First, the answer: Neither can independently diagnose cervical cancer!

Every time in the outpatient clinic, patients bring their reports and ask, "Doctor, I tested positive for HPV, does that mean I have cancer?" "If my TCT is normal, am I safe?"

The answer is actually quite clear:No screening test can directly diagnose cervical cancer.They are more like a "cervical cancer early warning system." The true gold standard for diagnosis is pathological biopsy, which involves analyzing cervical tissue under a microscope.

However, these two examinations are indispensable; one identifies the "culprit," while the other examines the "victim," making them the golden duo for cervical cancer screening.


II. HPV: Uncovering the "Mastermind" Behind Cervical Cancer

HPV is human papillomavirus, simply putThe "culprit" behind cervical cancer。

Purpose: To detect whether you are infected with high-risk HPV (particularly types 16 and 18, which cause 70% of cervical cancers).

Characteristics: Infection does not equal cancer! 80% of women will contract HPV in their lifetime, but the immune system can typically clear it on its own. Only persistent infection (lasting over 2 years) gradually damages the cervix.

Misconception: HPV positive equals cancer? Wrong! It only reminds you of the "cancer risk" and requires further examination; HPV negative equals safe? Not entirely correct either, as a small number of cervical cancers may be unrelated to HPV, and TCT should still be considered.

III. TCT: Examining Cervical Cells for "Whether They Have Been Harmed"

TCT is liquid-based thin-layer cytology testing, commonly known asExamine cervical cells for "whether they have turned malignant"。

Action Collect a small amount of cervical cells to observe whether the morphology is abnormal such as atypical hyperplasia or precancerous lesions

Characteristics: Normal cells = No obvious damage at present; Abnormal cells = Possible pathological changes have occurred, and the cause needs to be traced (such as whether there is HPV infection).

Misconception A normal TCT result means everything is fine No If HPV infection is recent and cells have not yet undergone changes TCT may miss the diagnosis A TCT abnormality definitely indicates cancer Not necessarily Inflammation or polyps can also cause changes in cell morphology

IV. Correct Approach: Combined Examination is the Ultimate Solution!

Examination Method

Suitable for

Advantages

Insufficient

HPV alone

Low-risk population aged 21-29

Simple and inexpensive, screening for risks

Possible missed diagnosis of individuals with existing pathological changes

TCT alone

Routine use is not recommended

Directly observe the cell state

Unable to determine the etiology

Combination of both

Individuals aged 30 and above, high-risk groups (multiple partners / smoking / low immunity)

Accuracy rate of 95%+

The cost is slightly higher.

Gynecologist's recommendation：

Ages 21-29: TCT every 3 years (HPV testing is optional).

Ages 30-65: HPV+TCT (co-testing) every 5 years, or TCT alone every 3 years.

Abnormal result: Don't panic! Proceed with colposcopy + pathological biopsy. Early detection of precancerous lesions yields a cure rate of nearly 100%.

V. Final Reminder: Avoid These Pitfalls at All Costs!

Avoid sexual intercourse, vaginal medication, or douching within 24 hours before screening to prevent affecting the results.

2. It cannot be performed during menstruation; it is best to do it 3-7 days after menstruation ends.

3. After receiving the HPV vaccine, regular screening is still necessary (the vaccine does not protect against all high-risk types of HPV);

4. Women aged 65 and older may discontinue screening if they have had normal screening results over the past 10 years.