There can be confusion about whether having the human papillomavirus (HPV) vaccine means you can skip cervical cancer screening. The answer is no. You need both.
To find out why, WellTuned spoke with Dr. Edwin Thorpe Jr., a medical director at BlueCross BlueShield of Tennessee.
“HPV vaccination prevents most infections that cause cervical cancer. Screening helps to find remaining precancerous changes early when treatment is most effective,” Dr. Thorpe says. “Together, this two-pronged approach has led to an 80% decline in cervical precancers among young women since the late 2000s.”
Understanding HPV and the HPV vaccine
Dr. Thorpe: HPV is a common virus spread through intimate skin-to-skin contact. The body’s immune system will clear most HPV infections on their own. However, some high-risk HPV types can cause cervical cancer by stimulating abnormal cell changes over time.
The HPV vaccine works by activating the immune system to prevent new HPV infections that are most likely to cause cancer. It does not treat existing HPV infections or reverse cell changes that have already occurred. For this reason, the vaccine works best when given before exposure to the virus. This is the basis for recommended routine administration at ages 11-12.
Vaccination later in life can still provide protection against HPV types a person has not yet encountered.
The current HPV vaccine protects against nine HPV types, including those responsible for about 90% of cervical cancers. Unfortunately, it does not protect against every cancer-causing HPV type.
Why screening still matters
Dr. Thorpe: Cervical cancer screening with the Pap smear (Pap test) detects early abnormal cell changes that can lead to cancer. The Pap test examines cervical cells under a microscope to look for abnormal changes.
An HPV test detects the high-risk HPV types known to cause abnormal changes in cervical cells. One test looks for cell damage (Pap), and the other looks for the virus that causes the damage (HPV test).
It is recommended that most individuals with a cervix begin screening at age 21. They should continue screenings through age 65, using Pap tests, HPV tests, or both. These recommendations apply whether or not someone has received the HPV vaccine.
New option: Self-collection for screening
Dr. Thorpe: Self-collection has recently been approved as an accepted option for cervical cancer screening for those aged 30-65 at average risk. This allows them to collect their own vaginal sample for high-risk HPV testing. Talk with your doctor as these tests must be ordered by a health care provider.
Self-collected samples are accurate for detecting high-risk HPV. They can help increase screening access by reducing barriers. Follow-up care with a clinician is still needed after a positive result.
What you need to know
Dr. Thorpe: HPV is common, and many people are exposed at some point in their lives. The vaccine prevents certain types of new HPV infections but does not cure existing viral infections. That’s why screening remains essential.
“HPV vaccination combined with routine cervical cancer screening is highly effective in preventing most cervical cancers,” Dr. Thorpe says. “Don’t skip screening just because you’ve been vaccinated.”
More from Dr. Edwin Thorpe on WellTuned
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