What is the difference between a Pap smear and an HPV test? What happens after an abnormal result?
An HPV test checks whether cervical cells are infected with high-risk types of HPV, and cervical cytology (a Pap smear) checks whether the cells have abnormal changes; abnormal cells do not necessarily mean cancer, and further examination, such as colposcopy, is generally needed (Department of Health Cervical Screening Programme, accessed October 2026). How an individual result is followed up is decided by the treating doctor.
What is the difference between a Pap smear and an HPV test?
The table below lists two commonly used screening tests (‘Cervical Screening’ page of the Department of Health's Cervical Screening Programme, accessed October 2026).
| Test | What it checks | If the result is abnormal (according to the Programme's website) |
|---|---|---|
| Human papillomavirus (HPV) test | Whether cervical cells are infected with high-risk types of HPV; high-risk HPV types can cause abnormal changes in cervical cells | A positive result needs a further triage test, as arranged by the service provider |
| Cervical cytology (also called a cervical smear or Pap smear) | Whether cervical cells have abnormal changes | Abnormal cells do not necessarily mean cancer; further examination, such as colposcopy, is generally done |
How often should cervical screening be done?
For screening methods and intervals by age, and a side-by-side comparison of the two Hong Kong guidelines, from the Cancer Expert Working Group on Cancer Prevention and Screening (2021) and the Hong Kong College of Obstetricians and Gynaecologists (2024), see how to choose an obstetrician and gynaecologist.
What usually happens next after an abnormal result?
Women with an abnormal result should consult a doctor about the examinations and follow-up needed; no screening test is completely accurate, so regular screening is still needed even if previous results were normal, and anyone with symptoms of cervical cancer should seek medical care as soon as possible (Department of Health Cervical Screening Programme website, accessed October 2026).
Women followed up in primary care whose screening result falls into certain abnormal categories should be referred early to a gynaecologist for colposcopy and further management (Primary Healthcare Commission reference on cancer screening for women, first edition, February 2025).
What an individual result means, and which examination comes next, is decided by the treating doctor according to the patient's situation. For colposcopy fees, see colposcopy fees; for the related specialties, see how to choose a cervical cancer doctor.
Frequently asked questions
What is the difference between a Pap smear and an HPV test?
An HPV test checks whether cervical cells are infected with high-risk types of HPV; cervical cytology (a smear) checks whether the cells have abnormal changes (Department of Health Cervical Screening Programme website, accessed October 2026).
What usually happens next after an abnormal smear result?
Abnormal cells do not necessarily mean cancer, and further examination, such as colposcopy, is generally done (Department of Health Cervical Screening Programme website, accessed October 2026); certain abnormal categories should be referred early to a gynaecologist for colposcopy (Primary Healthcare Commission reference on cancer screening for women, February 2025). Individual cases are decided by the treating doctor.