Which is better: HPV blood test or a Pap smear?

Cervical cancer

Cervical cancer is detected using human papillomavirus (HPV) blood testing and Pap smear tests. Doctors may advise a person to have both tests to rule out cervical cancer.

Cervical cancer can be avoided if physicians catch it early. Doctors can discover cervical cancer early on, before it develops and spreads to other parts of the disease.

The fourth most frequent cancer in women is cervical cancer. Almost majority of these instances have been linked to high-risk HPV infections. An HPV test, a Pap smear, or both are used in cervical cancer screening.

The HPV and Pap smear tests for identifying cervical cancer are discussed in this article.

Cervical cancer examination

About Pap smears and what they test for

The gold standard for cervical cancer screening is cervical cytology, generally known as a Pap test or Pap smear. In the cervix, the test searches for precancers, or aberrant cell alterations. Without the proper treatment, they might develop into cancer.

About HPV

The human papillomavirus (HPV) is a big viral family. In the United States, HPV is the most common sexually transmitted virus.

The virus that causes genital warts is not the same as the one that causes cancer. Skin HPVs, which cause common warts, account for the majority of HPV types. Mucosal HPVs, on the other hand, target and survive on mucosal surfaces.

Body parts that open to the outside, such as the vagina and anus, are lined by mucosal cells. Because mucosal varieties of HPV commonly infect these locations, doctors may refer to them as genital HPV.

HPV in the genital area is a low-risk virus that causes genital warts but seldom causes cancer. It might also be high risk, which means it’s more likely to cause cancer.

HPV is spread by skin-to-skin contact. HPV may be transmitted during vaginal, anal, or oral sex with someone who has the virus.

HPV can cause to genital warts and cancers. These are some of them:

  • anal cancer
  • tongue cancer
  • mouth and throat cancer
  • tonsil cancer
  • cervical cancer
  • vaginal cancer
  • vulvar cancer
  • penile cancer

About blood tests for HPV

According to the American Cancer Society (ACS), HPV does not transmit through blood or body fluids like sperm. HPV cannot be detected using blood, urine, anal, or oral swabs.

The only approach to identify HPV is to look at cervix cell samples under a microscope. This is because the virus infects the skin and mucosal cells through skin-to-skin contact.

However, a 2019 animal research found that HPV may cause infections through the bloodstream.

A pinprick blood test was also shown to be efficient in the early identification of antibodies for HPV 16 in a 2020 trial. Most HPV-related head and neck cancers and 70% of cervical cancers are caused by this form of HPV.

Differences between a precancerous cervical cell and HPV

Because HPV is such a common viral illness, many sexually active people are likely to get infected at some time in their life. The virus is usually cleared by the body’s immune system within a few months to two years.

Some HPV kinds might remain in the body. A long-term, untreated HPV infection can cause normal cells to become abnormal, which doctors refer to as precancerous cells.

These cells will continue to develop and proliferate if they are not detected, resulting in cancer. Precancerous cells, on the other hand, often take 10–20 years or more to grow into a tumor.

HPV test vs. Pap smear

Pap smears look for abnormal cells that might be malignant or precancerous. An HPV test, on the other hand, looks for DNA or RNA in cells to detect if someone has a high-risk HPV infection that can lead to cervical cancer.

Should they be used together?

Cervical cancer can be detected with Pap smears and HPV testing.

The American Cancer Society (ACS) advises that people with a cervix obtain a primary HPV test every 5 years between the ages of 25 and 65, according to their 2020 cervical cancer screening guidelines. It also suggests getting an HPV/Pap co-test every 5 years, or a Pap test every 3 years if HPV testing isn’t accessible.

What to expect during each test

During a pelvic exam, doctors frequently do both tests. A person rests on an exam table, bending their knees and supporting their feet with the surface.

A plastic or metal device is inserted into the vagina to enlarge it and allow a good view of the upper vagina and cervix.

The doctor then collects cell and mucus samples from the cervix using a brush, sets them in a specific solution, and sends them to a lab for testing.

For both tests, doctors may utilize the same sample.

Discussing results with a doctor

Results are generally available in 1–3 weeks. A doctor will contact the person to discuss their test findings if they detect anything unusual in the results.

The doctor will discuss the patient’s risk and the next steps to take. The following are examples of Pap smear results:

  • Normal: No abnormal cell changes in the cervix.
  • Unclear: Cervical cells could be abnormal, but it is unclear whether this relates to HPV. An unclear result can be due to pregnancy, an infection, or menopause.
  • Abnormal: There are cervical changes. This is likely the result of HPV and can be low grade or high grade. This result may also indicate cancer.

HPV tests, on the other hand, might be positive or negative, indicating the presence or absence of high-risk HPV.

If a person’s test results are positive, the doctor may suggest:

  • waiting for 6–12 months before getting a repeat test
  • getting a colposcopy, a test that aims to find abnormal cells in the cervix, usually after an abnormal Pap result
  • getting a biopsy, where a doctor removes a small tissue sample to send to the lab for analysis
  • receiving treatment for high-grade cervical changes

Are DNA blood tests effective?

According to the American Cancer Society, hereditary gene mutations are linked to 5–10% of all cancers. As a result, certain people are at a higher risk of acquiring cancer.

Hereditary cancers include the following:

Cervical cancer may run in certain families, according to the ACS, but no particular genetic mutation has been discovered for the cancer. This implies that genetic information, such as DNA testing, cannot be used to predict whether a person will get cervical cancer.

According to a research published in 2020, general gene testing detects more heritable genetic mutations than focused testing. Similarly, multi-gene panel testing for genetic cancer risk is more efficient and sensitive than standard testing, according to a 2019 study.

Questions that are often asked

The following are some of the most frequently asked questions regarding HPV blood testing and Pap smears.

Can a blood test replace a Pap smear?

No. HPV infects and alters cervical cells by staying on the skin and mucosal surfaces. These cell alterations can only be detected by collecting cell samples for Pap smears.

What is the cost of a Pap smear?

The price ranges. The cost of the test varies from $25 and $60 for people who do not have health insurance. The cost of the appointment and pelvic exam is not included in this charge.

What is the cost of an HPV test?

HPV tests can cost anywhere from $30 to $100, depending on where you receive them. This does not include the cost of the clinic or the visit.

How frequently does a person require testing?

People between the ages of 25 and 65 should have an HPV test every five years, according to the American Cancer Society’s Cervical Screening Guidelines for 2020. They should receive a Pap test every three years or an HPV/Pap co-test every five years if this isn’t practicable.

Conclusion

Cervical cancer is one of the most frequent cancers in women, and with early discovery, it is typically treatable. To help prevent cervical cancer, every woman over the age of 25 should get screened on a regular basis.

While some people choose less invasive cervical cancer screening testing, Pap smears and HPV DNA tests remain the gold standard for cervical cancer detection.

Sources:

  • https://www.who.int/health-topics/cervical-cancer#tab=tab_1
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713970/
  • https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21628
  • https://www.cdc.gov/std/hpv/stdfact-hpv.htm
  • https://www.medicalnewstoday.com/articles/blood-test-instead-of-pap-smear
  • https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
  • https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html
  • https://www.ncbi.nlm.nih.gov/books/NBK470165/
  • https://www.sciencedirect.com/science/article/pii/S1525157818303349
  • https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(20)30179-1/fulltext