Pap Smear

What Is a Pap Smear?

A Pap smear, also called a Pap test, is an exam a doctor uses to test for cervical cancer in women. It can also reveal changes in your cervical cells that may turn into cancer later.

Why Is a Pap Smear Done?

A pap smear is done to look for changes in cervical cells before they turn into cancer. If you have cancer, finding it early on gives you the best chance of fighting it. If you don’t, finding cell changes early can help prevent you from getting cancer.

Women ages 21-65 should have a Pap smear on a regular basis. How often you do depends on your overall health and whether or not you’ve had an abnormal Pap smear in the past.

How Often Should I Have a Pap Smear?

You should have the test every 3 years from ages 21 to 65. You may choose to combine your Pap testing with being tested for the human papillomavirus (HPV) starting at age 30. If you do so, then you can be tested every 5 years instead. HPV is the most common sexually transmitted infection (STI), and it’s linked to cervical cancer.

If you have certain health concerns, your doctor may recommend you have a Pap more often. Some of these include:

  • Cervical cancer or a Pap test that revealed precancerous cells
  • HIV infection
  • A weakened immune system due to an organ transplant, chemotherapy, or chronic corticosteroid use
  • Having been exposed to diethylstilbestrol (DES) before birth

Talk to your doctor if you have questions or concerns. He’ll let you know for sure.

Pap Smear Preparation

You shouldn’t have a Pap smear during your period. Heavy bleeding can affect the accuracy of the test. If your test ends up being scheduled for that time of month, ask your doctor if you can reschedule.

For the most accurate Pap smear, doctors recommend taking the following steps, starting 48 hours before your test.

  • Don’t have sex or use lubricants.
  • Don’t use sprays or powders near the vagina.
  • Don’t insert anything into the vagina, including tampons, medications, creams, and suppositories.
  • Don’t rinse the vagina with water, vinegar, or other fluid (douche).

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Pap Smear Procedure

The test is done in your doctor’s office or clinic. It takes about 10 to 20 minutes.

You’ll lie on a table with your feet placed firmly in stirrups. You’ll spread your legs, and your doctor will insert a metal or plastic tool (speculum) into your vagina. He’ll open it so that it widens the vaginal walls. This allows him to see your cervix. Your doctor will use a swab to take a sample of cells from your cervix. He’ll place them into a liquid substance in a small jar, and send them to a lab for review.

The Pap test doesn’t hurt, but you may feel a little pinch or a bit of pressure.

Pap Smear Results

Your doctor will get them within a few days. They’ll come back either negative (normal) or positive (abnormal).

Normal result

A negative result is a good thing. That means your doctor didn’t find any precancerous or cancerous cells on your cervix. You won’t need another Pap until you’re due for your next scheduled one.

Abnormal result

If your results come back positive, it doesn’t mean you have cancer.

There are several reasons you could have an abnormal Pap smear.

  • Mild inflammation or minor cell changes (dysplasia)
  • HPV or other infection
  • Cancer or pre-cancer
  • Lab test error

Inflammation can happen if you’ve had sex or used a diaphragm shortly before having a Pap smear.

If you have inflammation or minor cell changes, your doctor may take a “wait and see” approach. They may suggest you have another Pap test in a few months. If the abnormal cells haven’t cleared up by then, your doctor may order more tests. These might include a procedure called a colposcopy.

During a colposcopy, your doctor will insert a speculum into your vagina, just as he did for the Pap test. This time, he’ll look at the cervix with a colposcope. That’s a tool that has a lens and a bright light that allow your doctor to get a better look at your cervix. Your doctor will swab your cervix with vinegar or some other liquid solution. It’ll highlight any suspicious-looking areas. Your doctor will be able to see them through the lens on the colposcope.

If he finds areas that don’t look right, he’ll take a sample (biopsy). He’ll send the sample to a lab for further testing. He may swab your cervix with a chemical solution to limit bleeding.

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Pap Smear Risks

A Pap smear is considered a safe procedure. But it’s possible that the test may miss some abnormal cells or cervical cancers (false negative). Talk to your doctor about the benefits and risks of cervical cancer screening.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on June 25, 2020

Sources

SOURCES:

Mayo Clinic: “Pap Smear.”

Cleveland Clinic: “Pap Smear.”

PubMed Health: “Papanicolaou Test (Pap Smear).”

U.S. National Library of Medicine.

CDC: “Genital HPV Infection -- Fact Sheet,” “What Should I Know About Cervical Cancer Screening?”

American College of Obstetricians and Gynecologists: “Cervical Cancer Screening.”

Office of Population Affairs: “Cervical Cancer Screening (Pap Test).”

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