What Is Pap Smear & How Often I Need One?
The Pap test, sometimes called a Pap smear, is a very important test for finding abnormal cells on your cervix that could lead to cervical cancer. Pap tests find cell changes caused by HPV, but they don’t detect HPV itself.
Pap tests may be part of your regular check-up, pelvic exam or well-woman exam. During a Pap test, your doctor or nurse puts a metal or plastic speculum into your vagina. The speculum opens up to separate the walls of your vagina so that they can get to your cervix. Then they use a small sampler — a tiny spatula or brush — to gently collect cells from your cervix. Finally, the cells are sent to a lab to be tested.
Pap tests only take a few minutes. They shouldn’t hurt, but you might feel some discomfort or pressure when your doctor or nurse opens the speculum inside you. You might also feel a light scratching when they take cells from your cervix.
What’s the difference between a pelvic exam and a Pap test?
During a pelvic exam, your healthcare provider examines and feels (palpates) your uterus, ovaries and other parts of the female reproductive system. This examination helps your provider identify infections, problems and cancer if visible. Your provider may also perform STD tests during a pelvic exam. A pelvic exam doesn’t always include a Pap smear.
What’s the difference between a Pap smear and an HPV test?
HPV tests check for certain types of the virus that increase your cervical cancer risk. HPV is a common STD that affects approximately 79 million Americans. There are many different types of HPV. Not all cause cancer.
Providers can do HPV and Pap tests simultaneously, using the same steps (a gentle scrape of your cervix for cell samples). When sending these samples to a lab, your provider specifies whether the lab specialist (pathologist) should check for precancerous or cancerous cells (Pap smear), HPV or both (a co-test).
Does a Pap smear detect STDs?
A Pap smear can’t detect STDs. To test for chlamydia or gonorrhea, your healthcare provider takes a swab from your cervix. Blood tests can also identify certain STDs.
How much is a Pap smear?
The cost of a Pap smear varies but not too much. All in all, the pap smear price should be less than $100 with insurance in the United States. If you’re paying out of pocket, expect the costs to range from $25 to $150. And don’t forget there may be medical facilities in your area that offer Pap smears at a lower cost or at no cost.
Do I need a Pap test?
How often you get tested depends on your age, medical history, and the results of your last Pap or HPV tests. In general:
- If you’re 21–24 years old: you can choose to get a Pap test every 2 years.
- If you’re 25–65 years old: get an HPV test yearly.
- If you’re older than 65: you may not need HPV/Pap tests anymore, but it’s good to get it every 2 years.
You may need to get tested more often if you’ve had problems with your cervix before, have a weak immune system, or if your mother took a medicine called DES while she was pregnant with you. On the other hand, your pap smear age may be totally irrelevant. Your doctor or nurse will tell you which tests you need and how often you should get them.
What if I have an abnormal Pap test?
If your Pap smear results are abnormal, don’t panic. It’s pretty common to have unclear or abnormal Pap test results. Most of the time, it doesn’t mean you have cervical cancer.
- An unclear test result means that your cervical cells look like they could be abnormal. But it isn’t clear if it’s related to HPV or something else. Unclear results are also called equivocal, inconclusive, or ASC-US.
- An abnormal Pap test result means that there are abnormal cell changes on your cervix. This doesn’t mean that you have cervical cancer. The changes may be minor (low-grade) or serious (high-grade). The more severe changes are often called precancerous because they aren’t cancer yet but can turn into it over time.
If you have an unclear or abnormal Pap test result, you made need further tests and/or treatment, including:
- Another Pap test
- An HPV test: a test that looks for high-risk types of the virus that can cause precancerous cells
- A colposcopy: a special exam to look more closely at your cervix to see if there are precancerous cells.
You’ll probably need treatment if your doctor finds abnormal cells during your colposcopy. Common treatments include cryotherapy and LEEP.
Suppose you’re pregnant and test positive for a bacterial infection. In that case, your doctor will prescribe pregnancy-safe antibiotics for you and possibly your partner — because if you give birth with an untreated infection, your baby is at risk of dangerous infections, too, including pneumonia.
