Pap Test (Cervical Smear)

What is a Pap test?

A Pap test is a screening test done during a pelvic exam to check for abnormal changes in the cells of the cervix. The cervix is the lower part of the uterus that opens into the vagina. Abnormal cells can develop into cancer if not detected and treated. There are no signs or symptoms related to early cervical cancer so a pelvic exam of the female sex organs and a Pap test are needed. Cervical cancer is preventable and curable if abnormal cells are detected and treated early. Pap tests have reduced deaths from cancer of the cervix in the US by 70% over the past 50 years.

Other terms for Pap test are Papanicolaou smear, Pap smear, and cervical smear.

What does it test for?

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

The Pap test may also detect viral infections of the cervix, such as human papillomavirus (HPV) and herpes. It may detect vaginal infections such as yeast infections or trichomonas. Sometimes the Pap test can give information about your hormones, especially progesterone and estrogen.

How often should I have a Pap test?

You should have your first Pap test when you first become sexually active. You should then have a Pap test at least every 3 years. Your provider will recommend how often you should be tested based on your risk factors for cervical cancer. Some examples of risk factors are:

• You have had an abnormal Pap test.
• You have a family history or cervical cancer.
• You or your sexual partner have had an HPV infection or genital warts.
• You or your sexual partner have a history of many sexual partners.
• You smoke.

How do I prepare for a Pap test?

• Do not schedule your Pap test during your menstrual period. Two weeks after the first day of your last period is the best time to have the test.
• Do not douche or use vaginal creams during the 3 days before the test.
• Do not have intercourse within 24 hours before the Pap test because it can cause inaccurate test results.

What happens during the procedure?

A Pap test takes only a few seconds 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 lab for testing.

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, you may need more tests. 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 results. There are newer methods used now for Pap testing, including computer-assisted testing, which have been approved by the FDA and are more accurate. However, these newer methods cost more and may not be covered by insurance.

Ask your health care provider when you should come back for another Pap test or pelvic exam.

What are the benefits of this procedure?

Pap tests 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 tests are also useful for detecting some types of cervical or vaginal infections and hormonal problems.

What are the risks or disadvantages?

The Pap smear is a screening test. If abnormal cells are found, your health care provider will do more tests to make a diagnosis. Also, sometimes the results may be inaccurate (false positive or false negative) and you may need more tests to check the results.