Navigating Cervical Cancer Screening: Pap Smears vs. HPV Tests

Medically reviewed by Dr Johann Tang, Senior Consultant Radiation Oncologist

Cervical cancer is one of the most preventable cancers, but it also remains a significant health concern worldwide. According to the World Health Organisation, cervical cancer affects more than 300,000 women globally each year. In Singapore, this cancer is the 10th most common cancer among women, highlighting the importance of early detection and prevention. 

Regular screening, using methods like Pap smears and HPV tests, plays a vital role in identifying potential risks and enabling early intervention. Here’s a closer look at each test, their effectiveness, and the current guidelines for screening.

1. Pap Smear

A Pap smear, also called a Pap test, examines cervical cells for abnormalities that could indicate cancer or pre-cancerous conditions. During the test, a healthcare provider collects cells from the cervix using a small brush or spatula. These cells are then evaluated under a microscope to identify changes caused by infections, inflammation, or potentially cancerous growth.

Pap smears have been a cornerstone of this particular cancer screening for decades, helping reduce the rates worldwide. They are most effective in detecting cell changes that occur before cancer develops, allowing for intervention at the earliest stage.

2. HPV Test

An HPV test focuses on detecting the presence of human papillomavirus (HPV), the primary cause of this cancer. This test identifies high-risk HPV strains known to increase the likelihood of developing cervical cancer.

Like a Pap smear, the HPV test involves collecting cervical cells. However, instead of looking for cell changes, this test searches for the DNA or RNA of HPV viruses. Detecting high-risk HPV types early can guide healthcare providers in monitoring and managing potential health risks.

3. Comparison of Effectiveness

When it comes to detecting cervical cancer, Pap smears and HPV tests each offer unique advantages. Pap smears are highly effective at identifying abnormal cells that might later become cancerous. However, they can sometimes miss these changes if the sample is insufficient or the abnormalities are subtle.

HPV tests, on the other hand, excel in identifying the root cause by detecting high-risk HPV strains. Studies suggest that HPV tests are more sensitive than Pap smears in spotting women at risk, particularly in older populations. However, they may not directly indicate current abnormalities in cervical cells.

Combining both tests—commonly referred to as co-testing—offers the highest accuracy and is often recommended for certain age groups. Co-testing leverages the strengths of both methods to ensure comprehensive screening.

4. Screening Guidelines

The guidelines for cervical cancer screening depend on factors such as age, health history, and risk levels. According to current recommendations:

• Women aged 25-29: A Pap smear every three years is recommended. HPV testing is typically not required unless the Pap smear results are abnormal.
• Women aged 30-69: Co-testing with a Pap smear and HPV test every five years is preferred. Alternatively, a Pap smear every three years or HPV testing alone every five years is acceptable.
• Women over 69: Screening may no longer be necessary if previous test results were consistently normal and there is no history of cervical pre-cancer.

**HPV vaccine in Singapore is available to both boys and girls between 9-26 years old. 

For those with specific risk factors, such as a weakened immune system or a history of cervical abnormalities, more frequent screening may be advised.

If you have concerns about cervical cancer screening or need guidance on the most appropriate test for you, don’t hesitate to reach out to Dr. Johann Tang, an experienced radiation oncologist. Dr. Tang is dedicated to providing expert care and personalised cervical cancer treatment plans to help you stay ahead of your health. 

Book a consultation today to discuss your screening options and ensure your long-term well-being.