What to Know About Pap Smears

Insights from Flo Harris, FNP at A Woman’s View

Pap smears are one of those medical tests most of us know we’re supposed to get, but honestly? A lot of us aren’t entirely sure why, or what’s actually happening during the test.

And that’s completely okay.

Flo Harris, a nurse practitioner at A Woman’s View, recently sat down to answer all those questions you might have wondered about but never felt comfortable asking. Because here’s the thing: if you’re wondering about it, so are plenty of other women.

Let’s talk about what Pap smears actually test for, what to expect during the exam, and what happens if results come back abnormal.

Why Pap Smears Matter: A Prevention Success Story

Here’s something you might not know: regular Pap smear screening has reduced cervical cancer rates to less than 1%.

That’s not a small achievement. According to the American Cancer Society, cervical cancer was once one of the most common causes of cancer death for American women, but widespread screening has dramatically reduced both incidence and mortality rates.1 This simple, quick test is one of the most effective cancer prevention tools we have – right up there with mammograms for breast cancer and colonoscopies for colon cancer.

The key is that Pap smears catch problems early, often years before they could become cancer. That’s what makes them so powerful.

When Do You Need a Pap Smear?

Starting age: 21 years old

How often: Every 3 to 5 years (as long as results are normal)

If you thought Pap smears were a yearly thing, you’re not alone – that used to be the recommendation, and lots of women still think it is. But guidelines have changed.

The current recommendations from the American College of Obstetricians and Gynecologists (ACOG) are:2

Every 5 years if your Pap includes HPV testing (usually starting at age 25 or 30)
Every 3 years for Pap smear alone (ages 21-29)

Of course, your provider might recommend more frequent screening based on your individual health history. But for most women with normal results, you’re looking at every few years, not every year.

What Actually Happens During a Pap Smear

If you’ve been nervous about getting a Pap smear, knowing what to expect might help.

Your cervix sits at the very back of your vagina – Flo describes it as “the little tunnel that leads to your uterus.” Using a speculum so the cervix is visible, your provider collects cells using two simple tools:

A soft, flexible plastic spatula that lightly brushes the outside of the cervix
A small brush that goes just barely inside the cervical opening to collect cells from inside

The good news? “It’s not painful,” Flo explains. “The cervix actually has very few nerve endings, so usually patients just say, oh, it feels kind of funny.”

She compares it to getting your cheek swabbed for DNA – it’s collecting microscopic cells with a very light touch, not scraping or rubbing hard.

Those cells are then sent to pathologists who examine them under a microscope to see if they look normal or show any changes.

Understanding HPV: The Virus Behind Most Cervical Changes

Most Pap smears also test for HPV (human papillomavirus). If you’re wondering why that matters, here’s the connection: abnormal changes to cervical cells are usually caused by certain types of HPV.

Things to know about HPV:

It’s extremely common – the CDC reports that about 80% of sexually active people will get at least one type of HPV at some point in their lives3
There are many different types – over 100, in fact4
Some types are higher risk for causing cervical cell changes
Most of the time, your immune system clears HPV on its own within two years5

Here’s something that surprises many women: even after HPV clears from being active, you can still carry the virus in your body. It can become active again during times when your immune system is down – when you’re sick, stressed, or run down.

That’s why continued screening matters, even if you’ve had HPV before and it went away.

The Good News About Cervical Cancer Prevention

Even when HPV does cause cell changes, cervical cancer doesn’t develop quickly.

If abnormal cells were going to progress to cervical cancer, it would typically take around 10 years, according to the National Cancer Institute.6 This slow progression is exactly why Pap smears work so well – they catch changes years before they could become serious.

And most of the time, those cell changes go back to normal on their own.

What Happens If Your Pap Smear Is Abnormal

First: take a deep breath. Abnormal Pap smear results don’t mean you have cervical cancer.

Most of the time, abnormal results lead to one of these next steps:

For minor changes:

Repeat your Pap smear in one year instead of waiting three to five years
Often, cells return to normal on their own during that time

For more significant changes:

Colposcopy (a closer, magnified look at your cervix)
Small biopsy of the abnormal area (similar to biopsying a suspicious mole on your skin)

If the biopsy shows concerning changes:

Remove that part of the cervix to prevent any progression
Same concept as removing a mole that looked worrisome

The goal is always to catch and address changes before they become a bigger problem.

Will Cervical Procedures Affect Future Pregnancy?

This is a completely understandable concern, and one many women have.

The answer? Cervical procedures won’t affect your ability to get pregnant or carry a healthy pregnancy in the future. These procedures are safe and, when needed, they’re important for protecting your long-term health.

The HPV Vaccine: Another Layer of Protection

Beyond Pap smears, there’s another powerful tool for preventing cervical cancer: the Gardasil vaccine.

This vaccine protects against the high-risk types of HPV that can lead to cervical cancer. The CDC recommends HPV vaccination for preteens (boys and girls) at age 11 or 12, though it can be given as early as age 9.7

Gardasil vaccine details:

Can be given starting at age 9
Ages 9-15: Only 2 doses needed
Ages 16+: 3 doses needed
Approved through age 45
Once you complete the series, you’re protected for life (no boosters needed)
Also protects against the types of HPV that cause genital warts

Studies show that HPV vaccination has led to significant decreases in HPV infections and cervical precancers in young women.8

The Bottom Line

Pap smears have made cervical cancer rare – but only for women who actually get screened regularly.

If you’re due for a Pap smear, haven’t had one in a while, or have questions about what your results mean, we’re here to help.

Questions about Pap smears or cervical cancer screening? Call A Woman’s View at (828) 345-0800 to schedule an appointment with Flo Harris or one of our other providers. We’re happy to explain, answer questions, and make sure you understand every step of your care.

No question is too small, and we’re here to make your visit as comfortable and clear as possible.