This is a true story. Zhang Fang (pseudonym), 31 years old, had just been married for two years, had not yet had children, and was very busy at work. This year, the cervical smear examination was normal as usual, but in just six months, because of irregular vaginal bleeding, the examination revealed that she had cervical cancer. Why is this? Let’s learn about the common methods of cervical cancer screening: TCT (liquid-based thin layer cytology test) and HPV (human papillomavirus). The cervical cytology test TCT is a method of screening for the presence of tumors by reading the cells collected from the cervix with the doctor’s eyes. As a methodological matter, it is prone to false negatives, meaning that the TCT may be normal, but there is actually a possibility of cervical precancerous lesions. This is because there is a certain amount of subjectivity and possible error in the collection of cervical cells, the production of the film and the reading of the film by the physician. More than 90% of cervical cancers are associated with HPV infection, which is one of the culprits of cervical cancer. HPV is divided into high-risk and low-risk types. About 20% of sexually active women are infected with HPV. Generally, there is no discomfort after infection and most infections will subside naturally within six months to a year, but a small number of persistent infections can lead to cervical lesions and even cancer. For women over 30 years of age (especially those with high-risk HPV infection), combined HPV and TCT can be considered for cervical cancer screening; infection with high-risk HPV after 30 years of age suggests a higher risk of cervical cancer than HPV-negative patients, and screening with cervical smear can be enhanced at this time. If you are negative for both HPV and TCT, you may consider extending your screening cycle to once every 3-5 years. The 2012 updated guidelines of the American Colposcopy Association suggest the value of HPV typing, i.e., if HPV positive and TCT negative, HPV high-risk typing, such as HPV type 16 or 18 positive, can be performed if available. Since TCT is prone to underdiagnosis at this time, colposcopy and biopsy can also be considered directly for these infections. If the colposcopy biopsy is negative, repeat the pap smear after 1 year. Of course, having HPV infection does not necessarily mean getting the disease, and if the HPV vaccine is given before the infection occurs, usually before the first sexual intercourse can serve to partially reduce the incidence of cervical cancer.