What is a Pap test?
The Pap test, named after its inventor Dr. George Papanicolaou, is a screening test for cervical cancer. Its primary purpose is to detect abnormal cells on the cervix before they become cancer. A sample of cells from the cervix is collected and examined to determine whether the cells appear normal or abnormal. If abnormal, the Pap results will indicate to what degree. These results are used by a healthcare provider to recommend if further evaluation is needed.
How is a Pap test taken?
A device called a speculum is inserted into the vagina. This holds the vaginal walls apart and allows the cervix to be seen. (If you would like to see your cervix, ask your examiner to give you a mirror). A small device called a "broom" is used to take some cells from around the cervical opening. Sometimes a spatula and/or small, soft, brush is used. The Pap test takes less than a minute to obtain and is typically pain-free. The collected cells are placed in a liquid fixative and sent to a lab for microscopic analysis. We now recognize that most cervical abnormalities that result in abnormal Pap tests are caused by a sexually transmitted virus called HPV (human papilloma virus). There are many strains of HPV, but some are called “high risk” because they can cause cervical cancer. In certain circumstances, a high risk HPV test will also be run on the sample collected for the Pap test. (There will be an additional charge if the High Risk HPV Test is run.)
Why have a Pap test?
Cervical cancer develops very slowly. There may be years of precancerous changes that precede cancer. When a Pap test detects these precancerous cells, treatment can prevent cancer altogether. Very early cervical cancer can also be successfully treated. If, however, a cervical cancer goes undetected, it may spread to other organs where it is difficult to treat and may be fatal.
Who should get a Pap test?
Pap tests are recommended for all women based on the following guidelines:
- Women ages 21-29 should have a Pap test every 3 years
- Women ages 30-65 should have dual screening with a Pap test and high risk HPV test every 5 years. (This is also called a co-test.) Alternatively, a Pap test alone can be done every 3 years.
A Pap test cannot be done if you are on your period. Also, you should avoid douching, having intercourse, using vaginal medication, or putting spermicide in your vagina for 48 hours before your exam.
If you wish to be screened for sexually transmitted infections, let your clinician know.
Pap test results
It generally takes a week or two to receive your results. If your test is negative, or normal, you should follow the routine screening schedule. If your test is abnormal, you will be advised of what kind of follow-up is appropriate for your age group and type of abnormality. Sometimes, a follow-up procedure called a colposcopy is advised. During a colposcopy, the cervix is examined under magnification and biopsies of abnormal areas are taken. This allows for a definite diagnosis of the problem. Your medical provider can then recommend treatment or ongoing observation, as appropriate.
How can cervical cancer be prevented?
- Consider getting an HPV vaccine (Gardasil 9)
- Get recommended Pap tests
- Use condoms to prevent sexually transmitted infections, including HPV
- Limit number of lifetime sexual partners to prevent sexually transmitted infection exposure
- If you smoke, stop smoking; if you don’t smoke, don’t start. Smoking depresses the cervix’s immune defenses.