What is a Pap test?
- A Pap test is a test that checks the cells of the cervix, which is the opening to the uterus and is located at the top of your vagina.
- The test checks for changes that could lead to cervical cancer if not treated.
- During a pelvic exam, the health care provider inserts a speculum into the vagina and collects some cells from the cervix with a swab or spatula and brush.
- It may cause very minor cramping, which is usually not painful. The test only takes a few minutes.
Why is a Pap test so important?
- Women who have precancerous cervical changes usually do not have any symptoms, so a Pap test is the only way to know whether those changes are present.
- Regular Pap tests can prevent most cervical cancers by detecting precancerous changes long before they become cancer. Those potentially pre-cancerous changes can be easily treated and eliminated.
How often should women get a Pap test?
- New recommendations for Pap test screening or cervical cancer screening were established in 2012.
The current guidelines apply to women who have no history of abnormal pap tests.
The guidelines are as follows:
< 21 no routine Pap tests 21-29 years Pap test every 3 years 30-65 years Pap test & HPV test "cotesting" every 5 years (preferred screening) OR Pap test every 3 years (acceptable screening)
Based on your sexual history and age, a Pap test may be recommended at your visit.
When is the best time for a Pap test?
- One to two weeks after your period is over and after any bleeding from the vagina has stopped
- After any infection in the vagina has been treated and cleared (e.g. yeast infection)
How do I get ready for a Pap test?
- Do not have sex (i.e. penis in vagina) for 48 hrs prior to the test
- Do not put anything in the vagina for 48 hrs before the test (e.g. tampon, douches, cervical caps, diaphragms, creams or foams)
Possible Pap test results:
- Normal - This is good. The cervical cells are healthy. If previous Pap tests have also been normal, you will not need a Pap test for 3 to 5 years depending on your age.
- Unsatisfactory specimen - This specimen cannot be read. Causes include douching, bleeding, infection, or insufficient number of cells collected. An unsatisfactory Pap test will need to be repeated in 6-8 weeks.
- ASCUS - Atypical Squamous Cells of Undetermined Significance. The Pap test showed some changes in the cells but the cause is not clear. Usually the changes resolve on their own but sometimes additional testing will be recommended by your healthcare provider.
- Low grade changes - This most likely indicates that you have been infected with the human papilloma virus (HPV). Some types of HPV can be associated with the increased risk of cervical cancer. Your healthcare provider will recommend specific follow-up. This may include a Repeating the Pap test or aa colposcopy.
- High grade changes - The cells of the cervix have been infected with one of the HPV types that can cause cancer, but they are not cancerous yet. Colposcopy is needed to determine the location and nature of the abnormal area. Biopsy and treatment may be necessary. Evaluation and treatment of the cervix with high grade changes are VERY important. Fortunately, progression to cancer usually takes years, so there is plenty of time to make arrangements for appropriate evaluation.
To learn more about these recommendations go to the American Sexual Health Association and the American Society for Colposcopy and Cervical Pathology . The American Social Health Association provides up to date information on STIs and links to other helpful websites.