HPV, Pap Smear and Colposcopy: When They Are Needed and What the Differences Are

HPV (Human Papillomavirus) is a very common virus transmitted mainly through sexual contact. There are more than 100 different types of the virus, some of which are considered high-risk types because they can cause cellular changes in the cervix.

Most HPV infections clear naturally within a few years without causing problems. However, in some cases the virus may persist in the body and lead to cellular abnormalities that may eventually develop into cancer.

For this reason, HPV detection and monitoring of cervical cell changes are key elements in the prevention of cervical cancer.

The Pap smear, also known as the Pap test, is one of the most widely known preventive gynaecological screening tests.

During the examination, the gynaecologist collects a small sample of cells from the cervix. The sample is then examined under a microscope to detect possible cellular abnormalities.

The Pap smear can detect:

• precancerous changes
• cellular abnormalities associated with HPV infection
• early stages of cervical cancer

Thanks to Pap smear screening, cervical cancer can often be detected at a very early stage, when treatment is highly effective.

The test is usually recommended for women from the age of 21 years and repeated at regular intervals according to the gynaecologist’s recommendations.

The HPV test is a more modern examination that detects the presence of the HPV virus in the cervix.

Unlike the Pap smear, which examines cervical cells, the HPV test checks for infection with high-risk HPV types that are associated with cervical cancer.

This test can detect the presence of the virus before cellular abnormalities develop.

Many international guidelines now recommend the HPV test as the primary screening method for women aged 30 to 65 years, often in combination with the Pap smear.

The main advantages of the HPV test include:

• high accuracy in detecting HPV infection
• ability to identify risk before cellular abnormalities appear
• longer screening intervals when the result is negative

Although both tests are related to the prevention of cervical cancer, they examine different aspects.

The Pap smear analyses cervical cells in order to detect cellular abnormalities.

The HPV test detects the HPV virus itself, which may cause these abnormalities.

The two tests are often used complementarily, providing a more complete assessment of cervical health.

Colposcopy is a specialised diagnostic examination performed when the results of a Pap smear or HPV test indicate a possible abnormality.

During the procedure, the gynaecologist uses a special microscope called a colposcope to examine the cervix, vagina and vulva under high magnification.

The examination allows detailed evaluation of the area and helps identify suspicious regions that may require further investigation.

In some cases, a biopsy (a small tissue sample) may also be taken during the procedure to allow an accurate diagnosis.

Colposcopy is usually recommended when the results of preventive screening indicate a finding that requires further investigation.

A gynaecologist may recommend colposcopy when:

• the Pap smear shows cellular abnormalities
• the HPV test is positive for high-risk HPV types
• suspicious findings are detected during a gynaecological examination
• there is persistent HPV infection

The examination helps establish an accurate diagnosis and determine the most appropriate follow-up or treatment.

Colposcopy is a short and usually painless procedure performed in the gynaecological clinic.

The process is similar to a routine gynaecological examination. If a biopsy is required, a mild sensation of discomfort may occur, but it usually lasts only a few seconds.

Most women can return immediately to their normal daily activities after the examination.

Regular screening with tests such as the HPV test, Pap smear, and when necessary colposcopy, is a key element in the prevention of cervical cancer.

Through organised screening programmes, most precancerous cervical lesions can be detected early and treated before they develop into cancer.

For this reason, women are encouraged to undergo regular gynaecological check-ups and consult their gynaecologist regarding the appropriate frequency of screening tests.