A Pap smear or Pap test involves a doctor taking a small sample of cells from a person’s cervix using a brush or spatula-like instrument to look for changes in the cervix’s cells.
A doctor may use a Pap smear to look for cellular changes that can result from cancer, precancer, human papillomavirus (HPV), inflammation, or an infection. A doctor may perform a Pap smear during a routine examination.
Keep reading for more information about Pap smears, including at what age and how frequently a person should get them.
The Centers for Disease Control and Prevention (CDC) recommend that all women between the ages of 21 and 65 should get regular Pap smears tests.
The National Institutes of Health (NIH) do not recommend Pap smears for people under the age of 21. They also do not recommend that people over 65 get a Pap smear except under certain circumstances, such as abnormal results or increased risk factors for cancer.
The CDC further breaks down the testing times based on age. The following are the recommended testing schedules based on a person’s age:
A person should start getting Pap tests at the age of 21. If the result is normal, a doctor will likely suggest waiting 3 years until the next test.
A person may discuss with their doctor if they should have a Pap test only, or a combined Pap and HPV test.
If a person has a pap test only, and the results are normal, a doctor may suggest waiting 3 years until the next one.
If a person had a combined test, and both results are normal, a doctor may suggest waiting 5 years until the next screening test.
Age 65 plus
A doctor may suggest that screening is no longer necessary for a person over 65 if:
- they have had normal screening test results for many years
- they had a total hysterectomy, and a doctor removed their cervix
Risk factors include:
In general, there is nothing that a person needs to do to prepare for the examination.
If a person is menstruating at the time of their scheduled appointment, they should check with their clinician whether they should come in. In most cases, however, the Pap smear can go ahead.
Doctors also recommend that a person avoids the following before to a Pap smear:
- having sex
- douching the vagina
- using tampons or vaginal lubrication
- vaginal creams, suppositories, or medications
- using birth control foam, cream, or jelly
Most people need regular Pap smears from the age of 21. However, some people may wonder whether they need a Pap smear if they:
Have had a hysterectomy
Some people who have had a hysterectomy will still need a Pap smear. This will depend on the person’s health history and the type of hysterectomy they had.
Are not sexually active
Pap smears test for the presence of abnormal cell growth. Though this can be the result of a sexually transmitted disease (STI), such as HPV, a person may still develop cervical cancer without having sex.
A person’s doctor may recommend a Pap smear during pregnancy. However, a person should talk to their doctor about their situation and whether they need one.
Have gone through menopause
Women should still get Pap smears after menopause up until the age of 65. Continuing Pap smears after age 65 will depend on whether a person has risk factors for cervical cancer.
A healthcare provider typically performs a Pap smear during a routine care visit. During the visit, a doctor will ask the person several health questions and perform an examination.
During the Pap smear, the person will typically lie on their back with their legs separated. A healthcare provider will then insert a speculum into the vagina to keep the vagina walls open.
With the speculum in place, the healthcare provider will take a sample of cervical cells using a brush or spatula. They will place the sample inside a container filled with a transport medium, which is a fluid that will preserve the sample.
The healthcare provider will then remove the speculum. During the procedure, the person may feel slight discomfort, pain, or pressure. A person can reduce the discomfort by urinating before the test.
The examination does not require any recovery time, and the person can leave immediately following the Pap smear.
The healthcare provider will send the sample to a lab for examination. The test results can take about 1–3 weeks to come back, depending on the lab.
A person will usually get their results in a letter or through an online portal. A doctor can go over the results with the person to explain what they mean and discuss the next course of action, if necessary.
The results can be as follows:
- Normal: The Pap smear showed normal cells, so no further action is required until the next routine exam.
- Abnormal: The cells show abnormalities or growth, which does not necessarily mean a person has cancer. A doctor will likely order additional tests, such as a colposcopy, to check for certain conditions. The doctor may recommend another Pap smear immediately or in 6 months–1 year.
- Unclear: The doctor cannot determine if the results are normal or abnormal. They may do additional tests or have the person come back in 6 months–1 year for another Pap smear.
Pap smears are not always accurate. In some cases, a Pap smear may return false normal or false abnormal test results. However, regular Pap smears are generally effective in helping to screen for cervical cancer.
Pap smears do not check for STIs. A doctor may test for an STI if the person has symptoms that indicate an STI may be present.
A person may not experience any symptoms that would suggest that they needed to have a Pap smear. However, the person may experience symptoms of an STI or other infections such as:
- abnormal discharge
- pain during sexual intercourse or urination
- lesions or warts
- abdominal pain
If these occur, a person should see their doctor as soon as possible. During the examination, a doctor may recommend a person get a Pap smear as well.
Sexually active people should get regular screening for STIs. People who have more than one sexual partner are at an increased risk of contracting an STI.
People should also get regular testing for HPV. A doctor can perform an HPV test at the same time as a Pap smear. The Office of Women’s Health recommend that people over 30 have an HPV test every 5 years.
If the test shows abnormal results, a doctor may order a colposcopy. A doctor may also request a biopsy to test for cancer cells.
Women between the ages of 21 and 65 should get Pap smears every 3–5 years.
Pap smears check for the presence of abnormal cells and can indicate whether the person either has or could develop cervical cancer.
Most people receive normal results from the Pap smears. Should the test results come back abnormal, however, a person will likely require additional testing.