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
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.
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
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
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
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
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. For more information about abnormal Pap test
results, see the topic
Abnormal Pap Test.
Pap test results may be affected
Other Works ConsultedAmerican 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.
December 12, 2012
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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