Important things to know about cervical cancer screening

1. What is cervical screening?
   Cervical screening aims to detect early abnormal changes in the cervix to prevent cervical cancer. Common screening methods include cervical smear (also known as Pap smear or Pap smear) or human papillomavirus (also known as HPV) test. Cytology is used to detect abnormal cells in the cervix, while HPV test finds high-risk HPV that may cause cancer. The sampling procedures for both methods are similar, and both require health care workers to use a speculum and then use a brush or swab to collect cells. Regardless of which test you take, the most important thing is to screen regularly.
2. Which cervical screening test should I take?
   According to the recommendations of the Expert Working Group on Cancer Prevention and Screening, women who meet the screening criteria and are between 25 and 29 years old should use cervical smear as a screening method. Women between the ages of 30 and 64 can choose smear, HPV test, or a combined HPV and cervical smear test. As HPV testing has a higher sensitivity, can detect precancerous lesions at an earlier stage and allows for a longer interval between tests, the Department of Health has switched to HPV testing as the main screening method for cervical cancer for women aged 30 to 64 from April 2023.
3. When should I undergo cervical screening?
   Generally speaking, women aged 25 to 64 who have had sexual experience, regardless of marital status, should undergo regular cervical screening.

Women aged 65 or above who have had sexual experience and have never undergone cervical screening should also undergo screening, even if they have stopped menstruating, have not had sex for many years or have undergone sterilization.

Women aged 21 to 24 who have had sexual experience and have risk factors for cervical cancer should consult a doctor to assess whether they need cervical screening.

4. How often do I need screening?
   Generally speaking, women aged 25 to 64 who have had sexual experience should undergo regular cervical screening. If the results of cervical smears are normal for two consecutive years, they can undergo screening every 3 years thereafter. Women aged 30 to 64 can also choose to undergo HPV testing or combined HPV and cervical cell testing every 5 years.
5. Why do I need to undergo regular cervical screening?
   Scientific evidence has proven that regular cervical screening is an effective way to prevent cervical cancer. Cervical cell changes may appear after your last screening, so regular cervical screening can help you detect problems early and get better diagnosis and treatment results.
6. Where can I receive cervical screening?
   In Hong Kong, family doctors, gynaecologists, non-governmental organizations, Maternal and Child Health Centres and Women’s Health Centres of the Department of Health all provide cervical screening services. You can visit Where to receive cervical screening to search for service providers registered with the “Cervical Screening Information System”. Please note that each service provider has individual arrangements for service details, such as appointment and fees. Please check directly with the service provider of your choice.
7. Can I do HPV testing on my own?
   The World Health Organization and some overseas public health agencies have recognized vaginal HPV self-sampling as an effective method for cervical screening. However, there is currently no sufficient scientific evidence to prove that other HPV self-sampling methods, including urine sampling, are effective cervical screening test methods. The Department of Health will continue to closely monitor the latest scientific research evidence in this regard. You should consult your doctor or medical service provider to choose a cervical screening method that is suitable for you based on your personal circumstances.
8. Will cervical cancer develop between two cervical screenings?
   Most cervical cancers are caused by persistent infection with one of the carcinogenic or high-risk types of human papillomavirus (also known as HPV). Some cervical precancerous changes may develop into cancer over the years. Cervical cancer can develop between two cervical screenings, and this happens mainly in women who do not have regular cervical screening. In addition, in some cases, the abnormal cells were not found in the last test (false negative results). Therefore, it is very important to have regular cervical screening.
9. All screening methods have their limitations and are not 100% accurate. Therefore, even if the result of the last cervical screening was normal, you should still: have regular cervical screening; and be aware of the symptoms of cervical cancer and seek medical attention as soon as possible if any symptoms occur.
10. I don’t feel any discomfort. Do I need to have cervical screening?
    Yes. In most cases, early cell changes in the cervix, even early cervical cancer, do not cause any symptoms. Therefore, even if you don’t have symptoms, you must have regular cervical screening.
11. I have been vaccinated against human papillomavirus (HPV). Do I need to have cervical screening?
    Yes. Even if you have received the human papillomavirus (HPV) vaccine, you still need to have regular cervical screening because the HPV vaccine cannot prevent all types of HPV infection and cannot eliminate the virus if you have already been infected.
12. I haven’t had sex for a long time, do I need to undergo cervical screening?
    Yes. Cervical cancer can occur in women who have started having sex a long time ago. In fact, the risk of cervical cancer increases with age. Therefore, even if you have only had sex once or have not had sex for a long time, you need to undergo regular cervical screening. If you have never had cervical screening, you should do it as soon as possible.
13. I have reached menopause, do I need to undergo cervical screening?
    Yes. Menopause does not reduce a woman’s chance of developing cervical cancer. As long as you have had sex in the past, you should undergo regular cervical screening even if you have reached menopause.
14. I have had surgery to remove my uterus and cervix, do I need to undergo cervical screening?
    Generally speaking, women who have had their uterus and cervix removed for benign diseases and have no history of cervical cell changes can stop cervical screening. If you have any questions, please consult your doctor.
15. Can I have cervical screening if I am already pregnant?
    Women may experience vaginal bleeding after undergoing cervical screening, so pregnancy may not be the best time to do the test. However, your healthcare provider will advise you when to undergo cervical screening based on your clinical condition and screening history. If you have any questions, please consult your doctor.
16. I have no family history of cervical cancer. Do I need to undergo cervical screening?
    Yes. There is no obvious genetic predisposition for cervical cancer. Generally speaking, women aged 25 to 64 who have had sexual experience should undergo regular cervical screening.