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What Is a Pap Test? Here are 6 Things to Know

Few women are thrilled about a Papanicolaou test, more commonly called a Pap test or Pap smear.

The paper gown, the cold stirrups and the strange tools on a tray can all be a bit nerve-wracking. However, this screening for cervical cancer is a lifesaving tool.

“The Pap test is important for early detection of cervical cancer and also cervical conditions that are treatable before they turn into cancer,” said Kelley Saunders, MD, an OBGYN with Banner – University Medicine Women’s Institute.

The Pap smear test is the gold standard for cervical cancer screening, but you may not need to be screened as often as you think. Whether it’s your first screening or 40th, here are six things to know about this simple, life-saving screening.

A Pap test shouldn’t be painful

There’s nothing really comfortable about having your heels in stirrups or scooting your bum to the edge of the exam table, but a Pap test shouldn’t be painful. According to experts, a Pap test can be uncomfortable but only takes about 30 seconds.

To perform, your gynecologist or health care provider will use a medical instrument called a speculum, an instrument that oddly looks like a duck bill. The biggest anxiety usually surrounds the insertion of the speculum into your vagina, but a speculum isn’t holding your vagina open like a car jack. It actually only opens your vagina a couple of centimeters, enough to allow your provider to get a good look at your cervix.

Your provider will swab the outside and inside of the cervix to collect cervical cells. You may feel a little tickle or gentle scratch, and voila! You’re done. Your provider will put the sample into a solution and send it off to a lab where a pathologist will look at it.

You may not require a Pap test every year

In recent years, guidelines have changed about who should receive a Pap test and how often they should be getting them.

“In the past, it was recommended you have a Pap test every year, but newer evidence-based guidelines by the United States Preventative Services Task Force and endorsed by organizations like the American College of Obstetrics and Gynecology (ACOG) recommend screenings at different intervals,” Dr. Saunders said.

If you’re low risk, you should begin receiving Pap tests beginning at age 21. If your Pap test result is negative this should be repeated every three years. For women over age 30, Pap testing with human papillomavirus (HPV) is recommended every 5 years as long as screening remains negative.

“Most women over age 65 can discontinue Pap tests altogether,” Dr. Saunders said. “This is for women with no prior history of cervical cancer, high grade cervical intraepithelial neoplasia, or abnormal cells associated with HPV, within the last 25 years and with adequate documented negative prior screening.”

Women who are at high risk to develop cervical cancer – those with abnormal Pap smear/abnormal cervical cancer screening test results or history of cervical cancer or are immunocompromised – may need additional or more frequent testing.

Talk to your health care provider to see what’s right for you.

A Pap test is different from a pelvic exam

Both Pap tests and pelvic exams are important to your personal health and wellness, but a pelvic exam should be done annually during your well-woman exam—or any time you are experiencing pelvic pain or concerns.

During the exam, your provider will check your vulva, vagina, cervix, ovaries, uterus, rectum and pelvis for abnormalities. This exam may involve a speculum and a bimanual exam, a test that involves inserting two fingers in the vagina and pressing down on your belly with the other hand.

Whether you’re sexually active or not, you’ll still need a Pap test

Most cervical cancers are caused by the human papilloma virus, or HPV, which can be transmitted by having vaginal, anal or oral sex with someone who has the virus.

“HPV is the cause of the vast majority of cervical cancers and is also a cause of other skin cancers including of the penis, anus and back of the throat,” Dr. Saunders said. “Most people, roughly 85%, who are sexually active will be exposed to HPV in their lifetime.”

However, not all cervical cancers stem from HPV, so a Pap test is necessary even if you aren’t currently sexually active.

The HPV vaccine is also an important prevention strategy and is now available to preteens and young adults.

[To learn more, check out: “Why Your Kids Shouldn’t Skip the Cancer-Fighting HPV Vaccine.”]

Pap tests don’t screen for STIs (sexually transmitted infections)

A Pap test only tests for signs of HPV and not for other STIs or their effects. However, STI testing can be added on if desired or indicated by your provider. You should consider adding this test if you’re having unprotected sex with a new partner, if your partner has recently tested positive or you notice symptoms.

[Also read “I Have an STI, Now What?”]

An abnormal Pap test doesn’t always mean cancer

A Pap test detects abnormal cervical cells to help find early cervical cancers. However, if your test results come back abnormal, don’t panic. There are a number of reasons for having one, such as infections, pelvic inflammation, sexual activity, genital warts, HPV and precancerous or cancerous cells on your cervix.

If you just received an abnormal Pap test, here’s what to expect next.

Schedule a Pap test

Life can get pretty busy – especially after having children – but don’t forget to see your health care provider for a Pap test or an annual pelvic exam.

It’s important to get screened. It could very well save your life. To schedule an appointment with a health care provider near you, visit

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