Pap Smears: Screening for Cervical Cancer and What to Expect

A Pap smear, or Pap test, is a screening test for cervical cancer. It can catch cancer early, often even before it starts.

Pap smears are part of routine preventive care for anyone with a cervix.

In the last few years, evolving efficacy of Pap tests has led to changes in the guidelines for performing them. UPMC's recommendation is every 3 to 5 years between the ages of 21 and 65. But your doctor may suggest a different timeline.

Although yearly Pap smears are no longer recommended, it is still important to schedule an annual gynecological wellness exam with your ob-gyn.

What Is a Pap Smear?

A Pap smear test is a way to look for cells in your cervix that may be cancerous or pre-cancerous. Anyone with a cervix is at risk for getting cervical cancer. HPV is the most common cause.

A Pap smear may also help find other conditions, such as infections or inflammation.

Your doctor or health care provider collects these cells from your cervix and sends them to a lab to look at.

For the most part, doctors do Pap smears as part of a pelvic exam. (Though not all pelvic exams include a Pap test.)

When Pap smears happen along with HPV testing, we call this co-testing. HPV is the leading cause of cervical cancer.

What age should I get a Pap smear?

The American College of Obstetricians and Gynecologists (ACOG) says you should start having cervical cancer screenings at age 21.

How often should I get a Pap smear?

You should have both Pap smears and HPV tests regularly. Doctors often do them at the same time.

Between the ages of 21 and 29, you should have a Pap test every 3 to 5 years. For this age group, ACOG doesn't recommend co-testing, just a Pap test alone.

Between the ages of 30 and 65, you can have a co-test every 5 years.

Or, you can have:

Pap smear alone every 3 to 5 years.
HPV testing alone every 5 years.

If you have risk factors, or you have an abnormal Pap result, your doctor may advise more frequent screening. If you have questions about your coverage, we recommend you talk to your insurance provider.

What to Expect Before, During, and After a Pap Smear

Before a Pap smear

You should avoid having a Pap smear while you're on your period. If you can, schedule the test at least 5 days after the last day of your period.

Your doctor may give you guidelines for what to avoid before your test.

During a Pap smear

A Pap smear usually happens during a pelvic exam.

You'll lie down on a special exam table that has stirrups for your feet.

Your doctor will:

Insert a Pap smear tool (speculum) into your vagina. This non-sharp metal or plastic device widens your vagina walls so they can see your cervix.
Swab cells from your cervix and send them to a lab.
Do a pelvic exam at this time too, if you need one.

During a Pap smear, it's common for a nurse or medical assistant to be in the room with the doctor. If a nurse or chaperone isn't present, you can ask for one.

You can also ask that no one else be in the room.

Or, you can ask for your friend, partner, or family member to be in the room with you.

Does a Pap smear hurt?

You may feel mild discomfort when the doctor inserts the speculum and swabs your cervix, but it shouldn't be painful.

Let them know if you feel pain.

After a Pap smear

Depending on the lab, you'll get the results of your Pap smear within hours or days.

There are 3 possible results:

Normal. This means the lab found no abnormal cervical cells.
Unclear. This means the lab couldn't decide if the cells were abnormal or normal. There may not have been enough cells or mucus was hiding them. Your doctor may ask you to come back for a retest.
Abnormal. This means the lab found abnormal cervical cells. It doesn't mean you have cancer. Minor changes often return to normal on their own, but your provider may advise a follow-up test.

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