Pap test and HPV-DNA test: how do they differ, how are they done, and what do the results mean?
The Pap test (smear) and the HPV-DNA test are two tests that look at different things: the Pap test looks for changes in cervical cells, while the HPV-DNA test looks for high-risk types of the virus. Their goal is the same: to catch changes early, before they cause symptoms. In Türkiye, women aged 30–65 are offered free HPV-DNA screening every five years.
The Pap test (smear) and the HPV-DNA test are the two tests you hear about most often in relation to cervical health. Their names are easy to mix up, yet they look at different things and often complement each other. Let's separate the two: how are they done, and what do their results mean?
Why does screening matter?
Early changes in the cervix cause almost no symptoms. Not feeling anything does not mean everything is fine. The purpose of screening is to catch possible changes during exactly this silent period — because changes caught early are much easier to manage.
What is a Pap test (smear)?
A Pap test (Pap smear / cervical cytology) is the examination under a microscope of a sample of cells taken from the cervix. The aim is to see whether there is any change in the cells. The result may include terms such as NILM (normal), ASC-US, LSIL or HSIL; these describe the degree of change.
What is an HPV-DNA test?
The HPV-DNA test looks for the genetic material of high-risk HPV types in a sample taken from the same area. In other words, it answers not "have the cells changed?" but "is the virus there?" Most tests check for 14 high-risk types together; some report 16 and 18 separately.
How the two differ
In short: the Pap test looks at the effect (cell change), while the HPV-DNA test looks at the cause (the virus).
| Pap test (smear) | HPV-DNA | |
|---|---|---|
| What it looks at | Changes in cervical cells | Presence of a high-risk HPV type |
| Question it answers | Have the cells changed? | Is the virus there? (16/18 separately) |
| How it is used | Alone or together with HPV | Primary screening or together (co-test) |
Co-testing and genotyping (16/18)
- Co-test: Evaluating the Pap test and the HPV-DNA test together; it combines the strengths of both tests.
- Genotyping: If HPV is positive, a result that shows separately which type it is (especially 16/18). This distinction matters because 16 and 18 are followed more closely.
How is it done? Does it hurt? What to keep in mind beforehand
During a gynecological exam, a sample is taken from the cervix with a soft brush/spatula. It takes a few minutes and usually doesn't hurt; you may feel brief pressure.
- It is not preferred during a heavy period; your clinic will tell you the right time.
- Douching, vaginal creams or sex in the 1–2 days before the test can affect the result — follow your doctor's advice.
- Results usually come back within a few business days.
How often and at what age?
How often you are screened depends on your age, the test used and your previous results; there is no single rule for everyone. An important point specific to Türkiye:
In Türkiye, the Ministry of Health offers women aged 30–65 free HPV-DNA screening every five years at family health centers, community health centers and KETEMs (Cancer Early Diagnosis, Screening and Training Centers). Ask your family health center or your doctor about eligibility and timing.
What do the results mean?
- HPV-DNA negative: Reassuring; usually means a longer interval until the next screening.
- HPV-DNA positive: A type was found; this is not cancer. The next step is planned according to the type, the Pap test and your age.
- Normal Pap test + HPV positive: Common; repeat evaluation after a set interval is usually recommended.
No result on its own is a diagnosis or a treatment decision. The Pap test and HPV-DNA test are evaluated together with your age and previous tests. Talk to your doctor about your result.
Is there a test for men, or an oral test?
A general HPV screening test is not routinely recommended for men. There is also no approved HPV test for the mouth and throat. If there are symptoms (for example, genital warts), the relevant specialist (urology/dermatology) should be seen for evaluation. This does not replace screening for women's health.
When should you see a doctor?
See your doctor (or, in Türkiye, your family health center) in the following situations:
- if you are of screening age and have not been screened in a long time,
- if your Pap test or HPV test showed an abnormal / positive result,
- if you have bleeding after sex, bleeding between periods or unusual discharge.
Screening is a short procedure that can catch changes early, before they cause symptoms — and in Türkiye it is largely free of charge.
Frequently asked questions
Does a Pap test hurt?
It usually doesn't hurt; you may feel brief pressure or discomfort. The procedure takes a few minutes. If you are anxious, tell your doctor beforehand so it goes more comfortably.
Can I have a Pap test or HPV test during my period?
Because a heavy period can affect the result, a time outside your period is usually preferred. Your doctor (or, in Türkiye, your family health center) will tell you the right time.
How often should I be screened?
How often depends on your age, the test used and your previous results. In Türkiye, women aged 30–65 are offered free HPV-DNA screening every five years. Your doctor will set the interval that is right for you.
My Pap test is normal but I'm HPV positive. What does that mean?
This is a common situation and does not, on its own, indicate disease. Repeat evaluation at set intervals is usually recommended; your doctor will decide how to proceed based on your HPV type, your age and your previous results.
If my HPV test is negative, can I relax?
A negative result is reassuring and usually means a longer interval until your next screening. Even so, you continue with the recommended screening program when it is due.
Is screening free in Türkiye?
Yes. In Türkiye, the Ministry of Health offers women aged 30–65 free HPV-DNA screening every five years at family health centers, community health centers and KETEMs (Cancer Early Diagnosis, Screening and Training Centers).
Are men tested for HPV?
A general HPV screening test is not routinely recommended for men, and there is no approved HPV test for the mouth and throat. If there are symptoms, see the relevant specialist (urology/dermatology).
How long do test results take?
It depends on the laboratory and the type of test; usually a few business days. The center that performs the test will tell you the exact time.
Sources
- World Health Organization (WHO) — Information resources on cervical cancer screening (HPV-DNA and cytology).
- Centers for Disease Control and Prevention (CDC) — Cervical screening tests and how often to have them.
- National Cancer Institute (NCI) — Pap and HPV testing.
- Republic of Türkiye Ministry of Health, General Directorate of Public Health — Cervical cancer screening program (ages 30–65, free HPV-DNA).
Note: This content was written independently, based on current scientific information published by the institutions above; it is not a direct copy of any text.
This article is for general information only; it is not a diagnosis or treatment recommendation and does not replace a medical examination. Please consult your doctor about your own situation. The content reflects scientific knowledge as of the update date above.