Cervical cancer can almost always be prevented, and having regular Pap smear tests is the key. Cervical Cancer Screening Tests are used to screen for different types of cancer when a person does not have symptoms. Studies show that screening for cervical cancer helps decrease the number of deaths from the disease. A Pap smear test is commonly used to screen for cervical cancer. After certain positive Pap test results, an HPV DNA test may be done. HPV DNA test may be done with or without a pap smear test to screen for cervical cancer. Facts about Pap Smear Pap smear is not a test for diagnosing cervical cancer. It is a test to check the health of the cervix, which is the lower part of the womb (often called the neck of the womb). For many women the test results show that everything is fine. But for around 1 in 20 women, the tests show changes in cells that can be caused by many things.Most of these changes will not lead to cervical cancer. Pap smear test is a procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. A new method of collecting and viewing cells has been developed, in which the cells are placed into a liquid before being placed on a slide (liquid based cytology). Early detection and treatment of abnormal cells can prevent around 75% of cancers developing but like other screening tests, it is not perfect. It may not always detect early cell changes that may lead to cancer. Abnormal cells may not be recognized because sometimes they do not look much different from normal cells and there may be very few abnormal cells collected. About 1 in 20 tests have to be taken again because: There was infection around the cervix which needs to be treated before a clear slide can be made the cervical cells on the slide may have been hidden by blood or mucus/secretion not enough cervical cells on the slide to give an accurate assessment the sample may not have been properly prepared the slide may have been broken. Facts about HPV DNA test HPV DNA is a laboratory test in which cells are scraped from the cervix to look for DNA of human papillomaviruses (HPV). Your doctor may order HPV-DNA test : If you have a certain type of abnormal pap smear test result. Along with a Pap smear to screen women age 30 and older for cervical cancer. Instead of a Pap smear to screen women age 30 for cervical cancer. (Note: Some experts suggest this approach for women 25 and older.) Human papillomavirus (HPV) is a group of related viruses. HPV infection around the genitals is common. It can be spread during sex. They can cause warts on different parts of your body. There are more than 200 types. About 40 of them are spread through direct sexual contact with someone who has the virus. They can also spread through other intimate, skin-to-skin contact. Some of these types can cause cancer. There are two categories of sexually transmitted HPV. Low-risk HPV can cause warts on or around your genitals, anus, mouth, or throat. High-risk HPV can cause various cancers such as cervical cancer,anal cancer,certain oral and throat cancer,vulvar cancer,vaginal cancer and penile cancer. Most HPV infections go away on their own and don't cause cancer. But sometimes the infections last longer. When a high-risk HPV infection lasts for many years, it can lead to cell changes. If these changes are not treated, they may get worse over time and become cancer. In HPV DNA test ,cells are gently collected from the cervix area and sent to laboratory for examination under a microscope. This examiner checks to see if the cells contain genetic material (called DNA) from types of HPV that cause cancer. Common high-risk HPV types that could cause cancers are HPV-16 and HPV-18. High-risk types of HPV can lead to cervical cancer or anal cancer. The HPV-DNA test is done to determine if you are infected with one of these high-risk types. Certain low risk types may also be identified by the test. HPV-DNA test may be done with or without a Pap smear test to screen for cervical cancer. Screening women aged 30 and older with both the Pap test and the HPV-DNA test every 5 years finds more cervical changes that can lead to cancer than screening with the Pap smear test alone. Importance of Cervical Cancer Screening Cervical cancer can often be prevented. The signs that it may develop can be spotted early on so it can be stopped before it even gets started. However many of those who develop it have not been screened regularly. Not going for cervical screening is one of the biggest risk factors for developing cervical cancer. In Malaysia,women aged 20-65 years old who are sexually active should have pap smear test initially yearly for 2 years, if both tests are normal, they should have Pap smear test every 3 years. For women age more than 30 years old, they are recommended to have 'combined test' which includes Pap smear with HPV DNA test. How can the risk of developing cervical cancer be reduced? ​ Regular Pap smear/HPV DNA screening Stop smoking (smoking is associated with persistent HPV infection) HPV vaccination

References - Hacker NF. Cervical dysplasia and cancer. In: Hacker NF, Gambone JC,Hobel CJ, eds. Hacker and Moore's Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 38. -www.cancerscreening.nhs.uk -U.S. Department of Health & Human Services

Prepared by: Dr. Razif Bin Zainol Abidin Health Promotion, Cancer Education Resources and Clinical Unit HSAAS UPM

Date of Input: 20/08/2026 | Updated: 20/08/2026 | ahmadfaiq