Early stage disease is frequently asymptomatic. Pre-invasive lesions are often detected only after a cervical cancer screening test (Pap smear or liquid-based cytology).[59] Human papillomavirus (HPV) testing, either alone or in combination with Pap testing, appears to be more sensitive than and superior to Pap testing alone.[25][60][61] However, HPV testing increases the number of positive screening results, unnecessary referrals, and the use of downstream interventions such as colposcopy and biopsy, with uncertain long-term benefit.[60]

The diagnostic approach in asymptomatic patients depends on the findings from a routine Pap smear, as outlined below.

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