A Pap smear is an important health test women should get regularly because it helps detect and prevent cervical cancer.
According to the Centers for Disease Control and Prevention (CDC), doctors diagnose about 11,500 new cases of cervical cancer each year in the U.S. Anyone with a cervix is at risk, but if a Pap test catches it early, cervical cancer is highly curable.
Keep reading to learn more about this life-saving test and how often you should get a Pap smear.
What Is a Pap Smear?
A Pap smear (or Pap test) is another name for a Papanicolaou test, named for the doctor who invented it. It’s a fast and usually painless procedure in which your doctor collects cells from your cervix during a pelvic exam. The cervix is the opening to the uterus, located at the top of the vagina.
Providers do a Pap smear to screen for cervical cancer or precancer. They may also use the cells collected during the Pap smear to test for human papillomavirus (HPV) infection.
Certain high-risk types of HPV (16 and 18) are the most common cause of cervical cancer. Cervical cancer starts with abnormal changes in the cells in your cervix, which may eventually turn into cancer. Checking your cervical cells regularly with a Pap test can find signs of precancer, allowing doctors to remove or treat it before cancer develops.
Because over 90% of cases of cervical cancer are attributable to the HPV virus, your health care provider may recommend the HPV vaccine (Gardasil) if you have not previously received it. This vaccine protects against the highest-risk types of HPV that cause cervical, anal, oropharyngeal, vulvar, vaginal, and penile cancers. It is now approved for ages 26-45, so if you have not previously been vaccinated, it is important to discuss with your health care provider.
During a Pap smear, your provider will:
- First, place a speculum in your vagina to keep it open so they can see your cervix.
- Then, use a small brush to scrape some cells from the surface of your cervix.
- Finally, send the collected cells to a lab, where another doctor will examine them under a microscope.
You can get a Pap smear at your doctor’s office or a health center. Your health care provider may do it along with an HPV test as part of your routine cervical cancer screening co-test at a well-woman exam. They may also schedule the test if you have had a positive HPV test or symptoms of cervical cancer, such as:
- Abnormal bleeding between periods or abnormally heavy periods.
- Bleeding after sex.
- Pelvic pain or pain after sex.
- Vaginal bleeding after menopause.
How Often Should You Get a Pap Smear?
Cervical cancer occurs most often in people over 30. But doctors recommend that you start screening for it at age 21, regardless of when you start having sex.
How often you should take the test after that depends on your age, health, prior test results, and other cervical cancer risk factors. Make sure you tell your doctor if you have a family history of cervical cancer or any symptoms.
The CDC generally recommends:
- Women ages 21 to 29 should get a Pap smear every three years.
- Women ages 30 to 65 should receive a Pap test every three years or an HPV test every five years. Alternatively, they can take a Pap test and HPV test (co-test) every five years.
- Women over 65 may no longer need Pap smears if they previously had regular screenings with normal results.
- Pregnant women will likely get a Pap smear at their first prenatal visit.
- Those who have had a hysterectomy for noncancer reasons and had their uterus and cervix removed don’t need screening.
You may need more frequent screening if you:
- Are HIV positive.
- Had a recent abnormal Pap smear result.
- Have a weakened immune system due to health issues or medicines.
- Have had cervical cancer.
- Were exposed before birth to diethylstilbestrol (DES). Doctors prescribed this medicine to some pregnant women through the mid-1970s.
How to Prepare for a Pap Smear
Before you have a Pap smear, ask your health care provider if you should do anything to prepare for it. A Pap smear is most accurate when you’re not having your period. Therefore, they may recommend scheduling (or rescheduling) the test for at least five days after your period stops.
In addition, following this advice can help make your test more accurate:
- Avoid having vaginal sex for two days before the test.
- Don’t use a douche for two to three days before the test.
- Don’t use tampons, vaginally inserted birth-control foams, jellies, lubricants, or medicines for up to seven days before the test.
These sometimes affect the cell sample or cause an unclear test result, in which case you may need another Pap smear.
Understanding Pap Smear Results
You should get the results of your Pap smear within three weeks.
- A normal or negative result means no changes or abnormalities in your cervical cells.
- An abnormal result means there have been some changes in your cervical cells, but this doesn’t necessarily mean you have cancer. Many people have cell changes after HPV exposure, but their immune systems usually clear the virus, and the cells normalize. Your doctor will tell you if you need further tests or a follow-up Pap smear.
- An unclear result means you might have cell changes, but the reason isn’t apparent. Besides HPV, pregnancy, menopause, or other infections can cause changes to your cervical cells.
- An unsatisfactory result means the sample collected may not have had enough cells to examine. You may need another Pap smear.
Call your health care provider’s office if you have questions or don’t understand your results. You can also confirm when to have your next Pap smear.
Even if your Pap smear was normal, ongoing screening according to your doctor’s recommendations is essential. Cervical cells can change in the future and become precancerous. A Pap smear is the best way to prevent or catch cervical cancer early when it’s most treatable.