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Pap Smear (Pap Test)

Last Updated August 2022 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

A Pap smear is a medical exam used to determine if a woman has cervical cancer. A Pap smear is also called a Pap test. It’s performed by a doctor, usually as part of a general pelvic exam. During a Pap test, the doctor collects cells from your cervix (located at the bottom of your uterus). These cells are then analyzed by a lab. The lab looks for anything unusual about the cells.

Why should I have a Pap smear?

Pap smears are an important part of women’s health. They are your best method for catching cancer early. In fact, a Pap smear can even detect pre-cancerous changes to your cells. If you do have these changes, your doctor can treat what’s causing them. Doing so may prevent the cancer from developing.

Path to improved health

When should I begin having Pap smears?

The American Academy of Family Physicians (AAFP) does not recommend Pap smears for women who are under the age of 21.

The AAFP recommends Pap smears for women ages 21 to 65.

The AAFP recommends against screening for cervical cancer (Pap smears) in women older than age 65 years who have had adequate prior screening and aren’t otherwise at high risk for cervical cancer.

How often do I need a Pap smear?

The AAFP recommends screening for cervical cancer in women ages 21 to 65, with a Pap smear every 3 years. Women ages 30 to 65 who want to lengthen the screening interval can opt to do a Pap smear with human Papillomavirus (HPV) testing every 5 years. This is because newer medical evidence suggests that there is not benefit to performing these tests more often.

Is there anything I should do to get ready for my Pap smear?

Be sure to tell your doctor about all medicines you’re taking. Some birth control medicines can alter the test results.

There are some things you should avoid before your Pap smear. For two days before your Pap smear, do not:

  • Have sex
  • Douche
  • Use spermicides
  • Use vaginal creams
  • Use tampons
  • Use vaginal deodorants

You also shouldn’t have a Pap smear during your menstrual period. Any or all of these things could make abnormal cells harder to identify.

What will my doctor do during the Pap smear?

Your doctor will insert a speculum into your vagina. A speculum is a tool that holds the vagina open so that the doctor can examine your cervix. The speculum does that by spreading the vaginal walls apart. Then your doctor will collect cells from your cervix using a long cotton swab or small soft brush.

Will it hurt?

The exam can be uncomfortable, but it’s not usually painful. When your doctor collects the cells from your cervix, you may feel slight pressure or a quick pinch. The entire exam takes only a few minutes.

How will I feel afterward?

You should feel completely normal after your Pap smear. But you may have some spotting (a small amount of bleeding) for a short time.

How long will it take to get my results?

You may hear from your doctor in as little as 1 week, but it may take up to 3 weeks to get your results. It depends on your doctor and the lab.

Do I need a Pap test after menopause?

You should continue to have Pap smears, even after menopause. You should have them until you are 65 years of age unless you fall into one of the other categories.

What if I’ve had a hysterectomy?

The AAFP doesn’t recommend Pap smears for women who have had a hysterectomy, with removal of the cervix, for a non-cancerous disease.

Things to consider

If you are notified that your Pap smear is abnormal, it doesn’t mean you have cancer. There are many reasons that your Pap smear results may be flagged as abnormal. Most of the time, an abnormal result is caused by an infection of your cervix. Or it could be a poor sample.

Your doctor may perform another Pap smear right away. Or your doctor may have you wait several months before doing another Pap smear. In these cases, they could be waiting for the abnormal cells to clear themselves. Even though it can be scary, know that an abnormal Pap smear is most often nothing to worry about.

If your results are still abnormal or not conclusive (certain), your doctor may perform a colposcopy. A colposcopy is a procedure where your doctor will use a small microscope to look at your cervix. He or she also may remove a piece of tissue during this exam. This is called a biopsy. The tissue will be examined in a lab to determine if cancerous cells are present.

If your doctor finds cancer, they will discuss treatment options with you. These will depend on the stage of cancer you have. Cervical cancer is treatable—and curable—if caught in the early stages.

Questions for your doctor

  • Should I have a pap smear?
  • Can my doctor perform a pap smear?
  • Is there anything I can do to prevent cervical cancer?
  • Am I at greater risk for cervical cancer if it runs in my family?
  • What are the symptoms of cervical cancer?

Resources

National Institutes of Health, MedlinePlus: Pap Test

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