What to Expect During a Pap Smear
A Pap smear is an important screening test that helps find cancerous or precancerous cervical cells early.
What is a Pap test?
A Pap test (or Pap smear) is a test that’s done as part of a woman’s pelvic exam. During the pelvic exam, a doctor takes a sample of cells from the cervix, the opening to the uterus. The cells are examined for any abnormal cells that are cancerous or could become cancer. A Pap test helps find cancerous or precancerous cells early when they are much easier to treat.
What can I expect when I go for a Pap test?
If you’ve never had a pelvic exam before, here’s what you can expect.
You will take off your clothing, including your bra and underwear. Doctors will often perform a breast exam at the same visit as the pelvic exam. You will have a gown and perhaps a sheet to cover your legs. You will lie down and scoot your bottom toward the very end of the exam table. Then you will be asked to place the heel of each foot into a stirrup. The stirrups allow your doctor to position and open your legs so it’s easier to access your cervix.
Next, the doctor will slide a speculum into your vagina. This is a medical instrument with small, narrow paddles made of either stainless steel or plastic. The speculum is adjusted to spread open the vagina so the doctor can see and take cell samples from the cervix. Next, the doctor will take a tiny brush or scraper to gently remove cells from the cervix. He or she will put the cells on a slide or in a liquid and send the cell sample to a lab for examination.
During the pelvic exam your doctor will feel the uterus and ovaries using two fingers inserted inside the vagina and one hand on the lower belly.
The Pap test may feel uncomfortable, but is not painful.
For the most accurate test results, do not use these items for 2 to 3 days before your test:
- Vaginal deodorant, sprays, or powders
- Birth control foams or jellies
It’s also important to avoid sexual intercourse for 2 days before the test. Try to make your appointment for a Pap test when you are sure you will not be having your period.
What do the test results mean?
The cervical cell sample taken during the pelvic exam is examined by a pathologist. The results are reported back to your doctor.
There is a complicated system used to describe Pap test results. But, you are often told that test results are simply normal or abnormal. Abnormal does not automatically mean you have cervical cancer. Many times, test results are not clear or you get a false-positive. That means the test says abnormal, but it’s really normal. Usually, an abnormal Pap test means you need another Pap test or other further testing. Abnormal results may also mean you have an infection or precancerous changes.
If your results show abnormal changes, the doctor may repeat the Pap test. At the same time, he or she may also do an HPV (human papillomavirus) DNA test. This test can find whether you are infected with one of the types of HPV that can cause cervical cancer. If the HPV test is positive, your doctor may suggest a test called colposcopy. For this, the doctor uses a magnified lighted scope to view the cervix more closely. Sometimes a tissue sample is taken and sent to a lab for examination. Some experts also recommend that all women aged 30 and over receive an HPV test with their initial Pap test.
How often do I need a pap test?
You need to start having Pap tests at age 21. Women younger than 30 years old should have a Pap test every 2 years. Women aged 30 years and older should have a Pap test every 2 years as well. But, after three normal Pap tests in a row, women in this age group may have Pap tests every 3 years if they do not have risk factors. Work with your doctor to determine how often you need a Pap test based on your age and health history.