Pap

Does this test have other names?

Pap smear, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique

What is this test?

This test checks the cells from inside the cervix for any changes that could lead to cancer. The cervix is the lower part of a woman's uterus that opens into the vagina.

This test is named after Georgios Papanicolaou, MD, one of the healthcare providers who developed this technique of testing for cervical cancer.

Why do I need this test?

You may need this test as a screening test to look for cervical cancer or changes in cervical cells that might eventually lead to cancer. Major medical groups generally recommend that women get regular Pap tests every 3 years starting at age 21. Getting a regular Pap test can be life-saving. Cervical cancer is one of the most serious types of cancer in women.

If your test shows abnormal cells, your healthcare provider may be able to find and treat cervical problems right away, or stop cervical cancer before it becomes life-threatening. Pap tests can also diagnose serious infections and pelvic inflammation. 

What other tests might I have along with this test?

You will likely have a pelvic exam along with this test. Depending on your age and other factors, your tissue samples may also be tested for human papillomavirus (HPV) infection at the same time your Pap test is done. Infection with some types of HPV puts you at risk for cervical cancer.

If you have an abnormal Pap test result, your healthcare provider may order other tests. These may include:

• Colposcopy. Your cervix and vagina are looked at with a microscope called a colposcope, which magnifies any abnormal areas.

• Endocervical curettage. Cells are taken from the opening of your cervix with a spoon-shaped tool and looked at under a microscope. This may be done during the colposcopy.

• Biopsy. A small tissue sample is taken from your cervix and looked at under a microscope. This may be done during the colposcopy. 

What do my test results mean?

Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. 

Your results will either be normal or abnormal. If you get an abnormal result, this usually does not mean that you have cancer. It often means a minor cervical problem. Your healthcare provider may do another Pap test to confirm the initial results. Or he or she may recommend other tests such as colposcopy.

Occasionally a lab test has a false-positive result. This means you do not have a cervical problem even though the test result shows you do. 

How is this test done?

This test is done with a sample of cervical cells. For the test, you lie on your back with your knees bent and your feet in stirrups, then relax and spread your legs. As part of a pelvic exam, your healthcare provider first checks your vagina and reproductive organs for infections and health problems.

Then your provider uses a device called a speculum to open the vagina. The provider examines your cervix and scrapes off a few cells from inside your cervix.

Some women may have slight discomfort when the speculum is inserted.

Does this test pose any risks?

This test poses no known risks.

What might affect my test results?

Using vaginal lubricants, cleansers, contraceptives, or creams may mask your symptoms. Avoid using vaginal douches and abstain from sex for 2 days before an exam. Using these products or having sex may wash away or disguise abnormal cervical cells.

How do I get ready for this test?

It may seem like a good idea to wash up before having a Pap test, but this can actually erase the signs of a health problem. For accurate test results, avoid having sex or using tampons, douches, vaginal creams, deodorant sprays and powders, and contraceptive foams and jellies for 2 days before your exam.

Don't have the test while you're menstruating. The ideal time to have a Pap test is 10 to 20 days after the first day of your last period. 

Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illicit drugs you may use.