Pap Smear Test

Who Needs a Pap Smear?

The American College of Obstetricians and Gynecologists recommends that all women be screened for cervical cancer starting at age 21. This is the recommendation for all women, regardless of whether they are sexually active.

Recommendations for testing are:

• Women ages 21 – 30: Every three years, provided their screening results are normal.
• Women ages 30 – 65: Combined Pap test/HPV screening every five years. Alternatively, they can have a Pap test alone every three years or HPV screening alone every five years.
• Women over 65: Can stop testing if they have three normal Pap tests in a row or two normal combined Pap/HPV tests in a row.

Your provider may recommend a different schedule for Pap and HPV screenings based on your health history as well as your risk factors for cervical cancer. Talk to your healthcare provider to understand your screening options.

Why Do I Need a Pap Test?

Receiving routine pelvic exams and Pap tests is important for a woman’s overall health. Because cervical cancer is a slow growing cancer, it can usually be caught in its early stages with routine screenings. This makes successful treatment much more likely.

In addition to finding cancer and precancerous abnormalities, a Pap test can also diagnose other conditions of the vagina and cervix, including inflammation and infections. An HPV co-test can also be administered along with the Pap test. This tests for high-risk strains of the human papillomavirus, or HPV. This sexually transmitted infection is the biggest risk factor for cervical cancer in women over 30 and is also linked to other types of cancer in both women and men.

Your healthcare provider may have other reasons to recommend a Pap test.

Preparing for a Pap Test

In general, there is nothing you need to do to prepare for a Pap test. You should tell your provider if you:

• Have a latex sensitivity or allergy.
• Are pregnant or might be pregnant.
• Are taking any medications (both prescription and over-the-counter).
• Are on hormonal birth control.
• Have a history of bleeding disorders or are taking blood thinners or aspirin.

It’s best to avoid products such as douches, vaginal medications, or spermicides for two to three days before the test. You should also avoid sex for two to three days before a Pap test. These can interfere with vaginal pH and make it harder to detect abnormal cells. You may also want to avoid scheduling a Pap test while menstruating, because it can make it more difficult to determine the results.

Pap Test Procedure

A Pap test can be performed in your OB/GYN provider’s office during a regular appointment. During the procedure, you will be asked to undress from the waist down and wear a hospital gown or cover up with a sheet. You will lie on the exam table with your knees bent or in stirrups, and your healthcare provider will use an instrument called a speculum to gently open the walls of the vagina.

Your provider will then insert a small swab or spatula to gently remove cells from the cervix and vagina. If an HPV test is also being done, your provider will take a cell sample for that as well. The specimens will then be sent to a lab for examination. You may feel a slight discomfort during the procedure, but it should not hurt. If you experience any pain, you should let your provider know right away.

After the test, your provider may perform a pelvic exam. During this exam, your provider will check your reproductive organs, including the vulva, vagina, cervix, ovaries and uterus, to observe any changes or abnormalities.

After the Test

After the Pap test, you may experience a small amount of bleeding from your cervix being scraped. However, tell your provider if you experience heavy bleeding, severe pain or other unusual symptoms.

The results from your Pap test should be ready in a few days. If the results are normal, you can follow the recommended schedule for your next screening. If you get an abnormal result, your healthcare provider will talk to you about next steps. This may include follow-up testing such as a colposcopy procedure. During this procedure, your provider examines your cervix or vagina with a specialized instrument (a colposcope) to look for cell abnormalities. Your provider may also take a small sample of tissue to perform a biopsy to see if cancerous cells are present.