All the modern cervical cancer screening tests – that is, the Primary HPV test and co-test (HPV test + Pap test) – are good at finding cancer and precancer. The primary HPV test is better at preventing cervical cancers than a Pap smear alone and does not add more unnecessary procedures, which can happen with a co-test.

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Cervical cancer screenings, first introduced in the 1940s and called the Pap smear, have evolved in the last couple of decades, however, the collection method has remained the same: a cervical collection by a provider during a speculum exam, until now.

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Let’s break it down.

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• First, you'll most likely recognize the term Pap smear rather than cervical cancer screening or HPV test. This is confusing because in the last ~20 years, screening usually includes a human papillomavirus (HPV) test and an updated cervical cytology test. Also, by naming it a Pap smear, some women are unsure of what the exam is actually testing for. For background, the term Pap smear came from the last name of  Dr. Georgios Papanicolaou, who in 1942 invented a new stain (the Pap stain) to look at cervical cells to screen for cancer, a technique which is still used today.
• Second, screening guidelines used to require yearly exams because Pap smears alone are less sensitive when identifying cervical changes and only catch cell changes that have already happened. It then changed to every 3-5 years. Many of us were excited because we don’t enjoy the speculum experience, but do we know why the screening intervals changed? Spoiler: it's the HPV test.
• Lastly, the exam was always coupled with a breast and full pelvic exam, but this also changed recently. 

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If it is a cervical cancer screening, why do we call it a Pap smear?

The short answer: It’s habit! Many people associate cervical cancer screening with getting a Pap smear. This is understandable, given Pap smears were the first and only screening method for cervical cancer for 70+ years. 

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The Pap smear tests for cell changes that have already happened in the cervix, which could indicate precancer or cancer of the cervix. These changes are usually caused by an infection with a high-risk type of HPV. However, the Pap smear alone has a sensitivity (a measure of accuracy) of only 53%, meaning that it can miss abnormal cervical cell changes almost half of the time. 

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Once we learned in the 80s-90s that HPV was associated with almost all cervical cancers, screening transformed to test specifically for HPV. But, we still often see the screening referred to as a Pap smear because it’s what many people are used to calling it.

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Primary HPV Test

When you screen using the Teal Wand, you are collecting a sample to be tested on an FDA-approved primary HPV test for cervical cancer screening (Roche cobas® Primary HPV test). The primary HPV test is the most sensitive screening test for cervical cancer and is recommended by the American Cancer Society and the United States Preventive Services Task Force. 

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An HPV test detects whether you have a current high-risk HPV infection, which is critical because having high-risk HPV is the single most important risk factor in developing cervical cancer. Compared to the Pap smear, HPV tests can also detect infections at earlier stages, before cancer has developed.

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The Teal Wand is FDA-approved, and the sample finds HPV-related cervical precancer 96% of the time when it is present, which is as accurate as samples collected by a clinician using a speculum and brush. 

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Extended Screening Intervals

It was the introduction of the primary HPV test that extended the screening intervals from every 1-3 years (using only the Pap smear) to every 5 years using HPV testing (the co-test, which combines Pap and HPV testing, is also recommended every 5 years). This extension in the screening guidelines can be confusing, especially for women who were used to getting the Pap smear every year. But through extensive research of HPV, it is understood that the virus progresses slowly and can take years, even 15-20 years, to develop into cervical cancer. 

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With routine screening and follow-up care, cells infected with high-risk HPV can be caught early and treated before they progress into cervical cancer. Therefore, screening per guidelines is very important, but your own screening intervals could change depending on your screening history. Any history of HPV can shorten your screening intervals, so be sure to discuss your screening history with your provider.

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HPV testing is also the reason that self-collection options, like the Teal Wand, are possible. HPV can be detected from a sample collected from the vagina versus only the cervix. Since self-collecting with a Primary HPV test is new, the American Cancer Society recommends screening every 3 years even with normal results. This is different from the current guidelines for Primary HPV testing when a sample is collected in-person by a clinician using the speculum and brush - that interval, with normal results, is every 5 years. Just as we saw the screening intervals evolve decades ago, the screening guidelines for self-collection (at-home and in-clinic) will likely also evolve as more data is accumulated over time. See more about cervical cancer screening guidelines.

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Pelvic Exams Are No Longer Routine

A pelvic exam is when a provider inserts gloved fingers into your vagina and puts pressure on your abdomen to feel for your cervix, uterus, and ovaries to check for gynecological problems. Pelvic exams were traditionally done routinely after every speculum exam for cervical screening. In 2018, the American College of Obstetricians and Gynecologists (ACOG) stopped recommending routine pelvic exams in non-pregnant patients without symptoms, as the potential harms and discomfort outweighed the benefits for these patients. "Pelvic examinations should be performed when indicated by medical history or symptoms." Similarly, the United States Preventive Services Task Force (USPSTF) and American Academy of Family Physicians (AAFP) both recommend against routine pelvic exams in non-pregnant, asymptomatic women.

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At-Home Cervical Cancer Screening for Primary HPV

The evolution in cervical cancer screening over the past decades has led to significant advancements in testing, and it is exciting to see this progress now be translated into how a woman can experience her screening. With the Teal Wand, you can now be in control of your experience by collecting your own sample at home, comfortably and privately. And you can feel confident that your sample is being tested on an FDA-approved primary HPV test, the most accurate test for cervical cancer screening.