One question that we frequently get asked about the Eve Kit Service for HPV is - "is this the same as a Pap test/Pap smear?" The short answer is: no, they are not the same, but they are both ways to screen for cervical cancer.

What do the tests do?

Many people with vaginas might be familiar with the Pap test. It is a procedure that can only be performed by a healthcare provider as they must collect cells from the cervix. A cytologist, who is a lab professional with expertise in studying cells, then takes a look at the cells under a microscope. They look for cellular changes that might indicate pre-cancer or cancer.

This is what a cytologist sees - the pink part is a cell that is abnormal
Image from Wikimedia Commons

On the other hand, a HPV test is quite different. It can be performed by a healthcare provider or on your own. A sample is collected from the general vagina area, close to the cervix. The sample is then sent to a lab where a diagnostic device analyses the sample and looks for the presence of the HPV virus. This is a molecular test that is automated and research has shown it is better than a Pap test in correctly identifying people as having HPV.

What's the relationship between HPV and cervical cancer?

High-risk HPV infections have been identified to cause almost all cervical cancers. There are at least 14 high-risk strains known to cause cervical cancer, with HPV types 16 and 18 known to cause 70% of all cervical cancer cases. Additionally, HPV has been linked to other cancers such as anal, penile, mouth and throat cancers.

High-risk HPV infections can, over a long period of time, cause precancerous changes in cervical cells. The Pap test looks for these precancerous changes.  

HPV Progression

The natural progression of HPV infection to pre-cancer and cancer
Image from WHO

What do positive results for each of the tests mean?

A positive high-risk HPV test result means that you have a high-risk strain of HPV. It does not mean that you necessarily have, or will develop cervical cancer. Additional follow-up testing, typically a Pap test, is usually recommended to check if the virus has caused any abnormal changes in the cervix.  

A positive Pap test result means that cells look abnormal and there might be cancerous or precancerous changes. A colposcopy is often recommended as a follow-up to take a closer look at the cervix to determine the level of cellular change (i.e., how many cancerous cells are present on the cervix).

Is the HPV test a replacement for the Pap?

Both HPV tests and Pap tests are recognized by the World Health Organization as suitable screening methods for cervical cancer. The World Health Organization generally recommends HPV testing as primary screening for most regions, depending on resources available.

In Canada, current guidelines recommend the Pap test for primary cervical cancer screening and is covered by provincial health insurance. HPV testing is not covered by provincial health insurance. The Canadian Cancer Society has, however, shared research indicating that HPV testing might be better than the Pap test:

The researchers found that the HPV test identified more women with abnormal cells at high risk of becoming cancerous, compared to women who received a Pap test. These results suggested that HPV testing, and focusing on the high-risk strains, was a better screening test than the traditional Pap test.

In the United States, guidelines have changed as of August 2018. Previous guidelines recommended a Pap test every 3 years for women between 21 to 65 years old. The new guidelines now provide more options, recommending women between ages 30 to 65 choose between:

  • Pap test every 3 years
  • HPV test every 5 years
  • Combination of Pap and HPV test every 5 years

The Eve Kit Service for HPV

If you are interested in HPV screening, why not consider the Eve Kit Service? The Eve Kit Service lets you self-collect a sample anywhere comfortable, on your own schedule, without having to make an appointment or go to a clinic. The Service coordinates your HPV test with the same licensed labs that doctors and clinics use, you get your results online through a secure portal. And if you do test positive, the Eve Kit Service connects you with a doctor to ensure you get proper care. It's a convenient and easy way to get your cervical cancer screening done.