A Pap smear, also called a Pap test, is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on the cervix. During the routine procedure, cells from your cervix are gently scraped away and then examined for abnormal growth. The procedure is done here in the office and while it may be mildly uncomfortable, it doesn’t usually cause any long-term pain.
- Who needs a Pap smear?
Most women should start getting regular Pap smears at age 21. Some women may be at increased risk for cancer or infection. You may need more frequent tests if:
* You’re HIV-positive
* You have a weakened immune system from chemotherapy or an organ transplant
If you’re over 30 and have had three normal Pap tests in a row, ask your doctor about having one every five years if the test is combined with a human papillomavirus (HPV) screening. HPV is a sexually transmitted virus that can cause genital warts and cancer. The most common HPV viruses associated with cervical cancer are HPV types 16 and 18. If you have HPV, you have an increased risk of having an abnormal Pap smear.
Women over the age of 65 with a history of normal Pap test results for 20 years may be able to stop having Pap smears in the future.
You should still get regular Pap smears even if you’re in a monogamous relationship because the HPV virus can be dormant for years, and then suddenly become active.
- How often do you need a Pap smear?
How often you need a Pap smear is determined by various factors, including your age and risk.
Age and Pap Smear Frequency
21 years old, not sexually active, no known risk – factors none needed
21 years old, sexually active – every 3 years
21-29 – every 3 years
30-65 – every 3-5 years if your Pap smear and HPV test are negative
65 and older – you may no longer need Pap smear tests; talk to your doctor to determine your needs
- How to prepare for a Pap smear
If you’ll be menstruating on the day of your Pap smear, your doctor may want to reschedule the test, since results could be less accurate. Try to avoid having sexual intercourse, douching, or using spermicidal products the day before your test because these may interfere with your results.
In most cases, it’s safe to have a Pap smear in the first 24 weeks of a pregnancy. After that, the test may be more painful. You should also wait until 12 weeks after giving birth to increase the accuracy of your results.
Since Pap smears go more smoothly if your body is relaxed, it’s important to stay calm and take deep breaths during the procedure.
- What happens during a Pap smear?
Pap smears can be a bit uncomfortable, but the test is very quick.
During the procedure, you’ll lie on your back on an examination table with your legs spread and your feet resting in supports called stirrups. Your doctor will slowly insert a device called a speculum into your vagina. This device keeps the vaginal walls open and provides access to the cervix. Then your doctor will scrape a small sample of cells from your cervix. There are a few ways your doctor can take this sample. Some use a tool called a spatula, some use a spatula and a brush, and others used a device called a cytobrush, which is a combination spatula and brush. Most women feel a slight push and irritation during the brief scraping.
The sample of cells from your cervix will be preserved and sent to a lab to be tested for the presence of abnormal cells.
After the test, you might feel mild discomfort from the scraping, or a bit of cramping. You could also experience very light vaginal bleeding immediately following the test. Tell your doctor if discomfort or bleeding continues after the day of the test.