Screening modalities like the Pap test and HPV test can help detect abnormal or precancerous cervical cells. The Pap test screens for cell changes and is recommended starting at age 21 and every 3 years. The HPV test screens specifically for the human papillomavirus, which can cause cell changes. For women over 30, both tests may be used. Certain groups like those without insurance can access free screening services. While screening is important, both false positives and false negatives can occur with the Pap test. Multiple organizations provide guidelines around cervical cancer screening.

1. Screening Modalities
* Pap Test: aids in finding abnormal precancerous cells, any cells changes
on the cervix that might become cervical cancer in the future if not
treated appropriately. Women should be screening at age 21 and every 3
years, thereafter.
* The HPV test: aids in screening for the virus that can cause changes on
a cellular level on the cervix. In women over 30 years or older, it is used
to screen with a pap. If the HPV screen and pap are both negative, the
risk for cervical cancer is low. HPV screen may provide more result
while a pap may be less helpful in detecting if the virus is present.

2. Certain Populations
• If you do not have insurance there are centers that will
conduct the pap and HPV test for free:
• American Cancer Society
Phone: 800-ACS-2345
• Gynecologic Cancer Foundation
Phone: 800-444-4441
• National Breast and Cervical Cancer Early Detection
Program, CDC, NIH
Phone: 800-232-6348
• National Cancer Institute, NIH, HHS
Phone: 800-422-6237

3. Since the Pap Test is not 100 percent correct.
False positive and false negatives do occur
Women may have abnormal cervical cells that come back stating that
they are normal (low specificity), in which they are later discovered
on the next pap.
If the cells, are normal, and come back abnormal, this is a false
positive (low sensitivity). Then there is nothing wrong with the
cervical cells.
False positives, are the reason why the guidelines were changed from
doing a pap test yearly to every 3 years, since they led to unnecessary
LEAP procedures, and fertility issues
Sensitivity/Specific
ity

4. • people most at risk are 80% low income, due to lack of health care
• people with HIV/AIDS
• Black women with HPV may have higher cervical cancer risk than
white women with HPV (genetics)
• Women with multiple partners
• smokers
Certain Populations

5. Genetic Testing
• Although, there is the DNA HPV test done during a pap procedure,
there is no other alternate genetic testing that can be done to
determine if a women will get cervical cancer.
• In combination to a virus HPV that can lead to cervical cancer, can
resolve on its own.
• There are some genetics factors that can inhibit the virus to resolve
on its own, however, they are inconclusive as to whether they will lead
to cervical cancer

6. Treatment
• If a patient is under 30, the virus will resolve on its own, another pap
will be done, to confirm this
• “There is no cure for the virus itself, but many HPV infections go away
on their own. In fact, about 70 percent to 90 percent of cases of HPV
infection are cleared from the body by the immune system.
The treatment goal — when treatment is needed — is to relieve symptoms
by removing any visible warts and abnormal cells in the cervix.
Treatments that might be used include:
1 Cryosurgery — freezing off the warts with liquid nitrogen
2 Loop electrosurgical excision procedure (LEEP) — using a special
wire loop to remove the abnormal cells
3 Electrocautery — burning off the warts with an electrical current
4 Laser therapy — using an intense light to destroy the warts and any
abnormal cells
Only a small number of women infected with HPV will develop cellular
changes that need to be treated” (Clevelandclinic.org).

7. Groups that Issue
Guidelines
• CDC
• ACOG
• USPSTF
• ACS
• ASCCP

8. References
• Center for Disease Control
(2013).HPV Screening.
Retrieved from;
www.cdc.gov/hpv/screening.ht
ml
• Office ofWomen’s Health,
Department of Health and
Human Services (2013).HPV.
Retrieved from;
http://www.womenshealth.gov
/publications/our-
publications/fact-
sheet/human-