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Pap Smear

Reasons to Have One, What to Expect, Associated Risks & More

Key Points

  • A Pap smear is an important screening tool for detecting cervical cancer and precancers in women, typically starting at age 21 and continuing every three years.
  • From age 30, if a concurrent HPV test comes back normal along with a Pap smear, the frequency can be extended to every five years.
  • Women between 65 and 70, with three consecutive normal test results in the past decade, can usually discontinue Pap smears, as can women who have had a hysterectomy.
  • The procedure involves collecting cervical cells for lab testing and, while it may be uncomfortable, it should not be painful.
  • The main risk of a Pap smear is false results, but due to the slow development of cervical cancer, any abnormal cells are likely to be detected in subsequent tests.

2 Reasons Why You Would Need a Pap Smear

1. Detect Cervical Cancer

A Pap smear can be used to find cervical cancer cells early on.[1] Cervical cancer is cancer that originates in the cervix. This type of cancer is most common among women over the age of 30 and is mainly caused by human papillomavirus or HPV—the most widespread sexually transmitted infection in the United States.[2] During a Pap smear, a doctor or nurse collects cells from the outside of the cervix and sends them to a lab for testing.

2. Detect Precancers

Precancers are abnormal cells in the cervix that have not yet become cancerous.[1] A Pap smear can detect precancers so a doctor can remove them before they turn into cervical cancer. Pap smears that show abnormal cervical cells are normally followed by an HPV test, which reveals whether you have the type of HPV that may cause cervical cancer.[1] An HPV test is highly similar to a Pap smear but looks for DNA from HPV instead of cervical cancer cells.

Understanding a Pap Smear

A Pap smear screens women for cervical cancer so it can be detected and treated as early on as possible. Women are urged to receive a Pap smear starting at the age of 21. After the first Pap smear, women should receive a Pap smear every 3 years to detect cervical cancer and precancers.[3]

Women over the age of 30 who receive an HPV test at the same time as a Pap smear can receive both tests once every 5 years if both tests continue to come back with normal results.[3] Most women between the ages of 65 and 70 can stop receiving Pap smears as long as the last 3 tests have returned normal results within the past 10 years. Women who have had their cervixes removed with hysterectomy do not usually need Pap smears.[3]

Risks of a Pap Smear

Pap smear tests may be uncomfortable for some women, but they should not be painful. You may feel some pressure as the doctor or nurse inserts the speculum into the vagina to remove a sample of cervical cells. The main risk associated with a Pap smear is receiving false test results.[1]

A Pap test may not always detect the presence of abnormal cells. Your doctor may tell you that test results are normal, which allows more time for abnormal cells to grow into cervical cancer, if the test is inaccurate. However, cervical cancer normally takes about 10 to 20 years to develop.[1] This means your doctor will likely detect cervical cancer with the next Pap smear after 3 or 5 years and begin treatment to stop the cancer before it progresses.

In some instances, a Pap smear may return as a false positive and report the presence of abnormal cells that aren’t really there. When a Pap smear shows abnormal changes, your doctor may run additional tests to confirm the presence of cervical cancer or precancers before proceeding with treatment. These tests may include colposcopy-directed biopsy, an HPV test, cervix cryosurgery, or cone biopsy.[3]

A false-positive Pap smear can cause distress when you learn you may have cervical cancer or precancers. A false positive may also result in your undergoing tests or treatments you may not need.

What to Expect with a Pap Smear

A Pap smear can be performed by your primary care provider or gynecologist. Refrain from using tampons, having sexual intercourse, or douching within 24 hours of the Pap smear since these factors can lead to inaccurate test results.[3] Avoid scheduling your Pap smear while you are menstruating, but keep your appointment if you are experiencing abnormal or unexpected bleeding.

When you arrive for your appointment, your doctor may ask which medications you’re currently using, since some medications like birth control pills may interfere with Pap smear test results. Your doctor may also recommend that you empty your bladder prior to the Pap smear.[3]

When you are ready for the Pap smear, your doctor will have you lie on a table and place your feet in stirrups. The doctor will gently insert a thin instrument called a speculum into the vagina. The speculum will open the vagina so the doctor can get a clear view of the vagina and cervix, then gently scrape off a sample of cells.[3] A Pap smear may cause some discomfort and minor bleeding.

The sample of cervical cells is sent to a lab where they are tested for cancer and abnormalities. Results normally come back within 1 and 3 weeks, at which point your doctor will contact you to discuss the results.[1] If further testing is needed, your doctor will ask you to schedule a follow-up appointment.

Questions to Ask Your Doctor About a Pap Smear:

  • How long will my appointment last?
  • When should I receive my next Pap smear?
  • Will you contact me with test results?
  • When will I know my Pap smear results?
  • What happens next if abnormal cells are detected?
  • When can I stop receiving Pap smears?
  • Should I also receive an HPV test?

Pap Smear May Also Be Known as:

  • Pap test
  • Papanicolaou test
  • Cervical cancer screening
  • Cervical smear
  • Cervical screening
  • Smear test


Frequently asked questions

  • What is the purpose of a Pap smear?

    A Pap smear is a screening tool used to detect cervical cancer and precancers in women.
  • When should women start getting Pap smears?

    Women are advised to start getting Pap smears at the age of 21.
  • How often should a woman get a Pap smear?

    Initially, it's every three years. However, from age 30, if an HPV test and a Pap smear both return normal results, the tests can be done every five years.
  • Can women stop getting Pap smears at a certain age?

    Yes, women aged between 65 and 70 who have had three consecutive normal test results in the past ten years can usually stop getting Pap smears.
  • Do women who have had a hysterectomy need to get Pap smears?

    Typically, women who have had a hysterectomy do not need Pap smears.
  • What does the Pap smear procedure involve?

    The procedure involves collecting cells from the cervix for lab testing.
  • Is the Pap smear procedure painful?

    While the procedure may be uncomfortable, it should not be painful.
  • What are the risks associated with a Pap smear?

    The main risk associated with a Pap smear is the possibility of false test results. However, any abnormal cells are likely to be detected in subsequent tests due to the slow development of cervical cancer.

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