Pap Smears: Everything You Need To Know

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Every year, around 13,000 people in the US are diagnosed with cervical cancer, and 4,000 people die from it. Those are hard statistics, but that doesn’t mean you have to become one. Getting regular Pap smears can tip you off to changes in your cervix long before they become a problem. 

What is a Pap Smear/ Test & Why Is it Called a Pap?

Named after its inventor, Dr.Georgios Papanikolaou, a Pap smear, also referred to as a Pap test, checks if any cells in your cervix have been affected by Human Papillomavirus (HPV). With over 200 strain variations, HPV is the most common STI in the world: more than half of the population is infected with it, and around 30 strains have shown to eventually lead to cervical cancer if left untreated.

There’s lots of conflicting information about who needs to get Pap smears and how often. We are here with the latest information you need to maintain cervical health.

When to Start Getting Pap Smears & How Often

Most people need to start getting Pap smears by the time they are 21. HPV is a sexually transmitted disease--including via oral and anal sex, and possibly even kissing--so it’s time to start getting Pap smears once you have become sexually active.

Your doctor will let you know how often you need to get Pap smears. According to the latest US standards, most people need a test every 3-5 years, but your personal recommended frequency depends on several factors; age, lifestyle, and whether you smoke will influence your doctor’s recommendations, as will a weakened immune system or a history of irregular Pap results.

You can schedule a Pap smear with a family doctor or gynecologist, at a sexual health clinic, or Planned Parenthood. Schedule it at a time when you do not expect to be on your period.

Before the Pap Smear

There’s no special preparation you need before your appointment, but to avoid obscuring test results, avoid sex, and tampon use a day or two before. If you douche (which according to most doctors, you shouldn’t ever) avoid that before your appointment as well.

What to Expect During a Pap Smear 

A Pap smear is a very quick process. It only takes a few minutes, and should be painless.

While you lay down on an exam table with your feet in footrests, a doctor or nurse inserts a metal or plastic speculum into your vagina to widen the walls, allowing access to the cervix. They take a small brush or spatula and collect cells from the surface of the cervix with a gentle swabbing action. That’s it.

Some people experience slight discomfort from the speculum, or a scratching feeling from the swab, but if you’re healthy you shouldn’t be worried about pain. Slight bleeding after a Pap smear is common even if you’re in good health- most of the time, this is from the cervical scratch and should heal quickly. If you do spot afterwards, avoid putting anything in your vagina (such as a menstrual cup, menstrual disc, or tampon) to catch the bleeding. Your doctor can give you a pad or you can bring one.

Getting Your Pap Smear/Pap Test results

After you get a Pap smear, your doctor sends the sample cells to a lab for testing, where it will take anywhere from one to three weeks to get the results back. You usually call your doctor’s office to get results, or they will call you.

Your Pap smear will have one of three outcomes:

  1. Normal: the cells from your Pap smear look normal, and you don’t need to do anything until your next regularly scheduled test.
  1. Abnormal: the cells collected look abnormal. Do not panic: this does not mean you have cancer. Depending on what the cell changes looked like, your doctor will tell you what you need to do next. You may need to get another Pap smear immediately, or within six months. If the cell changes look more serious, your doctor may recommend you get other tests such as a colposcopy and biopsy.
  1. Unclear: your doctor was not able to determine from the test if the cells looked normal or abnormal. They may order another Pap smear for you immediately, or in 6 months to a year.

Abnormal and Unclear Pap Smear Results 

If your test results came back as anything other than normal, there could be a reason that has nothing to do with cancer.  Common factors affecting the results of a Pap Smear are:

-       A yeast infection or other inflammation

-       Benign (not cancerous) growths or cysts

-       Changes in hormones from pregnancy or menopause

-       Smoking

-       Immune system problems such as diabetes, HIV, or other autoimmune diseases

Your doctor will discuss with you what next steps you should take after an abnormal or unclear result.

Pap Smear Risks

As with any test scanning for disease and injury, there is a chance that a Pap Smear will not detect abnormalities that are there. Luckily, cervical cancer takes a relatively long time of 10 to 20 years to develop, so having regular tests increase your chances of finding irregular cells that may not have shown up on your last test.

There is also a small chance that your Pap smear can come back abnormal when there are no abnormal cells. This is why your doctor will recommend follow-ups to any abnormal results.

Pap Smears Are Not STD or STI Tests

Pap smears are only designed to detect cell changes that indicate cervical cancer. They are not an STD or STI test and cannot detect viruses or disease, including the HPV virus that causes cervical cancer, nor do they detect other cancers of the reproductive system, such as ovarian cancer.

Since STD/ STI tests often also involve vaginal swabs, it’s a great idea to get a Pap smear and STD/ STI test at the same time. You can also request an HPV test, which tests your cells for the presence of a couple high-risk strains of the HPV virus, but does not detect cancer[6] and is therefore not a replacement for Pap smears. Because HPV is so common and many strains clear up on their own within a couple years, these tests are far less common than Pap smears, and can only be performed on people with female genitals. Your doctor may recommend an HPV test as a follow-up if you have a Pap smear result that comes back unclear or abnormal. HPV tests can also be useful to let you know if you carry a high-risk strain, as your doctor may then recommend getting Pap smears more often.

Lower Your Chances of Cervical Cancer

To lower your chances of cervical cancer, you can do the following:

  • Practice safer oral and penetrative sex. This means using items such as dental dams and condoms and limiting consumption of substances that may impair judgment before sex. 
  • Stop douching. Douching removes the normal, healthy bacteria from your vagina that protect against infection, so avoiding it may also increase your protection against STDs+STIs. 
  • Talk to your doctor about the HPV vaccine that protects against several of the most deadly strains. Also known by the brand name Gardasil 9, this HPV vaccine is a series of 2-3 shots that protect against a number of strains known to cause most cases of cancer and genital warts.
  • Get regular Pap smears. Studies have shown that, when detected via regular Pap smears, people who have cervical cancer have a 92% cure rate, versus 66% in those who discovered their cancer via other symptoms. A large majority of the people who die from cervical cancer were not getting Pap smears in the recommended time frames.

There is no question about it: Pap Smears save lives.

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