After screening, hearing that “the cells are normal, but HPV was found” can leave you unsure which result to use as your reference. The two tests do not have to produce the same answer. Taking one step further from knowing how to prepare before screening, this time we will sort out what each test looks at and what to check after the results.
This is a generated image expressing the different purposes of the tests. It is not an actual test report or a microscope photograph.
What do the two tests check?
Cytology checks for changes seen in the cells, while an HPV test checks for high-risk viral infection that may be related to those changes. Even if the testing experience feels similar, what the laboratory checks is different.
| Test | What it checks | What to review mainly in the results |
|---|---|---|
| Cervical cytology (Pap test) | The appearance of cells collected from the cervix, the entrance of the uterus | Whether they are normal, what kind of abnormality is present, and whether the specimen was sufficient for interpretation |
| High-risk HPV test | Whether there is infection with HPV types related to cervical cancer | Whether the result is negative or positive, and the virus types the test distinguished and reported |
The two tests are sometimes performed together on a specimen collected from the cervix. One collection does not mean that both items were tested, so checking the test names on the report is more accurate. Not everyone needs to have both tests together at every visit. The items needed are decided based on age, previous test results, treatment history, and similar factors. An explanation of the testing process can also be found in MD Anderson’s guide to the Pap test.
Can the cells be normal while HPV is positive?
Yes. High-risk HPV was detected, but no abnormality was seen in the cells collected this time. The results are not contradictory, and a positive HPV result does not mean cancer.
HPV infection can go away over time, but if a high-risk type persists, it can be related to cell changes. For that reason, it is important not to skip the follow-up you were advised to have, even when you have no symptoms and cytology is normal. MD Anderson’s guide to a positive HPV result distinguishes confirmation of infection from a cancer diagnosis and emphasizes follow-up care according to the results.
Conversely, an abnormality on cytology does not mean that every case is cancer or is caused by HPV. Inflammation, hormonal changes, and similar factors can also affect the appearance of cells. Rather than the single word “abnormal,” check what the finding is. A negative HPV result is not interpreted as if the abnormal cytology finding had not occurred.
Why are a repeat test and further tests needed?
The reason for repeating the same test and the reason for checking tissue are different. If you are advised to have a repeat test, ask which of the purposes below applies.
- To obtain a specimen again: If there are too few cells, or if blood or mucus obscures them and makes interpretation difficult, another collection may be needed. An ‘unsatisfactory specimen’ is neither a normal result nor a diagnosis of cancer.
- To check for changes over time: This is when the test is repeated after a period of time to see whether the virus continues to be detected and whether the cell findings change. The timing of a repeat test varies with each person’s results and history.
- To look more closely at an abnormal area: Colposcopy magnifies the cervix for examination, and if needed a small piece of tissue is collected and checked. This is a process of looking more specifically at questions that remain after the screening test.
Whether further testing is done is not decided from the current result alone. Previous abnormal findings, a history of treatment for a precancerous lesion, age, and other factors are also reflected in the decision. Rather than applying another person’s repeat-test interval that you saw online, confirm a schedule that fits your own results. These principles and the role of each test were explained based on the U.S. National Cancer Institute’s guide to interpreting results.
What is helpful to keep track of after you receive your results?
Keep the test name, the exact result, and the next date together as one set. Preparing earlier reports as well helps when comparing them with previous results.
During the test you may feel discomfort or pain, and a small amount of bleeding may occur after collection. If it is too difficult, you may ask to stop rather than enduring it. If the bleeding is heavy, or if a small amount of bleeding has not stopped after several hours, contact the medical institution where you had the test. The specific testing process and precautions after collection were referenced from NHS guidance.
Neither test excludes all future risk with a single result. Even if the result is normal, continue the screening you were advised to have. You can review the related clinical information in the website guide on cervical cancer testing and in Women's Health Screening Information.