A common test, extraordinary results

For nearly all women, an annual gynecological examination means a Pap test. While the test is a common part of a health care routine, what does it actually test for, and why is it necessary?
The Pap test, also called a Pap smear, checks for changes in the cells of your cervix, the lower part of the uterus that opens into the vagina. The Pap test can tell if you have an infection, abnormal cervical cells or cervical cancer.

Why Do I Need a Pap Test?

A Pap test can save your life. It can find the earliest signs of cervical cancer. If caught early, the chance of curing cervical cancer is high. A Pap test can also find infections and abnormal cervical cells that can turn into cancer cells. Treatment can prevent most cases of cervical cancer from developing.
Getting regular Pap tests is the best thing you can do to prevent cervical cancer. About 13,000 women in America will find out they have cervical cancer this year. And in 2004, 3,500 women died from cervical cancer in the United States.

Do All Women Need Pap Tests?

You need a Pap test if you are 21 years or older or under 21 and have been sexually active for three years or more.
There is no age limit for the Pap test. Even women who have gone through menopause need regular Pap tests.

How often do I need to get a Pap test?

It depends on your age and health history. Talk with your doctor about what is best for you. The American College of Obstetricians and Gynecologists recommends a yearly test for women younger than 30.
If you are 30 or older, and have had three normal Pap tests for three years in a row, talk to your doctor about spacing out Pap tests to every two or three years.
If you are age 65 to 70, and have had at least three normal Pap tests and no abnormal Pap tests in the last 10 years, ask your doctor if you can stop having Pap tests.
You should have a Pap test every year no matter how old you are if you have a weakened immune system because of organ transplant, chemotherapy or steroid use, if your mother was exposed to diethylstilbestrol (DES) while pregnant or if you are HIV-positive.

Do I Still Need a Pap Test After a Hysterectomy?

It depends on the type of hysterectomy you had and your health history. Women who have had a hysterectomy should talk with their doctor about whether they need routine Pap tests.
Usually during a hysterectomy, the cervix is removed with the uterus. This is called a total hysterectomy. Women who have had a total hysterectomy for reasons other than cancer do not need regular Pap tests. Women who have had a total hysterectomy because of abnormal cells or cancer should be tested yearly for vaginal cancer until they have three normal test results.
Women who have had only their uterus removed but still have a cervix need regular Pap tests. Even women who have had hysterectomies should see their doctors yearly for pelvic exams.

How Can I Reduce MyChances of Getting Cervical Cancer?

Aside from getting Pap tests, the best way to avoid cervical cancer is by steering clear of the human papilloma virus (HPV). HPV is a major cause of cervical cancer and is also one of the most common sexually transmitted diseases (STD). So, a woman increases her chances of getting cervical cancer if she:
- Starts having sex before age 18
- Has many sex partners
- Has sex partners who have other sex partners
- Has or has had a sexually transmitted disease

What Should I Know about Human Papilloma Viruses?

Human papilloma viruses are a group of more than 100 different viruses.
- About 40 types of HPV are spread during sex.
- Some types of HPVs can cause cervical cancer when not treated.
- HPV infection is one of the most common sexually transmitted diseases.
- About 75 percent of sexually active people will get HPV sometime in their life.
- Most women with untreated HPV do NOT get cervical cancer.
- Some HPVs cause genital warts, but these HPVs do not cause cervical cancer.
- Since HPV rarely causes symptoms, most people don't know they have the infection.

How do I Know if I HaveHuman Papilloma Virus?

Most women never know they have HPV. It usually stays hidden and doesn't cause symptoms like warts. When HPV doesn't go away on its own, it can cause changes in the cells of the cervix. Pap tests usually find these changes.

How do I Prepare for a Pap Test?

Many things can cause wrong test results by washing away or hiding abnormal cells of the cervix. So, doctors suggest that for two days before the test, you avoid using tampons, vaginal creams, suppositories, medicines, deodorants, powders or having sex.

Should I Get a Pap Test When I Have My Period?

No. Doctors suggest you schedule a Pap test when you do not have your period. The best time to be tested is 10 to 20 days after the first day of your last period.

How is a Pap Test Done?

Your doctor can do a Pap test during a pelvic exam. While you lie on an exam table, the doctor puts an instrument called a speculum into your vagina, opening it to see the cervix. She will then use a special stick or brush to take a few cells from inside and around the cervix. The cells are placed on a glass slide and sent to a lab for examination. While usually painless, a Pap test is uncomfortable for some women.

When Will I Get the Results of My Pap Test?

Usually it takes three weeks to get Pap test results. Most of the time, test results are normal. If the test shows that something might be wrong, your doctor will contact you to schedule more tests. There are many reasons for abnormal Pap test results. It usually does not mean you have cancer.

What Does an Abnormal Pap Test Result Mean?

Abnormal Pap test results usually do not mean you have cancer. Most often, there is a small problem with the cervix.
Some abnormal cells will turn into cancer. But most of the time, these unhealthy cells will go away on their own. By treating these unhealthy cells, almost all cases of cervical cancer can be prevented. If you have abnormal results, to talk with your doctor about what they mean.

What Happens Now?

There are many reasons for abnormal Pap test results. If results of the Pap test are unclear or show a small change in the cells of the cervix, your doctor will probably repeat the Pap test.

If the test finds more serious changes in the cells of the cervix, the doctor will suggest more powerful tests. Results of these tests will help your doctor decide on the best treatment. These tests include:
- Colposcopy - The doctor uses a tool called a colposcope to see the cells of the vagina and cervix in detail.
- Endocervical Curettage - The doctor takes a sample of cells from the endocervical canal with a small spoon-shaped tool called a curette.
- Biopsy - The doctor removes a small sample of cervical tissue. The sample is sent to a lab to be studied under a microscope.

The FDA recently approved the LUMA Cervical Imaging System. The doctor uses this device right after a colposcopy to help see areas on the cervix that are likely to contain precancerous cells. This system shines a light on the cervix and looks at how different areas of the cervix respond to this light, giving a score to tiny areas of the cervix.

What is a False Positive Result?

A false positive Pap test is when a woman is told she has abnormal cervical cells, but the cells are really normal. If your doctor says your Pap results were a false positive, there is no problem.

A false negative Pap test is when a woman is told her cells are normal, but in fact, there is a problem with the cervical cells that was missed. False negatives delay the discovery and treatment of unhealthy cells of the cervix. But, having regular Pap tests boosts your chances of finding any problems. If abnormal cells are missed at one time, they will probably be found on your next Pap test.

Information provided by The National Women's Health Information Center, part of the U.S. Department of Health and Human Services.