What is a Pap smear?
A Pap smear is a test for women that can help find or prevent cervical cancer. During the procedure, cells are collected from the cervix, which is the lower, narrow end of the uterus that opens into the vagina. The cells are checked for cancer or for signs that they may become cancer. These are called precancerous cells. Finding and treating precancerous cells can help prevent cervical cancer. The Pap smear is a reliable way to find cancer early when it’s most treatable.
Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique
What is it used for?
A Pap smear is a way to detect abnormal cervical cells before they become cancer. Sometimes the cells collected from a Pap smear are also checked for HPV, a virus that can cause cell changes that may lead to cancer. Pap smears, along with HPV testing, are considered cervical cancer screening tests. Cervical cancer screening has been shown to greatly reduce the number of new cervical cancer cases and deaths from the disease.
Why do I need a Pap smear?
Most women between the ages of 21 and 65 should have regular Pap smears.
- Women between the ages of 21 and 29 should be tested every three years.
- Women ages 30–65 can be tested every five years if the test is combined with an HPV test. If there is no HPV test, the Pap should be done every three years.
Screening is not recommended for women or girls under the age of 21. In this age group, the risk of cervical cancer is very low. Also, any changes in cervical cells are likely to go away on their own.
Screening may be recommended if you have certain risk factors. You may be at higher risk if you:
- Had an abnormal Pap smear in the past
- Have HIV
- Have a weakened immune system
- Were exposed to a drug called DES (Diethylstilbestrol) before birth. Between the years 1940–1971, DES was prescribed to pregnant women as a way to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it during the pregnancy.
Women older than 65 who have had normal Pap smears for several years or have had surgery to remove the uterus and cervix may not need to have Pap smears anymore. If you are unsure whether you need a Pap smear, talk to your health care provider.
What happens during a Pap smear?
A Pap smear is often taken during a pelvic exam. During a pelvic exam, you will lie on an exam table while your health care provider examines your vulva, vagina, cervix, rectum, and pelvis to check for any abnormalities. For the Pap smear, your provider will use a plastic or metal instrument called a speculum to open the vagina, so the cervix can be seen. Your provider will then use a soft brush or plastic spatula to collect cells from the cervix.
Will I need to do anything to prepare for the test?
You should not have a Pap smear while you are having your period. A good time to have the test is about five days after the last day of your period. Additional recommendations are to avoid certain activities a few days before your Pap smear. Two to three days before your test you shouldn’t:
- Use tampons
- Use birth control foams or other vaginal creams
- Douche
- Have sex
Are there any risks to the test?
You may feel some mild discomfort during the procedure, but there are no known risks to a Pap smear.
What do the results mean?
Your Pap smear results will show whether your cervical cells are normal or abnormal. You may also get a result that is unclear.
- Normal Pap smear. The cells in your cervix were normal. Your health care provider will recommend that you come back for another screening in three to five years depending on your age and medical history.
- Unclear or unsatisfactory results. There may not have been enough cells in your sample or there may have been some other problem that made it hard for the lab to get an accurate reading. Your health care provider may ask you to come in for another test.
- Abnormal Pap smear. Abnormal changes were found in your cervical cells. Most women who have abnormal results do not have cervical cancer. But, your health care provider may recommend follow-up testing to monitor your cells. Many cells will go back to normal on their own. Other cells may turn into cancer cells if not treated. Finding and treating these cells early can help prevent cancer from developing.
Talk to your health care provider to learn what your Pap smear results mean.
Is there anything else I need to know about a Pap smear?
Thousands of women in the U.S. die from cervical cancer every year. A Pap smear, along with the HPV test, is one of the most effective ways to prevent cancer from developing.
References
- American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2017. Can Cervical Cancer Be Prevented?; [updated 2016 Dec 5; cited 2017 Feb 3]; [about 3 screens]. Available from: https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/prevention.html
- American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2017. The American Cancer Society Guidelines for the Prevention and Early Detection of Cervical Cancer; [updated 2016 Dec 9; cited 2017 Mar 10]; [about 4 screens]. Available from: https://www.cancer.org/cancer/cervical-cancer/prevention-and-early-detection/cervical-cancer-screening-guidelines.html
- American Cancer Society [Internet]. Atlanta: American Cancer Society Inc.; c2017. The Pap (Papanicolaou) Test; [updated 2016 Dec 9; cited 2017 Feb 3]; [about 6 screens]. Available from: https://www.cancer.org/cancer/cervical-cancer/prevention-and-early-detection/pap-test.html
- Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Basic Information About Cervical Cancer; [updated 2014 Oct 14; cited 2017 Feb 3]; [about 3 screens]. Available from: https://www.cdc.gov/cancer/cervical/basic_info/index.htm
- Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; What Should I Know About Screening?; [updated 2016 Mar 29; cited 2017 Feb 3]; [about 4 screens]. Available from: https://www.cdc.gov/cancer/cervical/basic_info/screening.htm
- National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: cervix; [cited 2017 Feb 3]; [about 3 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=46133
- National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Diethylstilbestrol (DES) and Cancer; [updated 2011 Oct 5; cited 2017 Feb 3]; [about 4 screens]. Available from: https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/des-fact-sheet
- National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: Pap test; [cited 2017 Feb 3]; [about 3 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=45978
- National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; PAP and HPV Testing; [cited 2017 Feb 3]; [about 2 screens]. Available from: https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet
- National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: precancerous; [cited 2017 Feb 3]; [about 3 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms?search=precancerous
- National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Understanding Cervical Changes: A Health Guide for Women; 2015 Apr 22; [cited 2017 Feb 3]; [about 2 screens]. Available from: https://www.cancer.gov/types/cervical/understanding-cervical-changes
- University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Pap; [cited 2017 Feb 3]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid;=pap
