Pap test

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 have 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.

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 doctor about whether they need to continue having routine Pap tests. It is important for all women who have had a hysterectomy to have regular pelvic exams. In most cases a pap smear should still be collected yearly.

How often do I need to get a Pap test?

It depends on your age and health history. Talk with your doctor about what is best for you. Most women can follow these guidelines:

• If you are younger than 30 years old, you should get a Pap test every year
• If you are age 30 or older and have had 3 normal Pap tests for 3 years in a row, talk to your doctor about spacing out Pap tests to every 2 or 3 years
• If you are ages 65 to 70 and have had at least 3 normal Pap tests and no abnormal Pap tests in the last 10 years, ask your doctor if you can stop having Pap tests

You should have a Pap test every year no matter how old you are if:

• You have a weakened immune system because of organ transplant, chemotherapy, or steroid use
• Your mother was exposed to diethylstilbestrol (DES) while pregnant
• You are HIV-positive

Women who are living with HIV, the virus that causes AIDS, are at a higher risk of cervical cancer and other cervical diseases. The U.S. Centers for Disease Control and Prevention recommends that all HIV positive women get an initial Pap test, and get re-tested 6 months later. If both Pap tests are normal, then these women can get yearly Pap tests in the future.

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 doctor 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 doctor 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 doctor about your results.

What do abnormal Pap test results mean?

A doctor 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 doctor 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 doctor 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 doctor to closely see the vagina and the cervix. Doctor 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 doctor 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.

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

One type of STD, called HPV, or the human papilloma 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:

• Starts having sex before age 18
• Has many sexual partners
• Has sexual partners who have other sexual partners
• Has or has had Human Papilloma Virus (HPV) or genital warts
• Has or has had a sexually transmitted disease (STD)
• Is over the age of 60
• Smoking