Understanding Cervical Changes - National Cancer Institute


Introduction


What Is the Cervix?


What Should I Know About HPV Infection?


Finding Abnormal Cells


What Do My Pap Test Results Mean?


Questions To Ask Your Health Care Provider


Finding the Support You Need


Table 1


Table 2


Table 3


Table 4


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Finding Abnormal Cells

The Pap Test
The HPV Test
How Is the HPV Test Done?
When Is an HPV Test Useful?

The Pap Test

The Pap test finds certain cell changes before they lead to cancer or cause you to have symptoms.

These cell changes can almost always be treated so that you don't get cancer of the cervix. Most changes in the cervix happen very slowly.

If the lab finds cell changes, the Pap test result is called "positive" or abnormal. If cells look healthy, the result is called "negative" or normal.

The Pap test is not always 100-percent accurate. If the test misses cell changes once, they can often be found the next time you have one. This is why it is very important that you have regular Pap tests. You should also go back to your health care provider for care if you get an abnormal result.

The Pap Test and DES

If you were born between 1940 and 1971, and your mother was given a synthetic form of the hormone estrogen called diethylstilbestrol (DES) when she was pregnant with you, be sure to tell your doctor. Your doctor will want to take additional cells to check for a rare type of cancer.

The HPV Test

Almost all cervical cancer begins as an infection with the virus called HPV. An HPV test, which is done much like a Pap test, can detect the virus in cervical cells.

Because health care providers know what causes most cervical cancers, it is important to get an HPV test if your health care provider recommends one.

How Is the HPV Test Done?

In an HPV test, a small number of cells is collected from the cervix, much like a Pap test. Sometimes this can be done at the same time as a Pap test. A lab then checks to see if HPV is present.

When Is an HPV Test Useful?

An HPV test can be useful in cervical cancer screening in two ways:

For women of all ages, an HPV test can be useful as follow-up to a Pap test with an unclear result of ASC-US (see Table 1).
If you are age 30 or older, an HPV test can be very useful if it is done together with a Pap test as a routine screening for cancer once every 3 years.

But if you are under age 30, getting an HPV and a Pap test together on a regular basis is not helpful. HPV tests can lead to unnecessary treatment, because HPV infection is very common in women under 30 and usually goes away on its own. This is why cervical cancer is very rare for women in this age group.

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