be spread onto a slide or placed into a liquid-based cytology container. An HPV test can also be performed from the same sample. The procedure usually takes a very short time and does not damage the tissue.
- The patient is placed in the gynecological examination position.
- The cervix is visualized with a speculum.
- A cell sample is taken from the cervix with a brush or spatula.
- The sample is sent to the laboratory.
- Results are evaluated as Pap Smear, HPV test, or co-test.
Is a Cervical Screening Test Painful?
Pap Smear and HPV testing are usually not painful. Some people may feel pressure or mild discomfort when the speculum is inserted. A brief light contact sensation may occur while the cell sample is being taken. Mild spotting may occur after the procedure; this is usually short-lived.
When Are Cervical Screening Test Results Available?
The result time may vary depending on the laboratory’s workflow. Pap Smear and HPV test results may be available within a few days to a few weeks in most centers. Whether the result is normal, abnormal, HPV positive, or HPV negative determines the follow-up plan.
How Are Cervical Screening Test Results Evaluated?
As a result of screening, the Pap Smear may be normal or abnormal. The HPV test may be reported as high-risk HPV positive or negative. An abnormal result does not necessarily mean cancer. Most of the time, it indicates cellular changes in the cervix that need to be followed.
ACOG states that in abnormal cervical screening results, the follow-up plan is determined according to the HPV result, Pap Smear finding, age, and previous test history (5).
- Normal Pap Smear: No abnormal cellular change has been detected.
- HPV Negative: The tested high-risk HPV types have not been detected.
- HPV Positive: One of the high-risk HPV types has been detected; the follow-up plan is determined according to the HPV type and smear result.
- Results such as ASC-US, LSIL, HSIL: These show the degree of cellular change, and colposcopy may be planned if necessary.
When Are Colposcopy and Biopsy Needed?
If abnormal cells are detected in a cervical screening test or if high-risk HPV positivity is present, colposcopy may be required. Colposcopy allows the cervix to be examined in detail under magnification. If a suspicious area is seen, a biopsy may be taken.
A biopsy is the process of taking a small tissue sample from the cervix and examining it in a pathology laboratory. More advanced procedures such as cone biopsy are usually planned when there is suspicion of a high-grade lesion or when diagnosis and treatment are required.
The Role of the HPV Vaccine in Cervical Cancer Screening
The HPV vaccine helps provide protection against some high-risk HPV types that can cause cervical cancer. However, being vaccinated does not mean screening tests should be completely stopped. Even vaccinated people should continue age- and risk-appropriate cervical screening.
In the WHO’s strategy to eliminate cervical cancer, HPV vaccination, regular screening, and treatment of precancerous lesions are addressed together (2).
Cervical Screening Test Prices 2026
Cervical screening test prices may vary depending on whether only a Pap Smear test is performed, whether HPV DNA testing is added, the liquid-based cytology method, laboratory scope, and whether additional evaluation is required.
The most accurate information about current cervical screening test prices for 2026 can be provided through a personal evaluation after examination. This is because each patient’s age, risk status, previous test history, and required screening method are different.
Frequently Asked Questions
The Pap Smear test is one of the methods used in cervical screening. Cervical screening may be performed as a Pap Smear, HPV test, or co-test using both together.
In general, Pap Smear screening begins at age 21. Screening frequency may vary according to age, HPV testing, and previous results (1,3).
HPV positivity does not mean cancer. Follow-up, repeat testing, or colposcopy may be planned according to the HPV type, smear result, and previous test history.
A smear test is usually not painful. There may be a mild feeling of pressure when the speculum is inserted. Taking the cell sample is a short procedure.
It is recommended to avoid sexual intercourse within 24-48 hours before the test. Vaginal cream, suppositories, tampons, and vaginal douching should also not be used before the test.
Yes. The HPV vaccine helps reduce the risk of cervical cancer; however, because it does not provide complete protection against all HPV types, age-appropriate screening tests should continue.
References
- CDC. Screening for Cervical Cancer. (https://www.cdc.gov/cervical-cancer/screening/index.html)
- World Health Organization (WHO). Cervical cancer. (https://www.who.int/news-room/fact-sheets/detail/cervical-cancer)
- American College of Obstetricians and Gynecologists (ACOG). Cervical Cancer Screening. (https://www.acog.org/womens-health/faqs/cervical-cancer-screening)
- National Cancer Institute (NCI). Cervical Cancer Screening. (https://www.cancer.gov/types/cervical/screening)
- American College of Obstetricians and Gynecologists (ACOG). Abnormal Cervical Cancer Screening Test Results. (https://www.acog.org/womens-health/faqs/abnormal-cervical-cancer-screening-test-results)