Pap smear basics
Every woman knows that she should have regular Pap smears. Here's what the Pap test really is -- and why it is so important.
During a Pap test, your healthcare provider collects cells from your cervix. These cells are examined for abnormalities that may indicate pre-cancer, cancer, infection or inflammation.
How are the cells collected?
Your doctor uses an instrument called a speculum to widen the vagina. Then, she gently swabs the surface of your cervix, and places the collected cells onto a microscope slide for examination at a lab. This is why it's also called the Pap smear.
Who performs the Pap test?
Physicians (especially gynecologists), physician assistants, nurse practitioners and nurse midwives typically perform the test, usually in a doctor's office, clinic or hospital.
Why do I need a Pap test?
The Pap test is a critical portion of your healthcare routine. The abnormalities that Pap tests detect may lead to cancer. When detected early, your doctor can address such abnormalities and head off cancer.
How often do I need a Pap test?
Not so long ago, every woman was encouraged to have at least one Pap test per year beginning at age 18. In 2009, however, the guidelines changed a bit, and the American College of Obstetricians and Gynecologists (ACOG) now recommends the following:
- Women should have their first Pap tests by age 21.
- Women ages 21 to 30 should be screened every two years.
- Women older than 30 who have had three consecutive normal Pap tests may be screened once every three years.
- Women with certain risk factors -- such as HIV, previous cervical abnormalities or cancer -- may require more frequent screening.
- Women over age 65 who've had no abnormal Pap tests in the last 10 years may, with a doctor's permission, stop having Pap tests altogether.
- Women who've had a hysterectomy do not need Pap tests unless the surgery was done as treatment for a cancerous (or precancerous) condition.
How do I prepare for a Pap test?
A shower the morning or night before your Pap smear is adequate, advises Dr. Matilde Parente, a female pathologist who's read thousands of Pap smears. Do not use vaginal washes, foams, gels, douches or other chemicals before your appointment. Refrain from having sex for one or two days before your test, and schedule the Pap for when you are not having active menstrual bleeding.
What results does a Pap test provide?
Your results will be reported as "normal" ("negative") or "abnormal" ("positive"). According to the National Cancer Institute, about 6 percent of all Pap tests in the U.S. are abnormal and require followup care.
What if my Pap test results are abnormal?
Abnormal cells rarely become cancerous. Your doctor may perform another Pap test to compare to the original. Often, abnormal cells in the cervix go away without treatment.
Your doctor may do followup testing (a colposcopy) to examine your cervix and vagina further. If the colposcopy finds abnormalities, the doctor may take a biopsy of the area for examination. From there, she can determine the chance of those cells becoming cancerous and whether further treatment is needed.