What is a Pap test?
Why do I need a Pap test?
Do all women need Pap tests?
My friend had a hysterectomy - does she still need a
Pap test?
How often do I need to get a Pap test?
Is there anything special I need to do before going for
a Pap test?
How is a Pap test done?
What happens after the Pap test is done?
What do abnormal Pap test results mean?
What will happen if my Pap test finds something that
is not normal?
My health care provider told me my Pap test result was
a false positive. What does this mean?
Is there anything new or being developed to improve
the accuracy of Pap tests?
Do sexually transmitted diseases (STDs) cause cancer
of the cervix?
What increases a woman's risk for cancer of the
cervix?See also…
The Pap test (also called a Pap smear) checks for changes in the
cells of your cervix. The
cervix
is the lower part of the uterus (womb) that opens into the vagina
(birth canal). The Pap test can tell if you have an infection,
abnormal (unhealthy) cells, or cancer.
Image Source: U.S. Food and Drug Administration
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A Pap test can save your life. It can find cancer of the cervix -
a common cancer in women - before it moves to other parts of your
body (becomes invasive). If caught early, treatment for cancer of
the cervix can be easier and the chances of curing it are far
greater. Pap tests can also pick up infections and inflammation, and
abnormal cells that can change into cancer cells.
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It is important for all women to make pap tests, along with
pelvic exams, a part of their routine health care. You need to have
a Pap test if you are over 18 years old. If you are under 18 years
old and are or have been sexually active, you also need a Pap test.
There is no age limit for the Pap test. Even women who have gone
through menopause (the change of life, or when a woman's periods
stop) need to get Pap tests.
Women who are living with
HIV,
the virus that causes AIDS, are more at risk for developing cancer
of the cervix and other cervical diseases. The U.S. Centers for
Disease Control and Prevention recommends that HIV positive women
have an initial Pap test, and then another one 6 months later. If
both of these Pap tests show no cancer or other problems, then a Pap
test can be done only once a year.
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Women who have had a
hysterectomy (surgery to remove the uterus) should talk
with their health care provider about whether they need to continue
having routine Pap tests. If the hysterectomy was done because a
woman had cancer or a precancerous condition, the end of the vagina
still needs to be tested for abnormal changes. Women who have had
both their uterus and cervix removed may not need routine Pap tests.
Women who have had only the uterus removed (and still have their
cervix) need regular Pap tests. It is important for all women who
have had a hysterectomy to have regular pelvic exams.
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Many health care providers tell women to get a Pap test every
year. But, your health care provider may recommend a Pap test every
1 to 3 years after you have had 3 normal Pap tests for 3 years in a
row. Talk with your health care provider about what is best for you.
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For two days before the test, you should not douche or use
vaginal creams, suppositories, foams or vaginal medications (like
for a yeast infection). It is also best to not use any vaginal
deodorant sprays or powders for two days before your test. And, do
not have sexual intercourse within 24 hours of your test. All of
these can cause inaccurate test results by washing away or hiding
abnormal cells. You should not have a Pap test when you have your
period. The best time to have one is between 10 and 20 days after
the first day of your last period.
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Your health care provider can do a Pap test during a pelvic exam.
It is a quick test that takes only a few minutes. You will be asked
to lie down on an exam table and put your feet in holders called
stirrups, letting your knees fall to the side. A sheet will cover
your legs and stomach. The health care provider will put an
instrument called a speculum into your vagina, opening it to see the
cervix and to do the Pap test. She or he will use a special stick,
brush or swab to take a few cells from inside and around the cervix.
The cells are placed on a small glass slide, then checked by a lab
to make sure they are healthy. While painless for most women, a Pap
test can cause discomfort for some women.
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If the cells are okay, no treatment is needed. If an infection is
present, treatment is prescribed. If the cells look abnormal, or not
healthy, more tests may be needed. A Pap test is not 100% right all
the time, so it is always important to talk to your health care
provider about your results.
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A health care provider may tell you that your Pap test result was
"abnormal." Cells from the cervix can sometimes look abnormal but
this does not mean you have cancer. Remember, abnormal conditions do
not always turn into cancer. And, some conditions are more likely
than are others to turn into cancer. If you have abnormal results,
be sure to talk with your health care provider to find out what they
mean and what you need to do (if anything) about it.
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If the Pap test shows something confusing or a minor change in
the cells of the cervix, the test may be done again. If the test
shows a major change in the cells of the cervix, the health care
provider may perform a
colposcopy. This is a procedure done in an office or
clinic with an instrument (called a colposcope) that acts like a
microscope, allowing the health care provider to closely see the
vagina and the cervix. Your health care provider may also take a
small amount of tissue from the cervix (called a
biopsy)
to examine for any abnormal cells, which can be a sign of cancer.
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Is there such a thing as a false negative Pap test result? Pap
tests are not always 100 percent accurate. False positive and false
negative results can happen. This can upset and confuse a woman.
Knowing what these types of results mean can help a woman to better
protect her health.
A false positive Pap test happens when a woman is told she has
abnormal cells (on and around her cervix), but the cells are in fact
normal. A false positive result means that there is no problem. A
false negative Pap test happens when a woman is told her cells are
normal, but in fact, there is a change in the normal, healthy cells.
This means there may be a problem and there may be a need for more
tests. There are many things that can interfere with accurate Pap
test results. This is why women need to be sure to get regular Pap
tests. Having regular Pap tests increases a woman's chances that any
problems will be picked up over time.
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While the standard Pap test is very good at detecting problems,
new methods are being developed to improve the accuracy of Pap
tests. The Food and Drug Administration (FDA) has approved several
new methods to help reduce false negative Pap test results. One is
called the Thin-Prep Pap test, where cervical cells are placed in a
different way on the microscope slide than with the standard Pap
test. This may make it easier to detect abnormal cells. Other
methods use computers to scan the cervical cells to look for
abnormal cells. Two computer "rescreening" methods have been
approved by the FDA - PAPNET and the AutoPap 300 QC.
These new methods cost more than the standard Pap test and are not
covered by all health insurance. Research is being done to find out
if they are in fact more accurate than the standard Pap test.
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One type of STD, called HPV, or the humanpapilloma virus,
has been linked to cancer of the cervix. HPV can cause wart-like
growths on the genitals. When it is not treated or happens
frequently, HPV can increase a woman's chances of developing cancer
of the cervix. HPV is a very common STD, especially in younger women
and women with more than one sexual partner.
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Any woman can get cancer of the cervix. But, the chances of
getting cancer of the cervix increase when a woman:
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Starts having sex before age 18.
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Has many sexual partners.
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Has sexual partners who have other sexual
partners.
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Has or has had humanpapilloma virus (HPV) or
genital warts.
-
Has or has had a sexually transmitted disease
(STD).
-
Is over the age of 60.
-
Smokes.
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For more information . . .
You can find out more about Pap tests by contacting the National
Women's Health Information Center (NWHIC) at 1-800-994-9662 or the
following organizations:
Cancer Information Service, NCI, NIH, HHS
Phone Number(s): (800) 422-6237
Internet Address: http://cis.nci.nih.gov/
American College of Obstetricians and Gynecologists (ACOG)
Resource Center
Phone Number(s): (800) 762-2264 x 192 (for publications requests
only)
Internet Address: http://www.acog.org/
National Cervical Cancer Coalition (NCCC)
Phone Number(s): (800) 685-5531
Internet Address:
http://www.nccc-online.org/
All material contained in the FAQs is free of copyright
restrictions, and may be copied, reproduced, or duplicated without
permission of the Office on Women's Health in the Department of
Health and Human Services; citation of the sources is appreciated.
