(Pap Smear; Pap Screening; Papanicolaou Test; Cervical Cancer Screening)
A Pap test is a way to look for changes in cells of the cervix. It is often done as part of a pelvic exam.
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Reasons for Test
Health issues and infections can cause changes in the cells of the cervix. These changes are called cervical dysplasia. Some of these changes can lead to cancer. A Pap test can find these changes early and stop cancer from developing. The test can also detect cancer cells that have already developed.
A Pap test is a part of regular cancer screening. There are many different guidelines on how often the test should be done. The doctor and patient will decide what schedule is best. Some general guidelines are:
- Age 21 to 29 years—Pap test every 3 years.
- Age 30 to 65 years—Pap test alone every 3 years, HPV test only or HPV and Pap test every 5 years.
- Age 65 or older—may be able to stop Pap and HPV tests if test results have been normal.
- Note: Pap smears will need to be done more often in people who have abnormal results. Testing may also need to be more frequent in people with certain health problems, such as a weakened immune system or a history of cervical dysplasia or cervical cancer.
There are no major problems caused by this test.
What to Expect
Prior to Test
To improve accuracy of results:
- Do not schedule the Pap test during your menstrual period. If possible, schedule it 2 weeks after the first day of your period.
- Do not use vaginal creams, medicine, or douches for 72 hours before the test.
- Do not use vaginal contraceptives for 72 hours before the test. This includes spermicidal foams, creams, or jellies.
- Do not have sex for 24 hours before the test.
Tell your doctor if you:
- Are having your period
- Are pregnant
- Have had an abnormal Pap test result
- Have had any cervical procedures, such as LEEP
- Are sexually active
- Have been exposed to HPV or other sexually-transmitted infections
- Have had abnormal vaginal discharge or vaginal infections
- Have had surgery, radiation therapy, or chemotherapy.
- Are taking birth control pills, hormone pills, or using hormone cream
Description of Test
You will lie on your back on an exam table. You will place your feet in footrests. A speculum will be inserted into the vagina to gently open it. A fine brush or spatula will be used to wipe the surface of the cervix and its canal. The speculum will be removed. The cervical cells that stuck to the tools will be placed in a fluid-filled bottle. The cells will then be sent to a lab for testing.
How Long Will It Take?
Will It Hurt?
A Pap test is painless. You may feel some pressure or a small cramp when the cervix is wiped to gather cells.
The results of your Pap test are sent to your doctor within 2 to 3 weeks. Your doctor will let you know about the results. In general:
- If cells are normal, then no treatment is needed. You will continue your regular Pap test screens.
- If an infection is found, then treatment will be prescribed.
- If abnormal tissue is found, then more tests will be done.
Problems to Look Out For
Call the doctor if you have:
- Signs of infection, such as fever and chills
- Foul vaginal odor, pain, or unusual discharge
- Severe belly pain or swelling
If you think you have an emergency, call for medical help right away.
- American Cancer Society (ACS) review of guidelines and issues on cancer screening can be found in CA Cancer J Clin 2019 May;69(3):184
- Cervical cancer screening. EBSCO DynaMed website. Available at: https://www.dynamed.com/prevention/cervical-cancer-screening.
- United States Preventive Services Task Force (USPSTF) recommendations for cervical cancer screening can be found in JAMA 2018 Aug 21;320(7):674
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