Why Have a Pap Test?
Early on, cervical changes don't cause symptoms. Often, the only way to know you have cervical changes is to do a Pap test. A Pap test can find these problems early, when they are easier to treat. Pap tests can also detect some infections of the cervix and vagina.
What is a Pap test?
A Pap test is a procedure that helps find changes in the cervix that may lead to cancer. The cervix is the part of the uterus that opens into the vagina. For this test, a small sample of cells is taken from the cervix. This is done in your healthcare provider’s office. The cells are then analyzed in a lab. A Pap test is a safe procedure. It takes just a few minutes and causes little or no discomfort.
The HPV connection
Human papillomavirus or HPV is a family of viruses that spread through skin contact. Certain types are almost always spread through sexual contact. Some HPV types cause genital warts (condyloma). But not all types of HPV cause visible symptoms. Certain types cause cell changes (dysplasia) in the cervix that can lead to cancer. In fact, HPV infection is the most important risk factor for cervical cancer. Healthcare providers can now test for HPV. Testing for HPV is often done with the Pap test. That’s why it’s important to have Pap tests as recommended by your healthcare provider. This helps ensure that any abnormal cells will be found and treated before they become cancerous.
Who should have a Pap test and HPV test?
Ask your healthcare provider when to start having Pap tests, whether you should have an HPV test done at the same time, and how often to have them. Follow these guidelines from the American Cancer Society for cervical cancer screening:
A first Pap test at age 21. And then every 3 years until age 29, HPV testing is not recommended during this time, though it may be done to follow-up on an abnormal Pap test.
Starting at age 30, the preferred testing is a Pap test done with an HPV test every 5 years. This should be done until age 65. Another option for women in this 30 to 65 age group is to have just the Pap test done every 3 years.
You may need a different screening schedule if you are at high risk for cervical cancer. Risk factors include having HIV, a weak immune system, or exposure to the medicine DES while your mother was pregnant with you. Talk with your healthcare provider about the best schedule for you.
If you’re over 65 and have had regular screenings for the last 10 years with no abnormal results in the last 20 years, you may stop cervical cancer screening.
If you had a hysterectomy that included removing your cervix, you can stop screening unless the hysterectomy was done to treat cervical cancer or pre-cancer. If you still have your cervix after the hysterectomy, you should continue screening according to the above guidelines.
Routine testing does not need to be done each year. However, if your test is abnormal, your provider will let you know how often to be tested.
Women who have been vaccinated for HPV should still follow these guidelines.
If you have had cervical cancer, talk to your healthcare provider about the screening plan that's best for you.
October 02, 2017
Cervical Cancer Screen and Prevention, Obstetrics and Gynecology (2016); 128(4); e111-e130
Freeborn, Donna, PhD, CNM, FNP,Sacks, Daniel, MD, FACOG