Pap Smear

What is a Pap Smear?

A Pap smear is a test to help prevent cervical cancer or find it early. The cervix is the lower, narrow end of the uterus that opens into the vagina. During a Pap smear, a health care provider collects cells from the cervix and sends them to a lab.

At the lab, the cells are checked under a microscope for cancer or for signs that they may become cancer. Cells that may become cancer are called precancers. Finding and treating precancers can help prevent cervical cancer. The Pap smear is also a reliable way to find cancer early when it's easier to treat.

Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique

What is it used for?

A Pap smear looks for abnormal changes in cervical cells before they become cancer. Sometimes the cells collected during a Pap smear are also checked for HPV, a virus that can cause cell changes that may lead to cancer.

Pap smears and HPV tests are cervical cancer screening tests that look for cancer before you have any symptoms. Research shows that cervical cancer screening can greatly reduce the number of new cervical cancer cases and deaths from the disease. Ask your provider which test is right for you or if you should have both a Pap smear and an HPV test.

How often do I need a Pap smear?

In general, if you're between age 21 and 65, you should have regular Pap smears:

• If you're between ages 21 and 29 and your last Pap test result was normal, your provider may say you can wait three years until your next test.
• If you're between ages 30 and 65 and your last Pap smear result was normal:
  • Your provider may say you can wait three years until your next test.
  • If you also had a normal HPV test result, your provider may say that you can wait five years until your next test.
• If you're over age 65, your provider may tell you that you don't need Pap smears anymore if you:
  • Have had normal Pap smears for several years.
  • Have had surgery to remove your uterus and cervix because you had a condition that was not cancer, such as fibroids.

If you have a higher risk for developing cervical cancer, your provider may recommend screening more often or after age 65. You may have a higher risk if you:

• Had an abnormal Pap smear in the past
• Have HIV
• Have a weakened immune system
• Were exposed to a drug called DES (Diethylstilbestrol) before you were born. Between the years 1940–1971, DES was prescribed during pregnancy to prevent miscarriages. It was later linked to an increased risk of certain cancers in the female children exposed to it during the pregnancy.

If you're under age 21, cervical cancer screening is not recommended. Your risk of cervical cancer is very low. Also, any changes in cervical cells are likely to go away on their own.

If you are unsure whether you need a Pap smear, talk with your provider.

What happens during a Pap smear?

During a Pap smear you will lie on an exam table. Your provider will use a plastic or metal instrument called a speculum to widen the vagina, so the cervix can be seen. Your provider will then use a small, soft brush or swab to collect cells from the cervix. The cell sample is sent to a lab for testing.

A Pap smear is often done as part of a pelvic exam. During a pelvic exam, your provider examines your uterus, ovaries, and genital area. But a pelvic exam doesn't always include a Pap smear. So, when you have a pelvic exam, ask your provider whether you'll have a Pap smear, too.

Will I need to do anything to prepare for the test?

You should not have a Pap smear while you are having your period. A good time to have the test is about five days after the last day of your period. For two to three days before your test, you should not:

• Use tampons
• Use birth control foam, jelly, or cream
• Use other creams or medicines in the vagina
• Douche (rinse the vagina with water or other fluid)
• Have vaginal sex

Are there any risks to the test?

You may feel some mild discomfort during a Pap smear. Afterwards, you may have some very light bleeding. But there are no known risks to having a Pap smear.

What do the results mean?

A Pap smear test has three possible results:

• Normal Pap smear or "negative" result. No abnormal changes were found in the cells of your cervix. Your provider may tell you that you can wait three years for your next test. If you also had a normal HPV test result, you may be able to wait five years for your next test, depending on your age and medical history.
• Unclear or unsatisfactory results. The lab sample may not have had enough cells, or the cells may have been clumped together or hidden by mucus. Your provider will usually ask you to come in for another test in 2 to 4 months.
• Abnormal Pap smear or "positive" result. Abnormal changes were found in your cervical cells. Most of the time, abnormal results do not mean you have cervical cancer. Minor changes in the cells usually go back to normal on their own. But your provider may recommend a follow-up test to check. More serious cell changes may turn into cancer if they are not removed. Finding and treating these cells early can help prevent cancer from developing.

Talk with your health care provider to learn what your Pap smear results mean.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a Pap smear?

Thousands of women in the U.S. die from cervical cancer every year. A Pap smear, along with an HPV test, is one of the most effective ways to prevent cervical cancer.