Cervical cancer screening involves tests that look for changes in the cells of the cervix that could lead to cancer. The goal is to find and treat these changes *before* cancer develops. The two main tests are the Pap test and the HPV test.[1, 2]

The **Pap test** (or Pap smear) looks for precancers, which are cell changes on the cervix that might become cervical cancer if they are not treated appropriately.[1]

The **HPV test** looks for the human papillomavirus (HPV), the virus that can cause these cell changes.[1]

Sometimes these tests are done together, which is called co-testing.[1]

HPV (Human Papillomavirus) is a very common virus that is the main cause of cervical cancer.[3] Most sexually active people will get HPV at some point in their lives, but the vast majority of infections go away on their own without causing any problems.[4, 3] A positive HPV test does not mean you have cancer; it means you have a virus that could potentially cause problems down the road and should be monitored by your doctor.[5]

The OncoE6™ test is a newer, more specific type of test. A standard HPV test just detects if the virus is present. The OncoE6™ test goes a step further by detecting the E6 oncoprotein, a specific protein that high-risk HPV types 16 and 18 produce only when they are actively causing the changes that can lead to cancer.[6, 7, 8] This helps distinguish a harmless, temporary infection from one that is on a path to cause cancer, helping to avoid unnecessary follow-up procedures.[7]

"Molecular Colposcopy" is a term used to describe the benefit of the OncoE6™ test. A traditional colposcopy is a visual exam where a doctor looks at the cervix with a magnifier to find abnormal areas to biopsy, but it's possible to miss the most serious spot. The OncoE6™ test avoids this "sampling error" by checking the entire cell sample for the molecular signature (the E6 protein) of a high-risk infection, giving a more complete picture of what's happening on the cervix.[9, 10]

HPV infections are extremely common in women in their 20s, but they are almost always temporary and clear up on their own.[4, 11] Because of this, testing for HPV in this age group leads to a high number of "false positives," which can cause unnecessary anxiety and lead to follow-up procedures for an infection that would have resolved naturally.[12, 4] That is why guidelines often recommend only a Pap test for this age group.[13, 2]

Current guidelines suggest that women over 65 can stop screening if they have a history of normal test results.[14, 13] However, women over 65 still account for about 20% of new cervical cancer cases and are more likely to be diagnosed at a late stage.[15, 16] One reason is that hormonal changes after menopause can make Pap tests less accurate and more likely to miss problems.[17, 18, 19]

An abnormal result usually requires a follow-up procedure called a **colposcopy**. This is a simple procedure where your doctor uses a magnifying lens to look at your cervix more closely. If they see a suspicious area, they may take a small tissue sample, called a **biopsy**, for testing.[20]

If a biopsy shows high-grade precancerous cells, your doctor may recommend a **LEEP (Loop Electrosurgical Excision Procedure)**. This procedure uses a thin wire loop with an electric current to remove the abnormal tissue.[21] While LEEP is very effective, it does carry a small risk of affecting future pregnancies, including an increased risk for preterm birth and miscarriage.[22, 23, 21]

Yes. The FDA recently approved HPV self-collection kits that can be used at home. You can collect a vaginal sample yourself and mail it to a lab for testing. This is a great option that can help overcome barriers like lack of time, transportation, or discomfort with pelvic exams.

Yes, studies show comparable accuracy for detecting high-grade changes, especially when using validated, PCR-based tests. One FDA-approved device showed 95% agreement with clinician-collected samples.