Regular screening plays a vital role in preventing disease and saving lives through early detection. One of the most important tests in women’s health is cervical screening, which uses human papillomavirus (HPV) and, when needed, cytology/Pap testing to identify HPV infection and abnormal cell changes before cervical cancer develops.
Human papillomavirus (HPV) is a very common group of viruses transmitted mainly through sexual and intimate skin-to-skin contact. While many infections clear on their own, certain high-risk types can cause cervical cell changes.
“Precancerous changes usually develop over many years, and early detection allows physicians to monitor or treat them before cervical cancer develops,” explains Dr. Revital Linder, deputy director of the Department of Obstetrics and Gynecology, senior physician in the Picciotto Family Gynecologic Oncology Unit, and head of the Cervical Clinic at Rambam Health Care Campus (Rambam) in Haifa.
“In Israel, women generally begin cervical screening around age 25, although recommendations may differ in other countries,” says Linder. “If results are normal, screening is typically recommended every three to five years. Women with a history of abnormal findings may require closer follow-up.”
Vaccination against HPV is highly effective and is routinely given to boys and girls during their school years. Although the vaccine significantly reduces the risk of infection, it does not protect against every HPV strain that can cause cervical cell changes. For this reason, vaccinated women should still undergo cervical screening.
A gynecologist performs the Pap test, which is usually painless. Using a soft brush, the physician collects a small sample of cervical cells and sends it for laboratory analysis.
“Women often worry about pain, embarrassment, the possibility that ‘something will be found,’ or negative experiences from previous examinations. Others simply struggle to prioritize their own health and postpone the appointment,” adds Linder. “However, the Pap test is usually brief and painless, and it can prevent cancer, which is why it is so important.”
Women who have experienced sexual trauma often benefit from a particularly sensitive approach. If they feel comfortable doing so, they should inform their physician in advance so the examination can be adapted to their needs. According to Linder, even small adjustments—especially giving the patient a sense of control—can significantly reduce anxiety.
“There are several common myths surrounding the Pap test,” notes Linder. “Some women believe it can spread cancer cells, others believe it can affect fertility, and some think they do not need screening if they have no symptoms. In reality, early cervical changes rarely cause symptoms.”
Human papillomavirus can remain dormant for many years. Although intercourse is the most common mode of transmission, skin and mucosal contact can also spread the virus, therefore all women should undergo cervical screening.
“An abnormal HPV or Pap test does not mean cancer,” assures Linder. “Most results reflect minor cellular changes or an HPV infection that will likely clear without intervention. Nevertheless, physicians must evaluate each finding individually.”
Depending on the result, physicians may repeat the test after several months or refer the patient for colposcopy, a magnified examination of the cervix. They may also take a small biopsy. Only a small percentage of women with abnormal results eventually develop cervical cancer.
In some cases, physicians may perform a conization, or cone biopsy, to remove a small area of tissue containing the abnormal cells. Repeated conizations are not routine; when needed, they may indicate ongoing or recurring cell changes caused by a persistent HPV infection.
Linder emphasizes that even persistent precancerous conditions are not cancer. “The term ‘precancerous’ sounds frightening, but it simply means that physicians have identified cells that could potentially become cancerous; it does not mean cancer is present. Screening, monitoring, and treatment are intended to prevent cancer from developing.” Patients who require repeated treatment should remain under the care of a cervical disease specialist, particularly if they wish to become pregnant in the future.
“Human papillomavirus is extremely common in both men and women, but healthcare systems do not generally offer screening for men,” concludes Linder. “It is impossible to determine when an infection occurred. An abnormal cervical screening result does not prove infidelity, and in most cases, there is no need to stop having sex. While a woman is not medically obligated to tell her partner, sharing test results with a supportive partner may reduce anxiety. Conversations between partners should be guided by medical facts rather than blame, assumptions, or fear.”
Based on an original Hebrew article that first appeared on Ynet.
