Cervical cancer screening

Screening for cervical cancer has dramatically helped reduce its incidence and mortality—age-adjusted death rates have been falling on average 0.7% each year over 2009–2018.1

colorectal cancer

A more complete picture

You can count on Quest for a more complete picture to help you and your patients make more informed decisions.

Easily order with Smart Codes

Quest’s age-based Smart Codes use a patient’s age and risk factors to determine which combination of HPV and select STI screening should be performed, along with an image-guided Pap. Smart Codes are consistent with ACOG recommendationsa and are available in addition to our standard menu of tests.

Tests included with Smart Code 91384
Ages (years) 91384–Image-Guided Papa with Age-Based Screening Protocols
21-24
  • Image-Guided Pap (ThinPrep® or SurePath)
  • High-Risk HPV mRNA (if Pap is ASC-US)
  • Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG)
25-29
  • Image-Guided Pap (ThinPrep® or SurePath)
  • High-Risk HPV mRNA (if Pap is ASC-US)
30-65
  • Image-Guided Pap (ThinPrep® or SurePath)
    Pap and HPV together as co-testing
  • High-Risk HPV mRNA
  • HPV Genotyping 16, 18/45 (when Pap is normal and HPV is detected)
Tests included with Smart Code 91384
91384–Image-Guided Papa with Age-Based Screening Protocols

AGES (YEARS)

21-24

  • Image-Guided Pap (ThinPrep® or SurePath)
  • High-Risk HPV mRNA (if Pap is ASC-US)
  • Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG)

AGES (YEARS)

25-29

  • Image-Guided Pap (ThinPrep® or SurePath)
  • High-Risk HPV mRNA (if Pap is ASC-US)

AGES (YEARS)

30-65

  • Image-Guided Pap (ThinPrep® or SurePath)
    (Pap and HPV together as co-testing)
  • High-Risk HPV mRNA
    (Pap and HPV together as co-testing)
  • HPV Genotyping 16, 18/45 (when Pap is normal and HPV is detected)

CT/NG: Chlamydia trachomatis/Neisseria gonorrhoeae.

Tests included with Smart Code 91386 and 91385
Ages (years) 91386–Image-guided Papa with Age-Based Screening, with CT/NG, trichomonas 91385–Image-guided Papa with Age-Based Screening, with CT/NG
21-24 Same as 91384, plus trichomonas (guidelines recommend routine screening of CT/NG in women ages 21-2414) Same as 91384 (guidelines recommend routine screening of CT/NG in women ages 21-2414)
25-29 Same as 91384, plus CT/NG and trichomonas Same as 91384, plus CT/NG
30-65 Same as 91384, plus CT/NG and trichomonas Same as 91384, plus CT/NG
Tests included with Smart Code 91386
91386–Image-guided Papa with Age-Based Screening, with CT/NG, trichomonas

AGES (YEARS)

21-24

Same as 91384, plus trichomonas (guidelines recommend routine screening of CT/NG in women ages 21-2414)

AGES (YEARS)

25-29

Same as 91384, plus CT/NG and trichomonas

AGES (YEARS)

30-65

Same as 91384, plus CT/NG and trichomonas

Tests included with Smart Code 91385
91385–Image-guided Papa with Age-Based Screening, with CT/NG

AGES (YEARS)

21-24

Same as 91384 (guidelines recommend routine screening of CT/NG in women ages 21-2414)

AGES (YEARS)

25-29

Same as 91384, plus CT/NG

AGES (YEARS)

30-65

Same as 91384, plus CT/NG

CT/NG: Chlamydia trachomatis/Neisseria gonorrhoeae.

Note about Smart Codes: Screening women older than 65 years who have had adequate prior screening and women younger than 21 years does not provide significant benefit. Screening women who have had a hysterectomy with removal of the cervix for indications other than a high-grade precancerous lesion or cervical cancer provides no benefit.3

Not all Pap tests are created equal

With our robust cervical cancer testing menu, you can rely on Pap testing from Quest Diagnostics to help you make a more informed diagnosis and treatment plan for your patients.

  • Quest evaluates more Paps and HSIL than any other lab
  • Normal Paps are rescreened at nearly 2x the minimum federal requirement for labs
  • All Paps from high-risk patients are double-screened
  • All abnormal Paps are reviewed by 1 or more pathologists
  • Our expert pathologists are available for consultation

While we offer a choice of Pap collection systems, Quest Diagnostics recommends the ThinPrep® Pap test, due to its proven clinical performance

59.7%
higher high-grade lesions (HSIL) detected than conventional Pap testing4

Learn more

ThinPrep

Test ordering information

TEST CODE TEST NAME
91384

Image-Guided Pap with Age-Based Screening Protocols

91385

Image-Guided Pap with Age-Based Screening with CT/NG

91386

Image-Guided Pap with Age-Based Screening with CT/NG, Trichomonas

To access all testing options for cervical cancer screening, please visit our test directory

Aptima® HPV mRNA testing: excellent sensitivity and better specificity vs HPV DNA testing

The Aptima® HPV mRNA assay identifies the presence and activity of high-risk HPV infections, allowing you to identify and focus on those women who most need your care.

Better specificity,5 which can minimize false positives6 and help reduce unnecessary invasive procedures
Identification of the HPV types most associated with cervical cancer, including adenocarcinoma
37%
Aptima HPV has been shown to reduce false positives by 37% vs Roche cobas® HPV7
24%
Aptima HPV has been shown to reduce false positives by 24% vs digene HC26

New 2020 research supports co-testing

Leading health organizations recommend co-testing every 5 years for women ages 30 to 65 as the preferred method for cervical cancer screening, and a recent Quest Diagnostics Health Trends retrospective, longitudinal study confirms that co-testing with Pap and HPV together identifies more cases of cancer and precancer.2

94%
of cancers were identified with co-testing <12 months to diagnosis2

22.5% of cancers would not have been identified with HPV alone2

Data <12 months of cancer diagnosis

99.7%
precancers were identified with co-testing <12 months to diagnosis2

11% of precancers would not have been identified with Pap alone2

Data <12 months of precancer diagnosis

Co-testing identified 50% or more of the women with any cancer, and ADC in particular, that HPV alone and Pap alone did not identify

Data on biopsy-confirmed cancer outcomes over the entire study period (9 years)

Co-tests prior to biopsy-confirmed cancer = 1,615

Adenocarcinoma is on the rise8

Co-tests prior to biopsy-confirmed adenocarcinoma = 479

Read the latest study that confirms that, now more than ever, co-testing makes a difference

Co-testing solutions for cervical cancer

Our co-testing solutions for cervical cancer are built on a strong combination of carefully evaluated Pap and high performing mRNA testing for high risk HPV. Ordering cervical cancer screening is efficient using one-click Smart Codes. For more information or a complete list of our tests, visit our test directory.

a The age-based offerings are based on ACOG recommendations and include image-guided Pap tests. The ACOG recommendations do not specify a particular type of Pap test. Both imaged and non-imaged Pap tests are acceptable under the recommendations. Non-imaged Pap tests, as well as the additional testing recommended by ACOG, are available at Quest Diagnostics and may be ordered individually. Visit QuestDiagnostics.com/TestDirectory to find our test menu.
b Defined as 3 consecutive negative Paps or 2 consecutive negative co-tests within the past 10 years, with the most recent test occurring within the past 5 years.

Test codes may vary by location. Please contact your local laboratory for more information.

​References:

  1. National Cancer Institute. Cancer stat facts: cervical cancer. Accessed November 21, 2020. https://seer.cancer.gov/statfacts/html/cervix.html
  2. Kaufman HW, Alagia DP, Chen Z, et al. Contributions of liquid-based (Papanicolaou) cytology and human papillomavirus testing in co-testing for detection of cervical cancer and precancer in the United States. Am J Clin Pathol. 2020;154(4):510-516. doi:10.1093/ajcp/aqaa074
  3. US Preventive Services Task Force. Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018 Aug 21;320(7):674-686. doi: 10.1001/jama.2018.10897. https://pubmed.ncbi.nlm.nih.gov/30140884/
  4. ThinPrep® 2000 system [package insert]. MAN-02624-001 Rev. 004. Hologic, Inc.; 2017.
  5. Aptima HPV Assay (package insert) AW-10958 Rev. 002, 2015-02. Hologic, Inc.; 2017.
  6. Monsonego J, Hudgens MG, Zerat L, et al. Evaluation of oncogenic human papillomavirus RNA and DNA tests with liquid-based cytology in primary cervical cancer screening: the FASE study. Int J Cancer. 2011;129(3):691-701. doi:10.1002/ijc.25726
  7. Cuzick J, Cadman L, Mesher D, et al. Comparing the performance of six human papillomavirus tests in a screening population. Br J Cancer. 2013;108(4):908-913. doi:10.1038/bjc.2013.22
  8. Adegoke O, Kulasingam S, Virnig B. Cervical cancer trends in the United States: a 35-year population-based analysis. J Womens Health (Larchmt). 2012;21(10):1031-1037. doi:10.1089/jwh.2011.3385