What is the difference between a Pap smear and HPV testing?

Cervical cancer screenings were first introduced in the 1940s with the Pap smear (speculum exam) to look for abnormal cell changes on the cervix. However, over the past ~20 years, as we learned that human papillomavirus (HPV) causes almost all cervical cancers, the screening has evolved to test for high-risk HPV infections. The Primary HPV test can catch these infections before abnormal cell changes occur, and is far more accurate than a Pap smear alone.

Primary HPV Test is the most accurate screening test for cervical cancer – catching disease over 95% of the time, and rarely missing cases where HPV-related disease is present. This is critical because having high-risk HPV is the single most important risk factor in developing cervical cancer. HPV tests can also catch infections at earlier stages, when cancer can still be prevented. The primary HPV test is recommended by the American Cancer Society and the United States Preventive Services Task Force (USPSTF). Samples collected with the Teal Wand are tested for high-risk HPV.

Pap Smears test for abnormal cell changes in the cervix (cervical cytology) that have already happened, which could mean that cancer has already developed. A Pap smear alone does not test for the presence of an high-risk HPV infection itself, and has a lower sensitivity of only 53%, meaning that they can miss abnormal cervical cell changes almost half of the time. This is also why you need to screen more frequently using only Pap smears.

You may still see the cervical cancer screening referred to as a ‘Pap smear’ in many places, even though you are being tested for HPV, simply because this is what we are used to calling it. To learn more, see our article on Primary HPV Test vs Pap Smear.