By Dr. Rebecca Keith
Beaufort Memorial Obstetrics & Gynecology Specialists
Pap tests have been standards of care for decades, but many women still get nervous beforehand – especially if it’s their first time.
Understanding the purpose of a Pap test and what to expect can help you feel more confident as you head in for your exam.
What is a pap test and what does it detect?
The purpose of a Pap test (also called a Pap smear) is to screen for cervical cancer by identifying precancerous cells. Proper treatment keeps these from turning into cancer cells.
The American Cancer Society reports that nearly 13,500 American women are diagnosed with cervical cancer every year. The number has dropped by 50% over the past few decades, largely due to increased testing.
Along with a Pap test, your women’s health provider may suggest an HPV test. This looks for human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to cervical cancer. Treating this infection is a proactive way to prevent cervical cancer.
When and how often do you need a Pap test?
The Center for Disease Control and Prevention recommends that you undergo your first Pap test at age 21.
Depending on your results and your medical history, you should follow this schedule:
- Ages 21 to 29 — You should have Pap tests at least every three years. If you have an abnormal test result, your healthcare provider may recommend more frequent testing.
- Ages 30 to 65 — As long as your tests are normal, you can continue to get tested every three years. However, you have options. Some women prefer HPV testing only or a combination of HPV and Pap smears; this allows you to go five years between tests, which many women appreciate.
- After age 65 — Continue your prescribed testing schedule. You may not need further testing after three normal Pap smears or two consecutive HPV tests.
How to prepare for your appointment
For two days leading up to your exam, avoid the following:
- Douching
- Sexual intercourse
- Spermicidal foam
- Tampons
- Vaginal medication
It’s also helpful to urinate just before your test. Having an empty bladder will make you more comfortable throughout the exam. No preparation is needed for an HPV test.
What to expect during the exam: Is it painful?
Though you may feel discomfort or pressure, a Pap test shouldn’t be painful.
During your test, the following takes place:
- Preparation — While you lie on an exam table, your healthcare provider inserts an instrument called a speculum into your vagina. This helps to hold your vagina open during the test.
- Removal — Your healthcare provider removes a few cells from your cervix with a small brush. Immediately afterward, your healthcare provider sends the tissue samples to a laboratory.
- Testing — Laboratory technicians study cell samples for signs of precancer or other abnormalities.
It can take up to three weeks to receive your Pap test results. When your results arrive, they will fall into one of three categories.
- Normal — Also called a negative test result, a normal test uncovers no abnormal cells in the cervix.
- Abnormal — A positive test indicates abnormal cells. Abnormal results rarely indicate cancer. The most common cause, according to the National Cancer Institute, is atypical squamous cells of undetermined significance. This means it’s unclear what caused the abnormality. Further testing determines the root cause and enables early treatment, which often prevents cancer development.
- Unsatisfactory — The laboratory cannot give a definitive result. A second Pap test, a few months later, is necessary.
Warning signs of cervical cancer
Regular Pap and HPV tests help detect and deal with cervical problems, but cervical cancer can develop between screenings.
To prevent cancer from spreading, talk with your care team anytime you experience cervical cancer symptoms, including:
- Abnormal menstrual bleeding
- Heavier and longer-lasting periods
- Long-term pale, pink or watery vaginal discharge
Rebecca Keith, M.D., is a board-certified OBGYN physician who sees patients at Beaufort Memorial Obstetrics & Gynecology Specialists in Beaufort and Okatie, specializing in creating a comfortable, respectful and open atmosphere for patients in every stage of womanhood.