Pap smear vs HPV test

The Pap smear (cytology) checks cervical cells for pre-cancerous changes. The HPV test checks for high-risk human papillomavirus strains that cause cervical cancer. Modern guidelines (USPSTF 2018, ACS 2020) recommend HPV testing as the primary screening for women aged 25-65 every 5 years, with Pap as the alternative or co-test.

Black women have higher cervical-cancer mortality than white women in the US despite lower incidence, driven primarily by access to follow-up colposcopy and treatment after abnormal screening. Most state Medicaid plans cover annual screening at no cost.