Pap Smear

A Pap smear, or Pap test, is a screening test for cervical cancer. It's part of routine preventive care for anyone with a cervix.

In the last few years, improvements in Pap tests have led to changes in the guidelines for performing them. If you're between the ages of 21 and 65, UPMC now recommends you get a Pap smear every three to five years. But your doctor may suggest a different timeline based on your personal health needs.

Although yearly Pap smears are no longer recommended, it's still important to schedule a well-woman exam with your doctor or 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.

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 under a microscope.

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

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

At 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 three to five 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 five years.

Or, you can have:

• Pap smear alone every three to five years.
• HPV testing alone every five 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.

Why Would I Need a Pap Smear?

Pap smears can catch cervical cancer early, often even before it starts. This cancer develops slowly, and is most often caused by HPV.

If you have a cervix, a Pap smear is an important part of regular preventive care.

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 five 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 your provider 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 four 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.
• Unsatisfactory — The sample your doctor collected may not have had enough cells to examine. You may need another Pap smear.

By UPMC Editorial Staff. Last reviewed on 2024-09-05.