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GynoTalksM.D., F.A.C.O.G.

Patient Education

HPV & Cervical Cancer

Almost all cervical cancer starts with a common virus — and almost all of it is preventable with screening and vaccination.

Human papillomavirus (HPV) is the most common sexually transmitted infection there is. Most people who have ever been sexually active will encounter it, and in the great majority of cases the immune system clears it without anyone ever knowing. The small fraction of infections that persist are what can, over many years, change cervical cells in ways that eventually lead to cancer.

That long timeline is the good news. It means routine screening finds the changes while they are still pre-cancerous and easy to treat — which is why cervical cancer is one of the few cancers we can genuinely prevent rather than simply detect early.

Symptoms and warning signs

  • No symptoms at all — early cervical changes and most HPV infections are silent, which is the entire reason screening exists
  • Bleeding between periods or after intercourse
  • Bleeding after menopause
  • Vaginal discharge that is new, persistent, or unusually watery or foul-smelling
  • Pelvic pain or pain with intercourse
  • Genital warts, which come from low-risk HPV types that do not cause cancer

Causes and risk factors

  • Persistent infection with a high-risk HPV type, particularly HPV 16 and 18
  • Never having been screened, or long gaps between Pap smears
  • Not having been vaccinated against HPV
  • Smoking, which makes it harder to clear an HPV infection
  • A weakened immune system, including from HIV or immunosuppressant medication
  • Beginning sexual activity at an early age or having multiple partners, both of which raise exposure

How it is diagnosed

  • Pap smear — cells are collected from the cervix and examined for abnormal changes
  • HPV testing, often run on the same sample, to identify high-risk viral types
  • Colposcopy — a magnified look at the cervix when screening comes back abnormal
  • Cervical biopsy taken during colposcopy to confirm what the abnormal cells actually are
  • Endocervical curettage to sample the canal of the cervix when needed

Treatment options

What happens after an abnormal result depends entirely on what the cells show. Most women never need more than closer follow-up.

  • Watchful waiting with repeat screening, when changes are mild and likely to resolve on their own
  • LEEP (loop electrosurgical excision procedure) to remove pre-cancerous tissue
  • Cold knife conization, when a larger or more precise excision is needed
  • Cryotherapy or laser ablation of abnormal cervical tissue
  • HPV vaccination, which prevents infection with the types that cause most cervical cancers
  • Referral to a gynecologic oncologist if a biopsy confirms invasive cancer

Dr. V on cervical cancer and HPV

One of five videos on this topic — HPV prevention, the Pap smear, and colposcopy are covered in the video library.

Watch on its own page

When to book an appointment

  • You are due for a Pap smear, or you are not sure when your last one was.
  • You have had an abnormal Pap result and want to understand what it actually means.
  • You are bleeding between periods, after sex, or after menopause.
  • You or your child are considering the HPV vaccine and want to talk it through.

Frequently Asked Questions

1If I have HPV, does that mean I will get cervical cancer?
No. Most HPV infections are cleared by the immune system within a year or two and never cause any lasting problem. Cervical cancer develops only from infections that persist for many years, and even then screening usually catches the changes long before they become cancer.
2How often do I actually need a Pap smear?
It depends on your age, your screening history, and whether HPV testing is done alongside the Pap. The intervals have lengthened considerably as HPV co-testing has improved, so the honest answer is that it is worth asking at your visit rather than assuming it is annual.
3I have had the HPV vaccine. Do I still need screening?
Yes. The vaccine protects against the HPV types responsible for most cervical cancers, but not all of them, so screening remains part of routine care even for vaccinated women.
4What does an abnormal Pap result mean?
It means some cervical cells looked different from normal — it is not a cancer diagnosis. The next step is usually either a repeat test or a colposcopy, which is a magnified examination of the cervix that lets us see exactly what is going on.
5Is the colposcopy painful?
Most women describe it as similar to a Pap smear, with some cramping if a biopsy is taken. It is done in the office and takes only a few minutes.

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Related Conditions

Cervical cancer is preventable. Screening is how.

Whether you are due for a Pap, have an abnormal result you want explained, or are weighing the HPV vaccine, get in touch and we will talk it through properly.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.