What Is a Pap Smear?

A Pap smear (Pap test) is a way to look at a sample of cells taken from a woman's cervix. The test is used to look for changes in the cells of the cervix that show cervical cancer or conditions that may develop into cancer.

All women who are or who have been sexually active, or who have reached age 21, should have an annual Pap smear. It is your best tool to detect pre-cancerous conditions and hidden, small tumors that may lead to cervical cancer. If detected early, cervical cancer can be cured.

How Is a Pap Smear Performed?

The Pap smear is done during a pelvic exam. A doctor uses a device called a speculum to widen the opening of the vagina so that the cervix can be examined. A plastic spatula and small brush are used to collect cells from the cervix. After the cells are taken, they are placed into a solution. The solution is sent to a lab for testing.

Is the Pap Smear Painful?

A Pap smear is not painful, but the pelvic exam may be a little uncomfortable.

When Will I Know the Results of the Pap Smear?

It may take several weeks to get the test results. If you haven't heard from your doctor's office after 3 weeks, give them a call to see if your results have come back.

What Do the Results of a Pap Smear Mean?

A normal Pap smear means the cells from the cervix look normal. An abnormal Pap smear means the cells do not look normal. Sometimes repeat Pap smears are needed. Different tests also may need to be done, such as a colposcopy (the use of a special microscope to examine the cervix and vagina). Pap smears can occasionally show signs of infection but cannot be relied on to screen for sexually transmitted diseases (STDs). Other tests are necessary to determine the presence of an STD.There are several things you can do to help make the Pap smear as accurate as possible. These include avoidance of sex, douching, and vaginal creams for 48 hours before the test.

What Happens If the Results Are Abnormal?

An abnormal Pap smear does not necessarily mean that cancer cells were found during the examination. There are many causes for abnormal Pap smear results. Your doctor will evaluate the results to determine if further testing is necessary.

Why Would I Need to Repeat the Pap Smear?

A repeat Pap smear may be necessary if you had an infection at the time of the test or if there were not enough cells collected during the test. Since decreased levels of the female hormone estrogen also can influence Pap smear results, menopausal women may need to take estrogen before they repeat the test.

If the results of the repeat Pap smear are still abnormal, your doctor may recommend that you have a colposcopy to further evaluate the problem.

What Is a Colposcopy?

Colposcopy is an examination of the cervix and the walls of the vagina. During the examination, a speculum is inserted into the vagina (as done in a Pap smear). Your doctor looks through a magnifying instrument called a colposcope to detect cervical problems that cannot be seen by the eye alone. During the colposcopy, the colposcope remains outside the vagina. Biopsies (tissue samples) of the abnormal cervical area may be taken.

Colposcopy is not always necessary immediately after an abnormal Pap smear. Be sure to ask your doctor about other options.

How Often Should I Get a Pap Smear?

You should get a Pap smear once a year if you are having or have had sex or if you have reached the age of 21. Some women who have a higher risk of cancer may need a Pap smear more often. Women who have had normal Pap smears for several years in a row, and have had only one sex partner may need the test less often.

Women with certain risk factors, such as being HIV positive (carrying the virus that causes AIDS), a weakened immune system due to chemotherapy, organ transplant, chronic steroid use, or have a history of diethylstilbestrol (DES) exposure before birth, should continue to be screened more frequently.

What Symptoms Should I Watch for Between Pap Smears?

Pre-cancerous conditions of the cervix seldom cause symptoms. For problems to be detected, a pelvic examination and a Pap smear are usually required.

When cancer is present in the cervix, the most common symptom is abnormal bleeding. Bleeding may start and stop between regular menstrual periods, or it may occur after sexual intercourse or douching. Abnormal vaginal discharge is another symptom. Pain is NOT an early warning sign of the disease. These symptoms are not sure signs of cancer. But be sure to see your doctor if any of these symptoms develop.

Do I Need to Get Pap Smears If I Have Had a Hysterectomy?

Pap smears may be discontinued after a total hysterectomy (removal of the uterus and cervix), unless the surgery was performed for cervical pre-invasive or invasive cancer or other uterine cancers. Women who have had a partial hysterectomy with the cervix remaining should continue to have routine Pap smears. Check with your doctor to determine if you still need Pap smears. Even women who no longer require Pap smears should see their doctor annually for pelvic exams.