(Pap Smear; Pap Screening; Papanicolaou Test; Cervical Cancer Screening)
The cervix is the opening to the uterus (womb). It can be seen at the top of the vagina. The cells on the cervix can become cancerous. The change from normal cells to cancer cells takes time. Changes detected early can be treated before cancer develops. A Pap test is a way to look for changing or cancerous cells on the cervix.
Reasons for Test
A Pap test is often done as part of a pelvic exam. It is done to check cervical cells for changes ( cervical dysplasia]]> ) that could develop into cancer. It can also detect cancer cells.
The current recommendations are:
- If you are aged 21-29 years—have the Pap test every two years
- If you are aged 30 or older—have the Pap test every three years
- If you are aged 65 or older—You may be able to stop having Pap tests if you have had three normal results in a row and no abnormal results in the past 10 years.
- Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, like a suppressed immune system or a history of cervical dysplasia or cervical cancer. Talk to your doctor about the right screening schedule for you.
What to Expect
Prior to Test
- Do not schedule the Pap test during your menstrual period. If possible, schedule it two weeks after the first day of your period.
- Do not use vaginal creams, medicines, or douches for 72 hours before the test.
- Do not use contraceptives such as spermicidal foams, creams, or jellies for 72 hours before the test.
- Do not have sex for 24 hours before the test.
Tell your doctor if you:
- Are having your period
- Are pregnant
- Have had a previous Pap test showing abnormalities
- Have had any cervical procedures, like LEEP]]> .
- Are sexually active
- Have been exposed to ]]>HPV]]> or other sexually-transmitted diseases
- Have had abnormal vaginal discharges or vaginal infections
- Have had surgery, ]]>radiation treatment]]> , or ]]>chemotherapy]]>
- Are taking birth control pills , hormone pills, or using hormone cream
Description of Test
You will lie on your back on an examination table. You will place your feet in foot rests. The doctor will insert a speculum into your vagina. It will gently open your vagina. A fine brush or spatula will be used to wipe the walls of the cervix. The speculum will be removed. The cervical cells that stuck to the tools will be placed in a fluid-filled bottle. The cells will then be sent to a lab for testing.
You will be able to leave after the test is done. You may have a small amount of bloody discharge after the test.
How Long Will It Take?
The pelvic exam takes less than five minutes.
Will It Hurt?
A Pap test is generally painless. You may feel some pressure or a small cramp when the cervix is wiped to gather cells.
The results of your Pap test are sent to your doctor within 2-3 weeks. Your doctor will inform you of the results. If needed, she will talk to you about follow-up testing or treatment:
- If cells are normal, no treatment is needed. You will continue your regular pap test screens.
- If an infection is found, treatment will be prescribed.
- If abnormalities are found, further tests will be done. Once your doctor determines the cause, she will discuss treatment options with you. Further tests may include:
American Congress of Obstetricians and Gynecologists
The National Women's Health Information Center
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
American College of Obstetricians and Gynecologists. First cervical cancer screening delayed until age 21 less frequent Pap tests recommended. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/from_home/publications/press_releases/nr11-20-09.cfm . Published November 20, 2009. Accessed November 23, 2009.
College of American Pathologists. College of American Pathologists website. Available at: http://www.cap.org/apps/cap.portal . Accessed June 9, 2008.
Grady D. Guidelines push back age for cervical cancer tests. The New York Times website. Available at: http://www.nytimes.com/2009/11/20/health/20pap.html?_r=1 . Published November 20, 2009. Accessed November 23, 2009.
Pap smear. University of Iowa Department of Obstetrics and Gynecology website. Available at: http://obgyn.uihc.uiowa.edu/ . Updated 2004. Accessed June 9, 2008.
Last reviewed October 2009 by ]]>Ganson Purcell Jr., MD, FACOG, FACPE]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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