Category: Women's Health / Cancer Screening
Cervical Screening
Also known as: Smear test · Pap smear
Cervical screening is testing offered to people with a cervix who have no symptoms, to find changes that could develop into cervical cancer. Modern screening usually tests a cervical sample for high-risk human papillomavirus, the virus that causes cervical cancer, and may also examine the cells themselves for abnormal changes. Screening is not a diagnosis and it is not a test for symptoms: it identifies people who need closer follow-up. In Singapore a Pap test is used from age 25 and an HPV test from age 30.
Why cervical screening exists
Cervical cancer is unusual among cancers because its cause is known and its development is slow. Persistent infection with high-risk HPV is the cause of cervical cancer, and it usually takes 15 to 20 years to develop after infection.
That gives screening a long window to work in. The goal is to find precancerous cell changes before they become cancer, at a point where treatment can prevent cancer from developing. Early cell changes almost never cause symptoms, which is why screening is offered to people who feel well.
HPV test and Pap test: what is the difference?
Both start the same way. A healthcare professional gently collects cells from the cervix and sends them to a laboratory. What the laboratory looks for is what differs:
- An HPV test looks for the genetic material of high-risk HPV types in the sample. It answers whether the virus that causes cervical cancer is present.
- A Pap test, also called a smear test or cervical cytology, examines the cells under a microscope for abnormal changes.
- Many programmes now use HPV testing as the first-line test, because detecting the cause is more sensitive than looking for changes it has already produced.
Who is screened, and how often
Screening ages and intervals are set by national programmes and differ between countries. In Singapore, a Pap test is used for women aged 25 to 29 and an HPV test from age 30 onwards, with subsidised screening available to eligible Singapore Citizens under Healthier SG Screening.
WHO's general guidance is that women should be screened every 5 to 10 years starting at age 30, and women living with HIV every 3 years starting at age 25.
Self-sampling
For some HPV tests, a person can collect their own vaginal sample rather than having it collected during a clinical examination. This can remove a practical or personal barrier to being screened at all.
Whether self-sampling is approved, and how the sample is processed, depends on the specific test and the country in which it is supplied. Self-sampling collects a sample for an HPV test. It does not replace clinical assessment where that is what the result calls for.
What your result means
A negative high-risk HPV result means no high-risk type was detected, and you will normally be invited again at the routine interval.
A positive high-risk HPV result means the virus was detected. It does not mean you have cancer, and it does not mean you will develop it. After a positive result, a healthcare provider can look for cell changes or precancers that could develop into cervical cancer if left untreated, and treating precancers prevents cervical cancer.
Screening is not for symptoms
Cervical screening is designed for people without symptoms, and a routine screening interval is not the right response to a new symptom. Symptoms that should prompt medical advice include vaginal bleeding after intercourse, between periods or after menopause, watery or bloody discharge with a foul smell, and lower abdominal or pelvic pain.
If you have any of these, speak to a healthcare professional promptly rather than waiting for your next screening invitation.
Frequently asked questions
Is cervical screening the same as a Pap smear?
Not quite. Cervical screening is the programme. A Pap smear, or Pap test, is one of the tests used within it, examining cervical cells for abnormal changes. Many programmes now use an HPV test as the first-line screening test instead, because it looks for the virus that causes cervical cancer.
What happens if my HPV test is positive?
A positive result means a high-risk HPV type was detected. It does not mean cancer. A healthcare provider will look for cell changes or precancers that could develop into cervical cancer if untreated. Treating precancers prevents cervical cancer from developing.
Do I still need cervical screening if I have had the HPV vaccine?
Yes. The vaccine prevents infection with the HPV types it covers, but it does not cover every high-risk type and does not treat an existing infection. Routine screening is still recommended for people who have been vaccinated.
Can I do cervical screening at home?
For some HPV tests, vaginal self-sampling lets a person collect their own sample privately instead of having it collected during a clinical examination. Whether self-sampling is approved depends on the specific test and the country it is supplied in.
Do I need cervical screening if I have no symptoms?
Yes. Screening is specifically for people without symptoms. Early cervical cell changes usually cause no symptoms at all, which is why routine screening is what finds them. If you do have symptoms, see a healthcare professional rather than waiting for a screening appointment.
Related terms
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References
Understanding your health information
Our glossary is designed to help make health and testing terminology easier to understand.
The information provided here is for general educational purposes only and should not replace professional medical advice, diagnosis or treatment. The purpose and regulatory status of individual Camtech Health tests may differ depending on the product and country in which they are supplied.
If you have symptoms, receive an unexpected result or are concerned about your health, speak with an appropriately qualified healthcare professional.
