Pap Tests

What is a Pap test?

The Pap test (also called a Pap smear) checks for changes in the cells of your cervix. The cervix is the lower part of the uterus (womb) that opens into the vagina (birth canal). The Pap test can tell if you have an infection, abnormal (unhealthy) cells, or cancer.

Image Source: U.S. Food and Drug Administration

Why do I need a Pap test?

A Pap test can save your life. It can find cancer of the cervix - a common cancer in women - before it moves to other parts of your body (becomes invasive). If caught early, treatment for cancer of the cervix can be easier and the chances of curing it are far greater. Pap tests can also pick up infections and inflammation, and abnormal cells that can change into cancer cells.

Do all women need Pap tests?

It is important for all women to make pap tests, along with pelvic exams, a part of their routine health care. You need to have a Pap test if you are over 18 years old. If you are under 18 years old and are or have been sexually active, you also need a Pap test. There is no age limit for the Pap test. Even women who have gone through menopause (the change of life, or when a woman's periods stop) need to get Pap tests.

Women who are living with HIV, the virus that causes AIDS, are more at risk for developing cancer of the cervix and other cervical diseases. The U.S. Centers for Disease Control and Prevention recommends that HIV positive women have an initial Pap test, and then another one 6 months later. If both of these Pap tests show no cancer or other problems, then a Pap test can be done only once a year.

My friend had a hysterectomy - does she still need a Pap test?

Women who have had a hysterectomy (surgery to remove the uterus) should talk with their health care provider about whether they need to continue having routine Pap tests. If the hysterectomy was done because a woman had cancer or a precancerous condition, the end of the vagina still needs to be tested for abnormal changes. Women who have had both their uterus and cervix removed may not need routine Pap tests. Women who have had only the uterus removed (and still have their cervix) need regular Pap tests. It is important for all women who have had a hysterectomy to have regular pelvic exams.

How often do I need to get a Pap test?

Many health care providers tell women to get a Pap test every year. But, your health care provider may recommend a Pap test every 1 to 3 years after you have had 3 normal Pap tests for 3 years in a row. Talk with your health care provider about what is best for you.

Is there anything special I need to do before going for a Pap test?

For two days before the test, you should not douche or use vaginal creams, suppositories, foams or vaginal medications (like for a yeast infection). It is also best to not use any vaginal deodorant sprays or powders for two days before your test. And, do not have sexual intercourse within 24 hours of your test. All of these can cause inaccurate test results by washing away or hiding abnormal cells. You should not have a Pap test when you have your period. The best time to have one is between 10 and 20 days after the first day of your last period.

How is a Pap test done?

Your health care provider can do a Pap test during a pelvic exam. It is a quick test that takes only a few minutes. You will be asked to lie down on an exam table and put your feet in holders called stirrups, letting your knees fall to the side. A sheet will cover your legs and stomach. The health care provider will put an instrument called a speculum into your vagina, opening it to see the cervix and to do the Pap test. She or he will use a special stick, brush or swab to take a few cells from inside and around the cervix. The cells are placed on a small glass slide, then checked by a lab to make sure they are healthy. While painless for most women, a Pap test can cause discomfort for some women.

What happens after the Pap test is done?

If the cells are okay, no treatment is needed. If an infection is present, treatment is prescribed. If the cells look abnormal, or not healthy, more tests may be needed. A Pap test is not 100% right all the time, so it is always important to talk to your health care provider about your results.

What do abnormal Pap test results mean?

A health care provider may tell you that your Pap test result was "abnormal." Cells from the cervix can sometimes look abnormal but this does not mean you have cancer. Remember, abnormal conditions do not always turn into cancer. And, some conditions are more likely than are others to turn into cancer. If you have abnormal results, be sure to talk with your health care provider to find out what they mean and what you need to do (if anything) about it.

What will happen if my Pap test finds something that is not normal?

If the Pap test shows something confusing or a minor change in the cells of the cervix, the test may be done again. If the test shows a major change in the cells of the cervix, the health care provider may perform a colposcopy. This is a procedure done in an office or clinic with an instrument (called a colposcope) that acts like a microscope, allowing the health care provider to closely see the vagina and the cervix. Your health care provider may also take a small amount of tissue from the cervix (called a biopsy) to examine for any abnormal cells, which can be a sign of cancer.

My health care provider told me my Pap test result was a false positive. What does this mean?

Is there such a thing as a false negative Pap test result? Pap tests are not always 100 percent accurate. False positive and false negative results can happen. This can upset and confuse a woman. Knowing what these types of results mean can help a woman to better protect her health.

A false positive Pap test happens when a woman is told she has abnormal cells (on and around her cervix), but the cells are in fact normal. A false positive result means that there is no problem. A false negative Pap test happens when a woman is told her cells are normal, but in fact, there is a change in the normal, healthy cells. This means there may be a problem and there may be a need for more tests. There are many things that can interfere with accurate Pap test results. This is why women need to be sure to get regular Pap tests. Having regular Pap tests increases a woman's chances that any problems will be picked up over time.

Is there anything new or being developed to improve the accuracy of Pap tests?

While the standard Pap test is very good at detecting problems, new methods are being developed to improve the accuracy of Pap tests. The Food and Drug Administration (FDA) has approved several new methods to help reduce false negative Pap test results. One is called the Thin-Prep Pap test, where cervical cells are placed in a different way on the microscope slide than with the standard Pap test. This may make it easier to detect abnormal cells. Other methods use computers to scan the cervical cells to look for abnormal cells. Two computer "rescreening" methods have been approved by the FDA - PAPNET and the AutoPap 300 QC. These new methods cost more than the standard Pap test and are not covered by all health insurance. Research is being done to find out if they are in fact more accurate than the standard Pap test.

Do sexually transmitted diseases (STDs) cause cancer of the cervix?

One type of STD, called HPV, or the humanpapilloma virus, has been linked to cancer of the cervix. HPV can cause wart-like growths on the genitals. When it is not treated or happens frequently, HPV can increase a woman's chances of developing cancer of the cervix. HPV is a very common STD, especially in younger women and women with more than one sexual partner.

What increases a woman's risk for cancer of the cervix?

Any woman can get cancer of the cervix. But, the chances of getting cancer of the cervix increase when a woman:

Disclaimer: All information provided in this document is for educational purposes only. It is not intended as a substitute for advice provided by a medical doctor or qualified healthcare provider. You should not use this information for self-diagnosis or for treating a health problem or disease. If you have any questions whatsoever about your medical health or believe you have a medical problem or disease, you should contact your medical doctor or healthcare provider. You should never disregard medical advice or delay seeking medical advice or treatment because of something you have read herein. No guarantee is made about the accuracy, completeness, or relevance of the information contained herein.