The Connection Between HPV and Cancer

By Diane M Harper, MD, MPH, MS Professor of Medicine Center of Excellence for Women's Health Departments of Obstetrics and Gynecology, Community and Family Medicine and Biomedical and Health Informatics University of Missouri-Kansas City School of Medicine

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How does a Pap smear test for HPV? If the test is negative does that mean I'm safe?

Pap testing looks at the shape of the cell nucleus compared to the whole skin cell from your cervix. If HPV has caused any damage to the cell, we can see the changes in the shape of the cell.

HPV that lives inside the cell that is not causing any damage to the cell will NOT be seen as an abnormal cell on a Pap test because the virus has not caused any changes, but might be detected on the HPV test.

Pap testing has been used as a single test alone to detect early pre-cancers and is very effective. If you do not have access to HPV testing or cannot afford it, Pap testing alone is still a very good test to use for your screening.

If your HPV test and your Pap test are both negative and normal, your chances for having a cervical cancer precursor are less than five in 1,000 — very low.

How often should I get Pap smears to test for cancer?

In the US, the recommendations for Pap testing include starting at the age of 21 years and repeating it every 3 years, if it is normal.

At the age of 30 years, you have the option of having both the Pap and HPV test, or having just the Pap test. If you choose the Pap test alone, and it is normal, you need to continue with the Pap test every 3 years. 

If you choose the Pap and HPV test, and both are normal/negative, then you should be screened every 5 years, and not any earlier.

At the age of 65 or 70 years, a woman, in discussion with her doctor, can decide if she can stop her Pap and HPV testing. If a woman has had a hysterectomy and never had an abnormal Pap test, then she no longer needs to have Pap testing.

How is HPV treated?

There is no medicine or cure for HPV.  We treat cells that have changed because of the HPV infection with freezing or excision. This treatment removes the dangerous tissue, but does not cure you of HPV.

Diane M Harper, MD, MPH, MS

Article written by Diane M Harper, MD, MPH, MS
Professor of Medicine Center of Excellence for Women's Health Departments of Obstetrics and Gynecology, Community and Family Medicine and Biomedical and Health Informatics University of Missouri-Kansas City School of Medicine