Cervical cancer remains one of the most common cancers affecting women in India. What makes it especially tragic, doctors say, is that it is also one of the most preventable. Regular screening through Pap smears and HPV testing can detect early cell changes long before cancer develops, often when treatment is simple and highly effective.
“A Pap smear is a preventive screening test and a major milestone in protecting women from cervical cancer,” says Dr Sampada Dessai, Consultant Gynaecological Cancer and Robotic Surgeon at P. D. Hinduja Hospital, Khar. “Cervical cancer develops slowly and silently, often without symptoms in the early stages. Screening after the age of 25 allows us to detect abnormal cervical cell changes when they are still easily treatable.”
What exactly is a Pap smear?
A Pap smear involves collecting a small sample of cells from the cervix, which are then examined for precancerous or cancerous changes. The test is quick, minimally uncomfortable, and can be done during a routine gynaecological visit.
“The goal is not to diagnose cancer, but to catch early cellular changes before they turn cancerous,” Dr Dessai explains. “That’s what makes this test so powerful.”
According to Dr Kunjal Patel, Molecular Oncopathologist, Neuberg Centre for Genomic Medicine, "A Pap smear is a preventive screening test, a milestone in the protection of women from cervical cancer. As cervical cancer can go on to develop slowly and silently over a long period of time, without showing any symptoms in the early stages, thus a regular screening after the age of 25 can help in detecting the changes in the cells of the cervix that are abnormal at the stage when they are still very easily treatable.
The test is done by collecting a few cells from the cervix, and these are then examined for any precancerous or cancerous changes. Individuals aged 21–24 years do not require screening; those aged 25–65 years should undergo primary HPV testing every 5 years (preferred), HPV/Pap co-testing every 5 years (acceptable), or a Pap test every 3 years (acceptable,) and those aged 65 years and older may discontinue screening if a series of prior tests were normal."
He added, "HPV DNA testing identifies the presence of high-risk human papillomavirus associated with cervical cancer, and when combined with Pap smear testing, it provides a more comprehensive assessment, particularly for women at increased risk.
Early initiation of screening and adherence to the recommended screening intervals are important measures to lower the risk of cervical cancer and ensure good reproductive health in the long run."
When should women start screening?
Screening recommendations vary slightly by age and risk profile, but doctors agree on one key point: early and regular screening saves lives.
According to current guidelines:
- Women aged 21–24 years do not require routine screening
- Women aged 25–65 years should undergo
- Primary HPV testing every 5 years (preferred), or
- HPV and Pap co-testing every 5 years, or
- A Pap smear alone every 3 years
- Women aged 65 years and above may discontinue screening if previous results have been consistently normal
“HPV DNA testing identifies high-risk strains of the virus linked to cervical cancer,” says Dr Dessai. “When combined with Pap testing, it provides a more comprehensive risk assessment, especially for women at higher risk.”
Why screening matters so much in India
Despite the availability of effective screening tools, cervical cancer continues to affect Indian women at a young age.
“Cervical cancer is common, but it is also one of the most preventable cancers,” says Dr Dessai. “Vaccination, screening, and timely treatment of precancerous lesions can prevent this disease, yet screening is still neglected by many women.”
She points to several reasons for this gap, lack of awareness, social stigma around gynaecological exams, limited access to screening facilities, and concerns about cost.
“These are simple, effective tests,” Dr Desai adds. “But they are often delayed until symptoms appear, and by then, the disease may already be advanced.”
Pap smear, HPV testing, and vaccination: How they work together
Doctors stress that no single approach is enough on its own. Prevention works best when screening and vaccination are combined.
“HPV vaccination does not replace screening,” explains Dr Bharat Bhosale, Consultant Medical Oncologist at S. L. Raheja Hospital, Mumbai. “Vaccines do not cover all cancer-causing HPV types, and many women may have been exposed to the virus earlier.”
He adds that screening options expand with age. “From 30 to 65 years, women can choose between a Pap smear every three years, HPV DNA testing every five years, or co-testing every five years if results are negative,” Dr Bhosale says. “HPV PCR testing can detect high-risk viral strains even before cell changes appear. A positive result doesn’t mean cancer; it means closer follow-up is needed.”
Cervical cancer does not develop overnight. It offers a long window for prevention, but only if women are screened regularly.
“HPV vaccination prevents infection, Pap smears detect early cell changes, and HPV DNA testing identifies risk,” Dr Bhosale says. “Together, they offer women the strongest protection against cervical cancer, through early, silent, and effective prevention.”
For women over 25, a Pap smear is not just a test. It’s a safeguard, one that can prevent one of the most common cancers before it even begins.
Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.
