What is a Pap Test? When do I need one?

What is a Pap test? — A Pap test (sometimes called a "Pap smear") is a test that doctors use to check the cervix for early signs of cancer. The cervix is the part of a woman’s body where the uterus and the vagina meet. It is the bottom part of the uterus.

To do a Pap test, your doctor or nurse will push apart the walls of your vagina using a device that looks like a duck beak (called a speculum). Then, he or she will use a small tool to collect cells from your cervix. The staff at a lab will look at those cells under a microscope to see if they are abnormal.

Do not assume that you are having a Pap test every time the doctor or nurse uses a speculum. That device—the one that looks like a duck beak—is used for other reasons, too. If the doctor or nurses uses a speculum, ask whether you are being checked for cervical cancer.

Pap tests can find cancer cells or cells that could turn into cancer, called "precancer." The test can usually find cancer in the early stages, when it can be treated or even cured.

When should a woman start having Pap tests? — Women should start having Pap tests when they turn 21. They do not need to be sexually active before they start getting Pap tests. When they turn 30, their doctors might also suggest doing another test to check for cervical cancer, called an HPV test.

What should I do to prepare for a Pap test? — You do not need to do anything special to prepare for a Pap test. Women sometimes hear that they should not have sex or put anything in their vagina for 2 days before a Pap test, but it turns out that recommendation is not necessary. Pap tests work fine even in women who have had sex recently or who have used vaginal lubricants or creams.

Do not worry if you have your period on the day of the test. The test can still be done even if you are bleeding. If your bleeding is very heavy, you might want to call your doctor or nurse to see if you need to reschedule.

How often should a woman have a Pap test? — That depends on how old she is and what the results of her past Pap tests have been (table 1).

●Women age 21 to 29 should have a Pap test every 3 years.

●Women age 30 and older can have a Pap test every 3 years or a Pap test and HPV test every 5 years.

●Women age 65 and older should stop having Pap tests if they meet all 3 of these requirements:

•They had Pap tests done regularly until they turned 65.

•They had 3 normal Pap tests in a row.

•They had no abnormal Pap tests in the past 10 years.

Do I need to get Pap tests if I had a hysterectomy? — If you had surgery called a "hysterectomy" to remove your uterus, ask your doctor if you need to keep having Pap tests. If you no longer have a cervix, and if you did not have cervical cancer before your hysterectomy, you most likely do not need to have Pap testing after surgery.

Do I need to get Pap tests if I had the HPV vaccine? — Yes. You still need to get Pap tests if you got the HPV vaccine. HPV stands for "human papillomavirus." It is the virus that causes cervical cancer. Getting the HPV vaccine reduces your chances of getting cervical cancer. But it does not completely protect you. You still need to be checked for cancer.

What if I have an abnormal Pap test? — First, you should know that abnormal Pap tests are common. They are just an initial test, and most women with an abnormal Pap test do not have cancer. If your Pap test has cells that look "abnormal," your doctor or nurse can follow up with another test to find out for sure what is going on.

Depending on your age and the result of your Pap test, your doctor or nurse might order an HPV test done on the sample that he or she collected for the Pap test. The HPV test checks for infection with a type of HPV virus that can cause cancer.

Your doctor might also suggest that you have another follow-up Pap test or a test called a colposcopy. These are explained below:

●Another Pap test at 6 to 12 months – Sometimes a Pap test shows cells that could be either normal or abnormal. If you wait a few months and have another Pap test, you could find that the cells are back to normal. You might also need an HPV test at the same time.

●A colposcopy – For this test, the doctor or nurse looks at your cervix using a device that looks like a microscope. It allows the doctor or nurse to see the cervix in fine detail. During this test, the doctor or nurse might also take tiny samples of tissue from the cervix. This is called a "biopsy." Tissue from the biopsy can go to the lab and be checked for anything abnormal.

If it turns out that you have cervical cancer or precancer, there are effective treatments available. If your condition was found early, there is a good chance you can be cured.

SOURCE: UpToDate Website