What is a Pap smear test?
A Pap smear (also called a Pap test) screens for cervical cancer. The test checks for abnormal cells in the cervix that are cancerous or have the potential to become cancerous. During a Pap smear, your healthcare provider takes cells from your cervix to examine under a microscope for signs of cancer. A Pap smear may also detect certain infections and inflammation. The test is named for an American physician, Dr. George Papanicolaou, who developed the Pap smear.
What is the cervix?
The cervix is the lower part of your uterus that connects to your vagin*l canal. Sperm travels through your vagin*l canal and cervix to your uterus to fertilize eggs. During pregnancy, your cervix closes to keep the fetus in your uterus. The cervix opens during childbirth. When you aren’t pregnant, your cervix makes mucus to keep infection-causing bacteria out of your body.
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What can a Pap smear detect?
Healthcare providers perform Pap smears as part of a pelvic exam. The test checks for:
- Cervical cancer.
- Potentially precancerous cells in the cervix (cervical intraepithelial neoplasia).
- Human papillomavirus (HPV), a common sexually transmitted infection (STI) that increases the risk of cervical cancer.
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 STI tests during a pelvic exam. A pelvic exam doesn't always include a Pap smear.
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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 STI that affects approximately 79 million Americans. There are many different types of HPV. Not all cause cancer.
Providers can do HPV tests and Pap tests at the same time, 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 STIs?
A Pap smear can’t detect STIs. To test for infections like chlamydia or gonorrhea, your healthcare provider takes a swab from your cervix. Blood tests can also identify certain STIs.
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Who needs a Pap smear?
Women and anyone assigned female at birth should start getting Pap smears starting at age 21 and HPV tests at age 30.
How often do you need a Pap smear?
How often you’ll have the test depends on many factors, including your age, health history and results from your last Pap or HPV test. Most people don’t need Pap smears after age 65.
Generally, Pap smears occur:
| Age | Pap smear frequency |
|---|---|
| Younger than 21 | Not necessary. |
| 21 to 29 years old | Every three years. |
| 30 to 65 years old | Every three years with a Pap test alone or every five years with a Pap/HPV co-test. |
| Older than 65 | Not necessary if you’ve had adequate prior screenings, with normal results and are not at high risk for cervical cancer. |
| Age | |
| Younger than 21 | |
| Pap smear frequency | |
| Not necessary. | |
| 21 to 29 years old | |
| Pap smear frequency | |
| Every three years. | |
| 30 to 65 years old | |
| Pap smear frequency | |
| Every three years with a Pap test alone or every five years with a Pap/HPV co-test. | |
| Older than 65 | |
| Pap smear frequency | |
| Not necessary if you’ve had adequate prior screenings, with normal results and are not at high risk for cervical cancer. |
Certain factors may cause you to have more frequent screenings or screening past age 65. Some of these are:
- Having human immunodeficiency virus (HIV) or being immunocompromised from another condition or treatment like chemotherapy.
- Exposure to diethylstilbestrol (DES) while in your mother’s uterus. This medication can increase your risk of cervical cancer.
- Having been treated for cervical cancer.
If you’ve had a total hysterectomy (cervix and uterus removed) and do not have a history of cervical cancer, you may not need a Pap test.
Do I need a Pap smear if I've had a hysterectomy?
A total hysterectomy is a surgical procedure to remove your uterus and cervix. You may still be at risk for cervical cancer, so talk to your healthcare provider to make sure you can stop having regular Pap tests.
If you had a complete hysterectomy to treat a noncancerous problem, such as uterine fibroids, you probably won’t need Pap smears.
