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The most important risk factor for developing cervical cancer is infection with human papillomavirus (HPV). Doctors can test for the high-risk HPV types that are most likely to cause cervical cancer by looking for pieces of their DNA in cervical cells. The test can be done by itself (primary HPV test) or at the same time as a Pap test (called a co-test). You won’t notice a difference in your exam if you have both tests done.
The HPV test is most often used in 2 situations:
The ACS recommends the primary HPV test* as the preferred test for cervical cancer screening for people 25-65 years of age. (*A primary HPV test is an HPV test that is done by itself for screening. The US Food and Drug Administration has approved certain tests to be primary HPV tests.)
Some HPV tests are approved only as part of a co-test, when the HPV test and the Pap test are done at the same time to screen for cervical cancer. Because a primary HPV test may not be an option everywhere, a co-test every 5 years or a Pap test every 3 years are still good options.
All the screening tests (primary HPV test, co-test, and Pap test) are good at finding cancer and pre-cancer. The primary HPV test is better at preventing cervical cancers than a Pap test done alone and does not add more unnecessary tests, which can happen with a co-test. The most important thing to remember is to get screened regularly, no matter which test you get.
The result of the HPV test, along with your past test results, determines your risk of developing cervical cancer. If the test is positive, this could mean more follow-up visits, more tests to look for a pre-cancer or cancer, and sometimes a procedure to treat any pre-cancers that might be found.
Because there are many different follow-up or treatment options depending on your specific risk of developing cervical cancer, it is best to talk to your healthcare provider about your screening results in more detail, to fully understand your risk of cervical cancer and what follow-up plan is best for you.
For more information, see the American Cancer Society document HPV and HPV Testing.
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Eifel P, Klopp AH, Berek JS, and Konstantinopoulos A. Chapter 74: Cancer of the Cervix, Vagina, and Vulva. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
Fontham, ETH, Wolf, AMD, Church, TR, et al. Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update from the American Cancer Society. CA Cancer J Clin. 2020. https://doi.org/10.3322/caac.21628.
Jhungran A, Russell AH, Seiden MV, Duska LR, Goodman A, Lee S, et al. Chapter 84: Cancers of the Cervix, Vulva, and Vagina. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.
National Cancer Institute. Understanding Cervical Changes: Next Steps After an Abnormal Screening Test. 2019. https://www.cancer.gov/types/cervical/understanding-cervical-changes#ui-id-2. Updated October 8, 2019. Accessed on November 1, 2019.
Last Revised: July 30, 2020