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Interesting question!

Medical standard practice (and what has been approved by the FDA) is for a combined Pap test and HPV test every two years only in women over 30. (I explain why below). The Pap can detect abnormalities and cell changes that are not detected by one, single, HPV test.

Looks like the most important test to get is the Pap Test, as it can test for ALL cervical changes, including small changes, precancerous cells or cancerous cells.
Basically, you can think of the Pap test as a screening tool that checks for your overall health of your cervix's cells.

The HPV test is used to "clarify results" of an abnormal Pap. HPV infection (not HPV disease) is so common that most sexually active women will have had it in their lifetime (between 50-75%). The important thing to know about HPV, is that of the more than 100 types, 40 are spread through sexual contact. Some are "low risk" strains that may cause infection, some are "high risk" strains that may cause cancer.

Most people, at some time in their life, would theoretically test positive for HPV. This is unnecessary to be "diagnosed" with something that most of us have (it's akin to getting tested for the flu; most of us would theoretically test positive for this virus at some point in our lives!). And, for women under 30 years of age, it is actually thought to be more harmful to have an HPV test, as it could result in "too many tests and unnecessary treatment", according to ASHA.

The HPV test would only tell you if you have HPV now, which is unhelpful (unless it is to confirm any abnormal results in pap test). If you have an HPV infection now, you will not likely have it a few years from now, as most HPV infections clear up on its own. The Pap test would check for cell changes, including those caused from HPV.

There is no HPV test that checks for general "HPV status".

Last comment, according to ASHA:
"In women 30 and over, screening using both an HPV test and a Pap test is more likely to find abnormal cervical cell changes than either test alone." Plus, both tests can be performed at the same time, possibly even with the same cell sample.

It is great that you are being proactive in your reproductive health, and researching information about the best screening tools and tests!

Check out American Social Health Association (ASHA) for more Q&A related to pap tests and HPV tests.

Other great resources:
- American College of Gynecologists and Obstetricians (AGOC)
- Centers for Disease Control (CDC)

August 24, 2008 - 6:35am

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