Cervical cancer is one of the most preventable cancers in women. Regular screening means that abnormal changes in the cervix can be detected long before they ever develop into cancer. The challenge for many women is knowing which screening test they actually need.

If your doctor has mentioned both a Pap smear and an HPV test, or if you are unsure which one applies to you, this guide explains both tests clearly, how they differ, and what the current screening recommendations in Singapore are.

What Is a Pap Smear?

A ThinPrep Pap smear is a type of liquid-based cervical cytology test used to screen for cervical precancerous changes and cervical cancer.

Description

A ThinPrep Pap smear is a (also called a Pap test or cervical smear) is a screening test that looks for abnormal cells on the cervix.  

During a pelvic examination, cells are collected from the cervix using a brush or spatula. Instead of being smeared directly onto a glass slide (as in a conventional Pap smear), the collection device is rinsed into a vial containing a preservative solution. The sample is then examined under a microscope in the laboratory to detect irregular cell changes.  

The test is performed during a pelvic examination. A small swab or brush is used to gently collect cells from the cervix. In a specialist gynaecology clinic setting, the test itself only takes a few seconds.  Whilst some women may experience slight discomfort during the test, it is not typically painful.

A Pap smear does not diagnose cervical cancer directly. What it looks for are pre-cancerous cell changes that, if left unmonitored, could potentially develop into cancer over time. When abnormal cells are found early, they can be monitored or treated before cancer develops.

What Is an HPV Test?

The HPV test is a molecular screening test that detects the presence of high-risk strains of the human papillomavirus (HPV) in cervical cells. Certain strains of HPV, particularly HPV-16 and HPV-18, are responsible for the large majority of cervical cancers.

Importantly, HPV infection is extremely common. Most sexually active women will have HPV at some point in their lives, and the immune system typically clears the infection on its own. However, a persistent high-risk HPV infection that goes undetected can, over many years, lead to cervical cell changes.

The HPV test uses the same swab sample taken during a pelvic exam. The difference is in how the sample is analysed. Rather than looking at cell appearance (as in a Pap smear), the HPV test looks for viral DNA.

Pap Smear vs HPV Test: Key Differences at a Glance

Cervical Screening Recommendations in Singapore

Singapore’s screening guidelines recommend that all sexually active women begin cervical cancer screening from age 25. The standard recommendation is a Pap smear every three years.

For women aged 30 and above, HPV testing is increasingly used alongside or in place of the Pap smear, depending on the clinical picture and the specialist’s recommendation. Some women may be offered co-testing, where both a Pap smear and an HPV test are conducted at the same time using a single sample.

Women who have received the HPV vaccine are still advised to continue with regular cervical screening, as the vaccine does not protect against all high-risk HPV strains.

If you are unsure which test is right for you based on your age, vaccination history, or previous screening results, your gynaecologist is the best person to advise.

What Is Co-Testing, and Is It Right for You?

Co-testing means having both a Pap smear and an HPV test performed at the same appointment, using the same cervical swab sample. It is a more comprehensive approach to screening and is generally recommended for women aged 30 and above.

Co-testing provides two layers of information. The Pap smear looks at cell appearance, while the HPV test detects the presence of the virus. Together, they give a more complete picture of cervical health. If both results are negative, the next screening appointment is typically five years away rather than three.

Co-testing is particularly useful for women who want the reassurance of a more thorough screen, or those with a history of abnormal results.

What Happens If My Result Is Abnormal?

An abnormal Pap smear result does not mean you have cervical cancer. It means that some cell changes were observed that require further investigation. Your specialist will discuss what the result means and whether a repeat test, a colposcopy (a closer examination of the cervix), or another step is needed.

Similarly, a positive HPV test means that a high-risk HPV strain was detected. Depending on the strain and your age, your specialist will advise whether immediate follow-up is needed or whether a repeat test in 12 months is appropriate.

Both outcomes are manageable. The purpose of screening is to catch anything that needs attention early, when the options are most straightforward.

Is Cervical Cancer Screening Subsidized or Claimable with MediSave in Singapore?

Cervical cancer screening, including both the Pap smear and the HPV test, can be heavily subsidized for eligible Singaporean women undergoing screening at polyclinics, CHAS clinics, and in conjunction with other public screening campaigns.

Patients may opt to visit private specialist clinics for their cervical cancer screening if they wish to have their pap smear performed by a specialist gynaecology, and/or if they wish to seek a specialist opinion for another gynaecological issue at the same time – for example, as part of a pre-conception / fertility screen, or as part of holistic care for fibroids or ovarian cysts.  

In Singapore, MediSave can be used to pay for your own or approved dependants’ medical treatments and tests that are ordered by a doctor to diagnose or treat a medical condition, subject to claim limits. Patients with planned inpatient treatments for gynaecological conditions are advised to check on the specific MediSave claim limits for their admission.  Our team at Trinity Women’s Specialists is happy to advise you on finances of your specific condition.  

What is the Cost of Cervical Screening in Singapore?

Cervical cancer screening charges typically range from $60 – $260, when performed in conjunction with a full gynaecological consultation and examination.  The exact charges depend on the tests requested (ThinPrep Pap versus HPV test versus co-test).  

ThinPrep Pap and HPV tests can be offered together with certain holistic women’s health packages, such as fertility and general cancer screening packages.  At Trinity Women’s Specialists, we aim to keep our charges fair and transparent.  Please enquire with our clinic team if you wish to know the estimated charges for a consultation and Pap smear / HPV test.

What is Opportunistic Cervical Cancer Screening and What are its Benefits

Opportunistic cervical cancer screening refers to screening that is offered when a woman attends a healthcare visit for another reason (e.g., contraception, pregnancy care, routine health checks, or gynecological consultations), rather than through a formal population-based invitation program.

Benefits of Opportunistic Cervical Cancer Screening:

1. Increased Detection of Precancerous Changes

• Identifies cervical abnormalities such as cervical intraepithelial neoplasia (CIN) before they progress to cancer.
• Early treatment of precancerous lesions can prevent the development of invasive cervical cancer.

2. Earlier Diagnosis of Cervical Cancer

• Women who may not otherwise participate in regular screening can be tested during routine healthcare visits.
• Earlier-stage cancers have significantly higher cure rates and require less extensive treatment.

3. Improved Access to Screening

Captures women who:

• Miss organized screening invitations.
• Have recently moved.
• Have limited awareness of screening programs.
• Attend healthcare services frequently but do not proactively seek screening.

4. Convenience for Patients

• Screening can be performed during an existing appointment, reducing the need for a separate visit.
• This may improve uptake among busy women and working mothers.

5. Opportunity for Health Education

Healthcare providers can discuss:

• Cervical cancer prevention.
• Human papillomavirus (HPV) infection.
• HPV vaccination.
• Sexual health and risk factors.

This allows individualized counseling based on the patient’s age and risk profile.

6. Potential Reduction in Cervical Cancer Incidence and Mortality

• Even in the absence of a structured screening program, opportunistic screening can contribute to lower rates of cervical cancer through early detection and treatment.

7. Particularly Useful During Reproductive Healthcare Encounters

• Antenatal, postnatal, contraceptive, fertility, and menopause consultations provide opportunities to identify women who are overdue for screening.