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). Human papillomavirus (HPV) testing, either alone or in combination with Pap testing, appears to be more sensitive than and superior to Pap testing alone. 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.
The diagnostic approach in asymptomatic patients depends on the findings from a routine Pap smear, as outlined below.
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