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A Pap test is done to look for changes in the cells of the cervix. During a Pap test, a small sample of cells from the surface of the cervix is collected by your doctor. The sample is then spread on a slide (Pap smear) or mixed in a liquid fixative (liquid-based cytology) and sent to a lab for examination under a microscope. The cells are examined for abnormalities that may point to abnormal cell changes, such as dysplasia or cervical cancer.
The recommended Pap test schedule is based on your age and on things that increase your risk. Talk to your doctor about how often to have this test.
A high-risk type of the human papillomavirus (HPV) is the cause of most cases of cervical cancer. In women older than 30, an HPV test may be done at the same time as a Pap test. If you are age 26 or younger, you can get the HPV shot to prevent infection with the types of HPV that are most likely to cause cervical cancer.
If your Pap test shows an abnormal result, see the topic Abnormal Pap Test.
A Pap test is done to look for changes in the cells of the cervix. Finding these changes and treating them when needed will greatly lower your chance of getting cervical cancer.
Before a Pap test:
At the beginning of your visit, tell your doctor:
If you have had problems with pelvic exams in the past or have experienced rape or sexual abuse, talk to your doctor about your concerns or fears before the exam.
No other special preparations are needed before having a Pap test. For your own comfort, you may want to empty your bladder before the exam.
Tell your doctor whether you have had an abnormal Pap test in the past.
Talk to your doctor about any concerns you have about the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).
You will need to take off your clothes below the waist and drape a paper or cloth covering around your waist. You will then lie on your back on an examination table with your feet raised and supported by footrests. This allows the doctor to examine your external genital area, vagina, and cervix. You may want to wear socks to keep your feet warm while they are in the footrests.
The doctor will insert a lubricated speculum into your vagina. The speculum gently spreads apart the vaginal walls, allowing the inside of the vagina and the cervix to be examined.
Your doctor will collect several samples of cells from your cervix using a cotton swab, brush (cytobrush or cervix brush), or a small spatula. Cells are collected from the visible part of the cervix as well as from its opening (endocervical canal). In women who do not have a cervix, cells from the vagina are collected if a Pap test is needed. The cells are smeared on a slide or mixed in a liquid fixative and sent to a lab for examination under a microscope.
You will feel more comfortable during your Pap test if you and the doctor are relaxed. Breathing deeply and having a light conversation with your doctor may help you relax. Holding your breath or tensing your muscles will increase your discomfort.
You may feel some discomfort when the speculum is inserted, especially if your vagina is irritated, tender, or narrow. You may also feel pulling or pressure when the sample of cervical cells is being collected.
There is very little chance of a problem from having a Pap test. You may have a small amount of vaginal bleeding after this test. And you may want to use a pad or panty liner to protect your clothes from any spotting.
A Pap test is done to look for changes in the cells of the cervix. Results are usually available in 1 to 2 weeks. Ask your doctor when you can expect the results.
In the United States, the Bethesda system (TBS) is the most widely used system for reporting Pap test results. It provides information about the quality of the cell sample and the types of cell changes found.
The sample contained enough cells and no abnormal cells were found.
The sample did not contain enough cells, or abnormal cells were found. To learn more about abnormal Pap test results, see the topic Abnormal Pap Test.
Pap test results may be affected by:
Other Works Consulted
- American College of Obstetricians and Gynecologists (2012). Screening for cervical cancer. ACOG Practice Bulletin No. 131. Obstetrics and Gynecology, 120(5): 1222–1238.
- Centers for Disease Control and Prevention (2012). Genital HPV infection. Available online: http://www.cdc.gov/std/HPV/STDFact-HPV.htm.
- Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Runowicz CD (2011). Cervical cancer prevention and screening. In EG Nabel, ed., ACP Medicine, section 18, chap. 19. Hamilton, ON: BC Decker.
- U.S. Preventive Services Task Force (2012). Screening for cervical cancer: Summary of recommendations. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspscerv.htm.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Kirtly Jones, MD - Obstetrics and Gynecology|
|Last Revised||December 12, 2012|
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