Pap Test

What is a Pap test?

For a Pap test, your healthcare provider will collect and examine cells from your cervix. The cervix is the opening to the uterus. They do this test to screen for cervical cancer and other problems.

It’s important to talk with your healthcare provider about when and how often you should have a Pap test. Experts base screening guidelines on your age and risk factors for cervical cancer.

American College of Obstetricians and Gynecologists guidelines are:

• If you are age 21 or older, you should start cervical cancer screening, even if you are not yet sexually active. There is no need to screen younger than 21.

• If you are younger than 30, you can likely be tested for cervical cancer every 3 years if your Pap test results are normal.

• Starting at age 30, have a Pap test with an HPV test (co-test) every 5 years. This should be done until age 65. Other choices for people ages 30 to 65 are just the Pap test every 3 years, or just the HPV test every 5 years. Decide with your provider on which test is best for you.

• If your test results are abnormal or you are at high risk for cervical cancer, you may need more screenings more often than the guidelines suggest. Especially if you have a weak immune system or have been treated for abnormal cervical cells in the past.

• If you are age 65 or older and have had at least three normal Pap tests in a row, two normal HPV tests in a row, or two normal Pap/HPV co-tests in a row and have had no abnormal tests in the past, you may decide with your healthcare provider to stop cervical cancer screening.

• If you’ve had both your uterus and cervix removed (total hysterectomy), you don't need cervical cancer screening unless you’ve had past surgery for cervical cancer or precancer.

Why might I need a Pap test?

A Pap test, along with a pelvic exam, is an important part of your routine healthcare. It can help find abnormal cells that can lead to cancer. Your healthcare provider can find most cancers of the cervix early if you have regular Pap tests and pelvic exams. Cancer of the cervix is more likely to be successfully treated if it's found early.

The Pap test is useful for finding cancerous cells, and other cervical and vaginal problems, such as precancerous cells and inflammation.

Your healthcare provider may use a Pap test to diagnose the following conditions:

• Inflammation

• Infection

• Abnormal cells

• Precancerous cells

• Cancer

Your healthcare provider may do a test for the human papillomavirus (HPV) at the same time as a Pap test. Infection with HPV is the most important risk factor for cervical cancer in people older than 30.

Your healthcare provider may have other reasons to recommend a Pap test.

What are the risks of a Pap test?

Tell your healthcare provider if you are allergic to or sensitive to latex.

Tell your healthcare provider if you are pregnant or think you could be.

There may be other risks based on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.

Certain things may interfere with a Pap test including:

• Menstruation

• Using products such as vaginal creams, jellies, medicines, or spermicidal foams for 2 to 3 days before the Pap test. These things may change the pH of the cells or hide abnormal cells.

• Douching for 2 to 3 days before a Pap test as douching can wash away surface cells

• Having sex within 24 hours before the test may cause inflammation of the tissue

• Infections

• Certain medicines, such as tetracycline

How do I get ready for a Pap test?

• Your healthcare provider will explain the procedure and you can ask questions.

• Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, or tape.

• Generally, you don't need to do anything to prepare for this test.

• Tell your healthcare provider of all medicines (prescription and over-the-counter) and herbal supplements that you are taking.

• Tell your healthcare provider when you had your last period, and what type of birth control or hormone therapy, if any, you are using.

• Tell your healthcare provider if you have a history of bleeding disorders. Or if you are taking any blood-thinning medicines (anticoagulants), aspirin, or other medicines that affect blood clotting.

• Tell your healthcare provider if you are pregnant or think you could be.

• Don't use vaginal medicines, spermicidal foams, creams, or jellies, or douche for 2 to 3 days before the test or for the time set by your healthcare provider. Don't have sex within 24 hours before the test.

• You will be asked to empty your bladder before the procedure.

• Follow any other instructions your provider gives you to get ready.

What happens during a Pap test?

Procedures may vary based on your condition and your healthcare provider's practices.

Generally, a Pap test follows this process:

1. You will be asked to undress from the waist down and put on or cover up with a hospital gown.

2. You will lie on an exam table, with your feet in stirrups.

3. Your healthcare provider will insert an instrument called a speculum into your vagina. This will spread the walls of the vagina apart to show the cervix.

4. Your healthcare provider will use a small brush, swab or spatula to gently remove cells from the cervix and back of the vagina. They will place the cells in a vial of liquid or smear the cells on a glass microscope slide.

5. If you need an HPV test, your provider will take a sample of cells for this test as well.

6. If you have symptoms of a vaginal infection, your provider may take a sample of vaginal discharge for testing.

7. Most often, your healthcare provider will do a pelvic exam after the Pap test.

8. Your provider will send the specimen to a lab for further study.

What happens after a Pap test?

You may rest for a few minutes after the procedure before going home. Scraping the cervix may cause a small amount of bleeding. You may want to wear a sanitary pad for any spotting that may occur.

Tell your healthcare provider if you have any of the following:

• Bleeding

• Foul-smelling drainage from your vagina

• Fever or chills

• Severe abdominal pain

Pap test results usually take a few days. Ask your healthcare provider how you will be hear back about the results.

Your healthcare provider may give you other instructions after the procedure, based on your situation.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure