What is a Pap Smear? Patient Education Handout associated with UMHS Clinical Care Guideline

This information is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your health-care provider or make an appointment to be seen if you have questions or concerns about this information or your medical condition.

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What is a Pap smear?

A Pap smear is a test that checks for changes in the cells of your cervix. The cervix is the lower part of the uterus that opens into the vagina.

Other terms for Pap smear are Papanicolaou smear, Pap test, and cervical smear. Pap smears have reduced deaths from cancer of the cervix in the United States by 70% over the past 50 years.

What does it test for?

The Pap smear tests for abnormal changes in the cervical cells. A precancerous change in the cells, called cervical dysplasia, can be detected by a Pap smear. The abnormal cells can develop into cancer if the dysplasia is not discovered and treated.

The Pap smear may also detect viral infections of the cervix, such as genital warts and herpes. It may detect vaginal infections such as yeast infections or trichomonas. Sometimes the Pap smear can give information about your hormones, especially progesterone and estrogen.

Who should get Pap smears?

Most women at low risk for cervical cancer should get a Pap smear every two to three years. Your health care provider may recommend a more frequent test based on your risk factors for cervical cancer. You are at an increased risk for cervical cancer if:

• You have had an abnormal Pap smear.
• You began to have sexual intercourse in your teens or earlier.
• You have a history of many sexual partners.
• You or your sexual partner has had a genital wart virus infection.
• You smoke cigarettes.
• You have had vulvar or vaginal cancer.
• Your mother took the hormone diethylstilbestrol (DES) when she was pregnant with you.
• Your immune system is weakened; for example, because you have had a transplant, you are taking immunosuppressive drugs, or you have AIDS.
• Your sexual partner has or had cancer of the penis.
• Your sexual partner's previous partner had cervical cancer or abnormal cervical cells.

Your health care provider may not recommend continuing Pap smears beyond age 65 if previous Pap smears have been consistently normal.

You do not need a Pap smear if you had a hysterectomy for a benign condition, such as fibroids.

How do I prepare for a Pap smear?

Do not douche or use vaginal creams during the 2 days before the test. Do not have intercourse within 24 hours before the Pap smear because it can cause inaccurate test results.

What happens during the procedure?

A Pap smear takes only a few minutes and is performed as part of a routine pelvic exam. You lie on your back with your knees bent and your feet apart. Your health care provider inserts a speculum into the vagina. The speculum is a tool that holds open the walls of the vagina so your provider can see the cervix. Your provider uses a special swab, brush, or wooden stick to wipe off some cells from the cervix. The cells are sent to a laboratory to be viewed under a microscope.

What happens after the procedure?

If the cells look normal, no treatment is necessary.

The Pap test may show that you have an infection. Your health care provider may treat you for the infection and suggest that you have another Pap test in several months.

If the cells look abnormal, more tests may be necessary. Discuss with your provider when you should return for any tests or a follow-up exam.

A Pap test is not 100% accurate. You may want to talk to your health care provider about the test.

What are the benefits of this procedure?

Pap smears can detect precancerous and cancerous conditions. If these conditions are discovered, there is a good chance that simple treatment will prevent the development or spread of cancer. Pap smears are also useful for detecting some types of cervical or vaginal infections.