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Pap Test

What is a Pap test?
How is the Pap test done?
Who should have a Pap test and how often?
When can I stop having Pap tests?
What happens if a Pap test result is abnormal?
Is the Pap test result always accurate?

What is a Pap test?

  • Sometimes called a Pap smear or cervical cytology screening, is a simple test that can detect abnormal cervical cells
    • It is not the same as a pelvic exam
      • The Pap test allows early diagnosis and treatment of abnormal cells
      • Routine Pap tests help decrease the chance that abnormal cells are missed
      • If a Pap test misses abnormal cells this time, they may be found on your test

How is the Pap test done?

  • A Pap test is simple and fast
  • It takes less than a minute to do
    • With the woman lying on an exam table, a speculum is used to open the vagina
    • This device gives a clear view of the cervix and upper vagina
    • A small number of cells are removed from the cervix with a brush or other tool
    • The cells are put into a liquid and sent to a lab where they are placed on a glass slide
      • Sometimes, the cell sample is directly placed on a glass slide before it is sent to the lab
    • At the lab, the sample is examined using a microscope to see if abnormal cells are present
    • Many labs use a computer to examine the samples

Who should have a Pap test and how often?

  • You should start having Pap tests at age 21 years
  • How often you should have a Pap test depends on your age and health history:
    • Women younger than 30 years should have a Pap test every 2 years
    • Women aged 30 years and older should have a Pap test every 2 years
      • After three normal test results in a row, this age group may have Pap tests every 3 years if:
        • She does not have a history of moderate or severe dysplasia
        • She is not infected with human immunodeficiency virus (HIV)
        • Her immune system is not weakened
          • For example, if she has had an organ transplant
        • Was not exposed to diethylstilbestrol (DES) before birth

When can I stop having Pap tests?

  • It is not clear when a woman can stop having Pap tests
    • Some experts recommend that a woman who is aged 65 years or 70 years can stop having Pap tests after three normal results in a row within the past 10 years.
      • If you have certain risk factors, you should continue to have routine Pap tests
        • Risk factors include being sexually active and having had multiple partners or a previous history of abnormal Pap test results

What happens if a Pap test result is abnormal?

  • Additional testing after an abnormal Pap test result
    • A repeat Pap test in 6 months or 12 months, a test for human papillomavirus, or a more detailed examination called a colposcopy may be done
      • If results of follow-up tests indicate precancerous changes, you may need treatment to remove the abnormal cells

Is the Pap test result always accurate?

  • As with any lab test, Pap test results are not always accurate
    • Sometimes, the results show abnormal cells when the cells are normal
      • This is called a “false-positive” result
    • A Pap test may not detect abnormal cells when they are present
      • This is called a “false-negative” result
      • Many factors can cause false results:
        • The sample may contain too few cells
        • There may not be enough abnormal cells to study
        • An infection or blood may hide abnormal cells
        • Douching or vaginal medications may wash away or dilute abnormal cells
      • Your health care provider may suggest a repeat Pap test to check the results
        • A repeat test increases the likelihood that abnormal cells, if present, will be detected

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