Pap and HPV Tests for Cervical Cancer Screening
A persistent infection with some types of HPV can lead to various types of cancer in women.
Early stages of vaginal and cervical cancers may not cause any symptoms, making regular screening important. More advanced-stage cancer can lead to abnormal vaginal bleeding or discharge and pain during intercourse.
Cervical dysplasia is not cancer, but in some cases it develops into cancer.
Follow-up care for cervical dysplasia depends on its severity. For mild dysplasia, the doctor may recommend a repeat test in a year to determine whether the dysplasia has worsened or resolved on its own. For severe dysplasia, a procedure to remove the abnormal cells may be called for.
A newer test, called the HPV test, detects the virus itself in cervical cells rather than changes in cell appearance. The U.S. Food and Drug Administration (FDA) has approved several different HPV tests, some of which have approval as a primary HPV test — meaning that no Pap test is needed.
Currently, guidelines recommend that women ages 25 to 65 years get a primary HPV test every five years. A woman can self-collect a sample either at home or in a clinic using an FDA-approved, clinician-requested sample collection kit. This self-collection screening can take place every three years, so long as test results stay HPV-negative.
However, those who self-collect samples should still have a clinician carry out a test every five years, as this is the preferred method.
If you get HPV tests or a combination of HPV and Pap smears, you can stop screening between 60 and 65 years of age if your most recent tests came back negative and your doctor assesses that you have an average cervical cancer risk.
If a primary HPV test is not available, then a Pap test along with an HPV test can be performed every five years, or a Pap test alone can be performed every three years. If you only get Pap smears, you can also stop screening at 65 years of age, so long as your last three Pap smears have come back normal.
If you don’t identify as a woman but do have a cervix, you should still be screened regularly for cervical HPV or dysplasia in order to detect and treat early evidence of cervical cancer.
Paying for Cervical Cancer Screening
Most health insurance plans cover recommended cervical cancer screenings, often at no cost to the individual beyond the office visit fee. The provider may also waive this fee if the tests are part of an annual physical exam.
Insurance plans purchased through the HealthCare.gov Marketplace must cover Pap tests and HPV tests without charging a copayment or coinsurance, as long as the screening tests are performed by a healthcare provider in your plan’s network.
To see if you’re eligible for free screenings, contact a local program in your area.
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