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. He or she will 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 (ACOG), guidelines are as follows:

  • If you are at least age 21, you should start cervical cancer screening, even if you are not yet sexually active.
  • If you are younger than 30, you can likely be tested for cervical cancer every other year instead of yearly.
  • If you are older than 30 and have had 3 normal Pap tests in a row, you can be tested once every 3 years.
  • If 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 65 to 70 years old and have had at least 3 normal Pap tests in a row and are not sexually active, and have had no abnormal Pap 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 do not need cervical cancer screening unless you’ve had past surgery for cervical cancer or pre-cancer.

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 women over age 30.

Your healthcare provider may have
other reasons to recommend 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
  • Use of things, such as vaginal creams,
    jellies, medicines, or spermicidal foams, for 2 to 3 days before the Pap test, as
    these substances may alter 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
  • Sex within 24 hours before the test
    may cause inflammation of the tissue
  • Infections
  • Certain medicines, such as
    tetracycline
  • 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. Avoid 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.

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. He or she 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.

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.

Before you agree to the test or the 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 will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure