Cervical cancer is one of the most preventable cancers in women. It usually develops very slowly, often over many years. This means regular screening can detect early changes before cancer develops, or find cancer at a very early and highly treatable stage.
In Malaysia, cervical cancer is the fourth most common cancer among women, and the second most common among women aged 15 to 44. Despite this, many women still do not go for regular screening.
Why Is Screening Important?
Almost all cases of cervical cancer are caused by long-term infection with certain types of human papillomavirus (HPV). HPV is very common and is spread through sexual contact. Most HPV infections go away on their own, but if high-risk HPV stays in the body for many years, it can cause abnormal changes in the cervix that may lead to cancer.
Screening helps to detect HPV infection early, identify abnormal changes in cervical cells before they develop into cancer, and significantly reduce the risk of cervical cancer being diagnosed at an advanced stage.
Pap Smear vs HPV Test: What’s the Difference?
Pap Smear
- Looks for abnormal changes in cervical cells
- Has been used for many decades
- Needs to be done every 3 years
- Can miss early disease in some women
HPV Test
- Looks for the presence of high-risk HPV itself
- Detects risk earlier, before cell changes happen
- More accurate than a Pap smear
- Only needs to be done every 5 years if results are normal
Which Test Is More Effective?
Studies from around the world have shown that the HPV test is more sensitive and reliable than the Pap smear. This means it is better at detecting women who are at risk of developing cervical cancer.
A negative HPV test gives stronger reassurance and longer protection compared to a normal Pap smear. This is why many countries now recommend HPV testing as the main screening method.
Who Should Have Which Test?
For women aged 30 to 65 years, a HPV test every 5 years is recommended.
For women aged 20 to 30 years, a Pap smear is still preferred, this is because HPV infection is common at a young age and usually clears on its own.
What Happens If My HPV Test Is Positive?
A positive HPV test does not mean you have cancer. If HPV is detected, a Pap smear is usually done next to check for any abnormal cells. If the Pap smear result is normal, the HPV test is typically repeated after 12 months. If abnormal cells are found, further examination through a colposcopy (examining the cervix using a magnifying device) may be advised. This step-by-step approach helps ensure women receive appropriate care while avoiding unnecessary procedures.
Is HPV Testing More Expensive?
Yes, but it is more cost-effective in the long run because it needs to be done less frequently, hence reducing unnecessary repeat tests, and lowering the need to treat cervical cancer at a later stage.
Is There Still a Role for Pap Smears?
A Pap smear is still useful for younger women aged 20 to 30 years, as a follow-up test after a positive HPV result, in settings where HPV testing is not available, and for monitoring women who have previously been treated for abnormal cervical cells.
Should Both Tests Be Done Together?
In the past, some women had both HPV testing and Pap smears at the same time. However, research shows that doing both does not provide much extra benefit and may cause unnecessary worry and additional procedures. Most guidelines now recommend HPV testing alone as the main screening test.
What’s Next for Cervical Cancer Prevention?
One encouraging development in cervical cancer prevention is HPV self-sampling, which allows women to collect cell samples on their own in a comfortable and private setting. This can help more women take part in regular screening, especially those who may feel anxious or uncomfortable with clinic-based tests. At the same time, ongoing improvements in medical technology are helping doctors interpret results more accurately and decide on the most appropriate follow-up care. When combined with HPV vaccination, these advances offer even stronger protection and bring us closer to a future where cervical cancer is rare and preventable.
In Summary
Cervical cancer is largely preventable with regular screening and early detection. HPV testing has been shown to be a more reliable way to identify women at risk and is now recommended as the main screening test for women aged 30 to 65, while the Pap smear continues to play an important role for younger women and in follow-up care. Together with HPV vaccination, regular screening gives women peace of mind and the best possible protection against cervical cancer, supporting long-term health and wellbeing.
Dr Ng Soon Pheng,
Consultant Obstetrician & Gynecologist,
Columbia Asia Hospital Puchong.
