What Are The Differences Between HPV and Pap Smear Tests?

Both the Pap smear and the HPV test involve the same simple swab of cervical cells. So why do doctors sometimes recommend one, the other, or both at the same time?

The answer lies in what each test is actually looking for. A Pap smear checks for changes in your cervical cells, while an HPV test looks for the virus that can cause those changes in the first place. Learning how they differ can help you ask better questions at your next appointment and feel more informed about your cervical health.

What is a Pap smear test?

A Pap smear (also called a cervical smear) is a screening test that checks for abnormal or precancerous cell changes on your cervix, the lower part of your uterus that connects to the vagina.

During the test, your doctor gently collects a small sample of cervical cells using a soft brush or spatula. The sample is then examined under a microscope in a laboratory. The whole process takes just a few minutes and is generally well-tolerated.

It is also important to know that a Pap smear looks specifically at cell changes, not the presence of any virus.

What is an HPV test?

A human papillomavirus (HPV) test checks for the presence of high-risk strains of HPV in your cervical cells, particularly strains 16 and 18, which are most closely associated with cervical cancer.

HPV is a very common virus. Many people who have ever been sexually active may encounter it at some point in their lives. In most cases, the body clears it naturally without any symptoms. 

However, when certain high-risk strains persist, they may over time cause changes to cervical cells, increasing the risk of cervical cancer.

The test is performed the same way as a Pap smear, using a gentle swab of cervical cells. A positive result does not mean you have cancer. It simply means a high-risk strain of HPV was detected and that closer monitoring may be recommended to check whether any cell changes have developed.

HPV test vs Pap smear: What's the difference?

Both tests are used for cervical cancer screening, but they work in different ways. Knowing the difference helps you better understand your results and have more informed conversations with your doctor.

If your doctor recommends one test over the other, or both (called co-testing), it is because they want to give you the clearest  picture of your cervical health at that point in time.

If you're unsure which test applies to you or what the difference means for your cervical health, schedule an appointment with Thomson Medical. Our doctors can explain what each test looks for and help you understand which screening is appropriate for you.

Can a Pap smear detect HPV?

A Pap smear cannot directly detect the HPV virus. What it can detect are the cell changes that HPV may cause in your cervix over time.

This is why it is possible to have a normal Pap smear result and still test positive for HPV. The virus may be present, but if it has not yet caused any changes to your cervical cells, your Pap smear will appear normal.

This is not a flaw in the test. It simply reflects the fact that each test is designed to detect something different. This is also why, in some situations, your doctor may suggest doing co-testing.

HPV test vs Pap smear: Which should you get?

The answer is not the same for every woman. Your age, health history, and your doctor's guidance all play a part in deciding what is right for you.

HPV testing is more sensitive at detecting high-risk strains early, even before cell changes appear. Pap smears are better at identifying specific cell changes that need attention, with fewer false positives. 

Doing both tests together may give you a more complete picture of cervical health, particularly if:

• You are aged 30 and above

• You have a weakened immune system

• You have a history of abnormal results

If you are unsure which option suits you best, it may be worth raising it with your doctor at your next appointment.

What your Pap smear and HPV test results mean

Waiting for results and then trying to make sense of them can bring up a lot of questions. Your doctor will walk you through your results in detail and advise on next steps.

Here is a simple guide to what the most common result combinations mean:

• Normal Pap smear, HPV negative:

  • No cell changes were detected and no high-risk HPV strains were found.

  • Continue with your regular screening schedule as advised by your doctor.

• Normal Pap smear, HPV positive:

  • No cell changes were found, but a high-risk HPV strain is present. 

  • Your doctor will advise on the appropriate follow-up timeline. 

• Abnormal Pap smear, HPV negative:

  • Some cell changes were detected, but they do not appear to be linked to a high-risk HPV strain. 

  • Your doctor will advise on whether a repeat smear or further monitoring is needed.

• Abnormal Pap smear, HPV positive:

  • Both cell changes and a high-risk HPV strain were detected. 

  • Your doctor may refer you for a colposcopy (a closer examination of the cervix) to better understand the findings and determine next steps.

It is worth noting that an abnormal result does not mean cancer. Many abnormalities are caught early and can be monitored or managed with your doctor's guidance.

If your results have left you with questions or you're unsure what your next steps should be, schedule an appointment with Thomson Medical. Our doctors can walk you through your findings and recommend an appropriate follow-up plan.

FAQ

Will a Pap smear show if I have HPV? 

A Pap smear cannot detect HPV directly. It can only detect cell changes that HPV may have caused. It is possible to have HPV and still receive a normal Pap smear result if no cell changes have developed yet.

Is the HPV test less painful than a Pap smear? 

Both tests use the same gentle swab of cervical cells, so the physical experience is essentially the same. Any discomfort is usually brief. If you find the procedure uncomfortable, let your nurse or doctor know. They can help make the experience as comfortable as possible for you.

Why is my Pap smear negative but HPV positive? 

This is more common than many women realise. It means the HPV virus is present but has not yet caused any detectable changes to your cervical cells. Your doctor will advise on appropriate follow-up based on your results.

Is the HPV test done at the same time as a Pap smear? 

Yes. When both tests are performed together, known as co-testing, they are done in a single appointment using the same swab. You do not need to schedule a separate visit.

What happens if my HPV test comes back positive? 

Your doctor will recommend a follow-up plan based on your full results. This may include a repeat test after a period of time or a referral for a colposcopy (a closer examination of the cervix carried out by a specialist). A positive HPV result does not mean you have cancer, and your doctor will guide you through each step.

Do I still need a Pap smear if I had the HPV vaccine? 

The information provided is for general guidance only and should not be considered as medical advice. For a personalised consultation and tailored advice, schedule an appointment with Thomson Medical today.