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Making Sense of Your Pap & HPV Test Results

pictures of five women

This page is for women who got screened for cervical cancer with a Pap test and an HPV test. It will help answer common questions about:

Getting abnormal test results does not mean that you have cervical cancer now. For specific questions about your test results, talk to your doctor. Click hyperlinked words for more information.

What is cervical cancer?

Cancer that starts to grow on a woman’s cervix is called “cervical cancer.” Cancer can grow on a woman’s cervix the same way it can grow on other body parts. Most times, cervical cancer forms slowly. Cervical cancer often does not cause symptoms until it is advanced. When cervical cancer is advanced, it may cause abnormal bleeding, discharge, or pain.

cervix
The cervix is the opening of your uterus (womb). It is part of a woman's reproductive system.

What causes cervical cancer?

A virus, called genital human papillomavirus (pap-ah-LOmah-VYE-rus)—also called HPV—can cause normal cells on your cervix to turn abnormal. Over many years, abnormal cells can turn into cancer if they are not found and treated by your doctor. It can take 10 to 15 years (or more) for cells to change from normal to abnormal, and then into cancer. Abnormal cells are sometimes called “pre-cancer” because they are not normal, but they are not yet cancer.

You cannot see or feel HPV or these cell changes on your cervix.

HPV can cause changes in cervical cells over time. Image shows normal cells, pre-cancer cells, and cancer cells.

What is cervical cancer screening?

Screening tests can find early problems before you get sick. The Pap test is a screening test for cervical cancer. It looks for abnormal cells on your cervix that could turn into cancer over time. That way, problems can be found and treated before they ever turn into cancer. An HPV test may also be used with the Pap test for women 30 years or older, as part of routine screening.

Getting regular cervical cancer screening is key to preventing this disease.

Every year in the United States, about 12,000 women get cervical cancer, but it is the most preventable type of female cancer, with both HPV vaccines and regular screening tests.

What is HPV?

HPV is a common virus. There are about 40 types of HPV that can infect the genitals or sex organs of men and women. These HPV types can also infect the mouth and throat. HPV is so common that most people get it at some time in their lives. But HPV usually causes no symptoms so you can’t tell that you have it.

What can HPV do to my body?

  • Some HPV types can cause changes on a woman’s cervix that can lead to cervical cancer over time. These HPV types can also infect other parts of the body and cause other, less common cancers in men and women.
  • Other HPV types can cause genital warts. But the HPV types that can cause genital warts are different from the types that can cause cancer.

Most of the time, the body’s immune system fights off HPV naturally within two years-- before HPV causes any health problems. It is only when HPV stays on a woman’s cervix for many years that it can cause cervical cancer. Experts do not know why HPV lingers in certain cases but not others.

How could I get HPV?

HPV is passed on through genital (skin to skin) contact, most often during vaginal or anal sex. HPV may also be passed on during oral sex. Most people never even know they have HPV, or that they are passing it to their partner. So it may not be possible to know who gave you HPV or when you got it. HPV is so common that most people get it soon after they start having sex. And it may only be found years later.

All women who ever had sex are at risk for HPV and cervical cancer.

HPV is NOT the same as HIV (the AIDS virus) or herpes. All of these viruses can be passed on during sex. But they do not cause the same symptoms or health problems.

Cervical Cancer Screening Tests

One important way to prevent cervical cancer is through regular screening with the Pap test. An HPV test can also be used at the same time as the Pap test for women 30 years and older.

Since cervical cancer often does not cause symptoms until it is advanced, it is important to get screened even when you feel healthy.

The Pap and HPV tests look for different things:
The Pap Test
Checks your cervix for abnormal cells that could turn into cervical cancer.
The HPV Test
Checks your cervix for the virus (HPV) that can cause abnormal cells and lead to cervical cancer.


The Pap and HPV tests can find early problems that could lead to cervical cancer over time. These tests do NOT:

  • Check for early signs of other cancers
  • Check your fertility (ability to get pregnant)
  • Check for all HPV types –The HPV test only checks for specific HPV types that are linked to cervical cancer.
  • Check for other sexually transmitted infections (STIs).

When to get an HPV test.

Experts recommend HPV testing for women who are:

You don’t need to ask your doctor for an HPV test. Your doctor should offer you an HPV test if you need it and it is available in their practice.

Why is the HPV test NOT recommended as part of regular screening for younger women and teens?

HPV is very common in women under age 30. But it is not useful to test women under age 30 for HPV, since most HPV that is found in these women will never cause them health problems. Most young women will fight off HPV within a few years.

HPV is less common in women over the age of 30, who are at increasing risk for cervical cancer. HPV is also more likely to signal a health problem for these women, who may have had the virus for many years. Doctors may use the HPV test with the Pap test to tell if these women are more likely to get cervical cancer in the future, and if they need to be screened more often.

Getting regular Pap tests, even without the HPV test, is still a good way to prevent cervical cancer—for both younger and older women.

In the U.S., cervical cancer is rare in women in their 20s. It is much more common in women over 30. More than 16 out of every 100,000 women ages 40-44 will get cervical cancer each year. Less than 2 out of every 100,000 women ages 20-24 will get cervical cancer each year.


What Does My Pap Test Result Mean?

Your Pap test will come back as either “normal,” “unclear,” or “abnormal.”

Normal
A normal result means that no cell changes were found on your cervix. This is good news. But you still need to get Pap tests in the future. New cell changes can still form on your cervix.
Unclear
It is common for test results to come back unclear. Your doctor may use other words to describe this result, like: equivocal, inconclusive, or ASC-US. These all mean the same thing: that your cervical cells look like they could be abnormal. It is not clear if it’s related to HPV. It could be related to life changes like pregnancy, menopause, or an infection. The HPV test can help find out if your cell changes are related to HPV.
Abnormal
An abnormal result means that cell changes were found on your cervix. This usually does not mean that you have cervical cancer.

Abnormal changes on your cervix are likely caused by HPV. The changes may be minor (low-grade) or serious (high-grade). Most of the time, minor changes go back to normal on their own. But more serious changes can turn into cancer if they are not removed. The more serious changes are often called “precancer” because they are not yet cancer, but they can turn into cancer over time. It is important to make sure these changes do not get worse.

In rare cases, an abnormal Pap test can show that you may have cancer. You will need other tests to be sure. The earlier you find cervical cancer, the easier it is to treat.

If your Pap test results are unclear or abnormal, you will likely need more tests so your doctor can tell if your cell changes could be related to cancer.


It is estimated that each year in the U.S., over 3,000,000 women get unclear or abnormal Pap tests. About 10,000 of these women will actually have cervical cancer. Most women with unclear or abnormal Pap tests do not have cancer. But many of these women may have abnormal cells that need to be treated so that they do not turn into cancer in the future. Be sure to follow your doctor’s advice for more tests or treatment.


Making Sense of Your Pap and HPV Test Results

patient and physician
“I see my doctor regularly for a Pap test. This year, my doctor told me the test was abnormal. He also said I have HPV. I was confused. What does this mean?”

If you have an HPV test at the same time as your Pap test, it can be confusing to get both results at the same time.

Your HPV test will come back as either “positive” or “negative”:

  • A negative HPV test means you do not have an HPV type that is linked to cervical cancer.
  • A positive HPV test means you do have an HPV type that has been linked to cervical cancer. This does not mean you have cervical cancer now. But it could be a warning.

HPV test results are only meaningful WITH your Pap test results. To understand what these tests mean together:


If your HPV Test is Negative (normal), and your Pap test is...

Pap test is Normal

This means:
  • Your cervical cells are normal.
  • You do not have HPV.
  • You have a very low chance of getting cervical cancer in the next few years.

You should:

  • Wait three years before getting your next Pap and HPV test.
  • Ask your doctor when to come in for your next visit.

Experts used to suggest yearly Pap tests. But now you can safely wait longer because having two tests gives you extra peace of mind.

Pap test is Unclear (ASC-US)

This means:
  • You do not have HPV, but you may have cell changes on your cervix.
  • Even if you do have cell changes, it is unlikely that they are caused by HPV (or related to cervical cancer).

You should:

  • Get another Pap test in one year.

Pap test is Abnormal

This means:
  • Your cervical cells are abnormal.
  • You do not have HPV.

It’s important to find out why the two tests are showing different things.

For minor cell changes, your doctor will:

  • Take a closer look at your cervix to decide next steps.

For major cell changes, your doctor will:

  • Take a closer look at your cervix and/or treat you right away.

If your HPV Test is Positive (abnormal), and your Pap test is...

Pap test is Normal

This means:
  • Your cervical cells are normal, but you do have HPV.

You may fight off HPV naturally and never get cell changes. Or, you may not fight off HPV, and HPV could cause cell changes in the future.

It is believed that most women fight off HPV within two years. It is not known why some women fight off HPV and others do not.

You should:

  • Get another Pap test and HPV test in one year.

Cell changes happen slowly. Some time must pass before your doctor can tell if HPV will go away or cause cell changes.

Pap test is Unclear (ASC-US)

This means:
  • You have HPV, and you may have cell changes on your cervix.

You doctor will:

  • Take a closer look at your cervix to find out if your cells are abnormal.

Your doctor may need to remove the abnormal cells or follow up with you over time to make sure the cells do not get worse.

Pap test is Abnormal

This means:
  • You have HPV.
  • Your cervical cells are abnormal.

This does not usually mean you have cancer.

For minor cell changes, your doctor will:

  • Take a closer look at your cervix to decide next steps.

For major cell changes, your doctor will:

  • Take a closer look at your cervix and/or treat you right away.

If I have HPV, do I have cervical cancer?

No, HPV is not the same as cervical cancer. HPV is the virus that can cause cervical cancer. Many women have HPV. Few of them get cervical cancer if they follow their doctor’s advice for more testing and/or treatment.

What will happen if I need to come back for more testing?

Your doctor will do what’s right for you, based on your test results. Your doctor may:

  • Ask you to wait before giving you your next Pap and/or HPV test. This is called “watchful waiting.” It is common.
  • Take a closer look at your cervix. This is done using a special lens that makes your cervical cells look bigger (called a colposcopy).
  • Take a small sample of your cervix (biopsy) to study it more carefully.
  • Treat you. This involves killing or taking out the abnormal cells. These treatments may be uncomfortable, but they can be done during one visit to your doctor.
  • Refer you to a specialist. This might happen if your test results suggest that you may have cancer.

Why wait for more tests if I could have cancer?

It is possible that your cell changes will never turn into cancer. They may go back to normal on their own. But cervical cells change very slowly. Some time must pass before your doctor can tell if your cells need treatment. Since treatment can have risks and side effects, it is best to make sure you really need it. Be patient. Go back to your doctor for all appointments and testing—to make sure your cell changes do not get worse.

Remember: Many women get HPV or abnormal Pap tests. But few of them get cervical cancer—as long as they get the tests and treatments their doctor recommends. Most times, problems that are found can be treated before they ever turn into cervical cancer.

What else can I do to prevent cervical cancer?

  • Keep your next doctor’s appointment. Mark your calendar or post a note on your fridge, so you remember it.
  • Go back for more testing or treatment if your doctor tells you to.
  • Keep getting regular Pap tests—at least once every three years.
  • Do not smoke. Smoking harms all of your body’s cells, including your cervical cells. If you smoke and have HPV, you have higher chances of getting cervical cancer. If you smoke, ask your doctor for help quitting.
  • If you are age 26 or younger, you can get vaccinated against HPV. HPV vaccines do not cure existing HPV or related problems (like abnormal cervical cells), but they can protect you from getting new HPV infections in the future.

Questions To Ask Your Doctor











Be sure to ask your doctor about anything you don’t understand.

couple

How do I talk to my partner about HPV?

You and your partner may benefit from talking openly about HPV. Here are some things to know before talking to your partner.

  • HPV is very common. It can infect both men and women. Usually, HPV has no signs or symptoms, and the body fights it off naturally before it causes health problems.
  • Most sexually active people get HPV at some time in their lives, though most will never know it. Even people with only one lifetime sex partner can get HPV, if their partner had it when the relationship started.
  • HPV testing is not recommended for men, nor is it recommended for finding HPV on the genitals or in the mouth or throat. But the body usually fights off HPV naturally, before HPV causes health problems. So an HPV infection that is found today will most likely not be there a year or two from now.
  • Partners who are age 26 or younger should consider HPV vaccination to protect against the types of HPV that most commonly cause health problems in men and women.
  • The types of HPV found on a woman’s HPV test can cause cervical cancer; they do not cause genital warts.
  • Partners who have been together for a while tend to share HPV. This means that your partner likely has HPV already, even though your partner may have no signs or symptoms.
  • Having HPV does not mean that you or your partner is having sex outside of your relationship. There is no sure way to know when you got HPV or who gave it to you. A person can have HPV for many years before it is found.

If your sex partner is female, you should talk to her about the link between HPV and cervical cancer, and encourage her to get a Pap test to screen for cervical cancer.

Common Questions about HPV

Is there a treatment for HPV or abnormal cells?

There is no treatment for HPV (a virus). But there are treatments for abnormal cervical cells, which can be killed or removed. Treating abnormal cells will stop them from growing into cancer. But it may not remove the virus (HPV). That’s why it’s important to go back to your doctor as told, to make sure abnormal cells do not grow back. You may need to get Pap tests more often for a while. But most people do eventually fight the virus off.

Does having HPV or abnormal cervical cells affect my chances of getting pregnant or having healthy babies?

Having HPV or cell changes on your cervix does not make it harder to get or stay pregnant. The type of HPV that is linked to cancer should not affect the health of your future babies. But if you need treatment for your cell changes, the treatment could affect your chance of having babies, in rare cases. If you need treatment, ask your doctor if the treatment can affect your ability to get pregnant or have a normal delivery.

Will I pass HPV to my current partner?

If you have been with your partner for a while, your partner likely has HPV too. But your partner likely has no signs or symptoms of HPV. Partners usually share HPV, until your bodies fight it off naturally. There is no way to know if your partner gave you HPV, or if you gave HPV to your partner.

Can I prevent passing HPV to a new partner?

Condoms may lower your chances of passing HPV to your new partner, if used with every sex act, from start to finish. But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV. If your partner is age 26 years or younger, vaccinations are available to prevent the types of HPV that most commonly cause health problems in men and women. But the only sure way to prevent passing HPV to a new partner is to not have sex.

Can my male partner get tested for HPV?

Right now, there is no HPV test for men. The approved HPV tests on the market are not useful for screening for HPV-related cancers or genital warts in men.

I heard about an HPV vaccine. Can it help me?

There are two brands of HPV vaccine on the market (Cervarix and Gardasil), which are available to women through age 26. Both brands protect women against most cervical cancers. One of the vaccines (Gardasil) also protects against most genital warts as well as other, less common HPV-related cancers. But neither vaccine treats existing HPV, cervical cell changes, or genital warts. The vaccines are recommended at age 11 or 12 because they are most effective when given before a person’s first sexual contact. But you can get vaccinated through age 26, if you did not get all three vaccine doses when you were younger. These vaccines may one day become available to women older than 26 years, if they are found to be safe and effective for them.

If I’ve had a hysterectomy, do I still need to get screened for cervical cancer?

This depends on why you got your hysterectomy, and if you still have your cervix. If you got a total hysterectomy for reasons other than cancer, you may not need cervical cancer screening. Talk to your doctor to find out if you still need to get screened.

Free or Low-Cost Cervical Cancer Screening and Follow-up Tests

You may be able to get cervical cancer screening and followup tests for free or at low cost if you:

  • have health insurance. If you have questions about coverage, talk to your insurance company.
  • are eligible for Medicaid. To learn more, call 1-800-MEDICARE (1-800-633-4227). You can also find your nearest Medicaid office by visiting the U.S. Center for Medicare and Medicaid Services at www.cms.hhs.gov/RegionalOffices/
  • are age 65 or older. Medicare pays for the Pap test every 2 years, or every year for some women. To learn more about Medicare’s Pap test coverage, call 1-800-MEDICARE (1-800- 633-4227). The call is free and you can speak to someone in English or Spanish.
  • have a low income or do not have health insurance.

To find out if you can get free or low-cost tests and where to go, call or visit:

Learn More

Centers for Disease Control and Prevention (CDC)
1-800-CDC-INFO (1-800-232-4636)
Cervical Cancer homepage
HPV homepage

American Cancer Society (ACS)
1-800-ACS-2345 (1-800-227-2345)
www.cancer.org

American Sexual Health Association (ASHA)
919-361-8488
www.ashastd.org/std-sti/hpv.html

Association of Reproductive Health Professionals (ARHP)
www.arhp.org

GLOSSARY

Abnormal Pap test (ab-NOR-mal): A finding that is not normal. An abnormal result means that your cervix has cell changes. Your doctor may use medical terms to describe these results. You may hear that your result came back as “LSIL” or “HSIL”. LSIL stands for “low-grade squamous intra-epithelial lesions”— which means minor cell changes on the cervix. HSIL stands for “high-grade squamous intra-epithelial lesions”— which means more serious cell changes. Abnormal results do not mean you have cervical cancer. But you need to follow up as told by your doctor.

ASC-US (ASK-us): This word stands for “Atypical Squamous Cells of Undetermined Significance.” Doctors may use this word to describe a Pap test result that is unclear. Your doctor may also use words like “equivocal” or “inconclusive” to describe this result (see below).

Biopsy (BUY-op-SEE): Your doctor uses this test to study abnormal cells. A small piece of tissue is taken from your cervix and checked under a microscope.

Cancer (KAN-ser): A disease that starts when cells in the body turn abnormal and begin to grow out of control. Abnormal cells begin in one part of the body and can spread to other body parts. When they spread, the damaged cells replace normal cells. There are many types of cancer. Cancers are named based on where the abnormal cells first started growing. Cervical cancer is when the abnormal cells begin in the cervix.

Cells: The basic unit that makes up all living things.

Cervix (SUR-viks): The part of the womb (or uterus) that opens to the vagina.

Colposcopy (kol-POS-coe-pee): A method your doctor can use to magnify the cervix to see any abnormal cells.

Equivocal (ee-QUIV-o-kal): A Pap test result that is unclear. Your doctor may also use the term “ASC-US” to describe this result.

Follow-up: Going back to see your doctor for more testing or treatment.

Genitals (JEN-i-tlz): The reproductive organs, especially the external sex organs.

HPV or human papillomavirus (pap-ah-LO-mah-VYE-rus): A very common virus that infects the skin cells. There are many types of HPV. About 40 types, called genital HPV, affect the genital areas of men and women. Some of these types can cause cervical cancer in women. Other types can cause genital warts in men and women.

HPV test: A test that looks for HPV on a woman’s cervix. Doctors take cells by swabbing the cervix. This is often done at the same time as a Pap test.

Inconclusive (in-kuh n-kloo-siv): A Pap test result that is unclear. Your doctor may also use the term “ASC-US” to describe this result.

Pap test: Screening test that looks for early signs of cervical cancer. It finds abnormal cells on a woman’s cervix. For this test, your doctor takes cells from your cervix so that they can be looked at with a microscope. The Pap test is often done at the same time as a pelvic exam (see below).

Pelvic exam (PEL-vik ex-am): Exam to check the female reproductive organs. This exam is part of a woman’s routine health care visit. Your doctor will look at the outside of your genitals, or sex organs, to look for problems. Your doctor will also look at and feel your internal organs—such as your vagina, cervix, ovaries, and womb.

Prevent: Avoid or stop from getting.

Pre-cancer: Cell changes that are not normal, but have not yet turned into cancer.

Screening test: Getting tested for early signs of disease so the problem can be treated before the disease ever develops. Cancer screening tests look for early signs of cancer so you can take steps to avoid ever getting cancer. The Pap and HPV tests screen for early signs of cervical cancer.

Uterus (YOO-tuh-rus): The uterus, or womb, holds a growing baby and helps push the baby out during labor.

Virus (VYE-rus): Something that lives in the body and can cause infections. Viruses are so small that they cannot even be seen with a regular microscope.

Vulva (vuhl-vuh): External parts of the female genital organs.

KNOW THE FACTS

  • Cervical cancer is caused by a common virus called HPV. Anyone who ever had sex can get HPV.
  • Cervical cancer can be prevented with regular screening tests and follow-up care. Vaccines are also available through age 26.
  • The Pap test—either alone or with the HPV test—is the best way to find early signs of cervical cancer.
  • If you get an abnormal test result, be sure to follow up as told by your doctor.
  • Most women who get abnormal Pap test results or who have HPV do not get cervical cancer—as long as they follow their doctor’s advice for more tests or treatment.

For more information, call 1-800-CDC-INFO (1-800-232-4636) or visit www.cdc.gov/hpv/ or www.cdc.gov/cancer/cervical/

 
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