Published on January 9, 2024
If a visit to the gynecologist has ever been a source of anxiety and uncertainty for you, you’re not alone. It can feel daunting to discuss some of the more intimate aspects of your body with someone you hardly know, and societal stigmas around the topic don’t help matters. But routine medical appointments and cancer screenings are crucial for achieving better outcomes for your health.
A Pap test, also known as a Pap smear, is something you’ve likely experienced at the gynecologist* if you have a cervix and are over the age of 21. It’s the screening for cervical cancer, and it (along with the human papillomavirus, or HPV, vaccine) has made cervical cancer one of the most preventable cancers.
Whether you know what’s going on beyond the stirrups during a Pap test or not, you should always feel empowered to ask questions for a little peace of mind:
1. What happens during a Pap test? Does it hurt?
During a Pap test, cells are collected from your cervix—a small canal that connects your uterus and vagina. A speculum is used to open your vagina so your health care provider can see your cervix and remove cells with a brush or other sampling tool. The cells are then sent to a lab for testing to see if abnormal cells are present.
While it may not be the most enjoyable experience, a Pap test should not hurt. You may experience slight discomfort and should notify the health care provider performing the test if you are feeling any pain or cramping so they can help you feel more comfortable. You may have some slight bleeding following the test. Feel free to ask your health care provider to walk you through the test as they do it, and don’t forget to breathe slowly and deeply, and try to relax the muscles in your body as best you can. A Pap test generally lasts a few minutes.
2. What do my test results mean?
If your Pap test results come back normal, it means that there were no cervical cell changes and you should continue screening as recommended (either every 3 or 5 years, depending on whether you had a high-risk HPV test along with your Pap test—called co-testing—which you can learn more about in question 5). You should still visit your health care provider annually for a routine exam to check for other gynecologic issues.
If your results come back abnormal, that does not mean you have cervical cancer. In fact, many people with a cervix have abnormal cervical cancer screening results that often can be related to HPV. While cell changes often go back to normal on their own, additional testing will be needed to determine whether cancer is present. Follow-up tests could also indicate high-grade changes, which may lead to treatment to remove the abnormal cells before they become cancerous, thereby preventing the development of cancer. Follow the recommendations of your health care provider when discussing your test results. The timeframe you can expect to receive results ranges from a few days to 1-2 weeks, depending on the lab.
Test results can also be unsatisfactory, which means that there might not be enough cells detected or they may be clumped together. If this happens, you may need to return for additional testing in a few months. Be sure to follow the recommendations of your health care provider.
3. Can I be on my period the day I’m getting a Pap test?
While you can get a Pap test during your period, the American College of Obstetricians and Gynecology recommends that you schedule your Pap for when you are not on your period. Being on your period won’t change the way a Pap test is done, but it can lead to a false-negative result—as the presence of blood in a Pap smear could conceal abnormal cells.
If you are on your period and unable to reschedule your appointment for a time in the near future, talk to your health care provider. At the end of the day, the best cancer screening is the one that gets done, and your health care provider can help you navigate to the best decision.
4. Am I supposed to be getting a Pap test every year?
If you are of average risk for cervical cancer and between the ages of 21-29, it is recommended that you have a Pap test every 3 years. If you’re between the ages of 30-65, you have options: You can have a Pap test alone every 3 years, a high-risk HPV test (discussed below) alone every 5 years or a high-risk HPV test with a Pap test—also known as co-testing—every 5 years.
If you’re over the age of 65, discuss with your health care provider about whether you still need to be screened.
If you’re considered at increased risk for cervical cancer or results from your Pap test come back abnormal, you may need to be screened more often. Always follow the recommendations of your health care provider.
5. Are there other screening options besides a Pap test?
The HPV test is another way to screen for cervical cancer and as discussed above, can be used either alone or in combination with a Pap test. According to the Centers for Disease Control and Prevention, more than 9 of every 10 cases of cervical cancer are caused by HPV.
The procedure is the same as a Pap test—the difference lies in what the sample of cells is tested for in the lab. If an HPV test is performed, the sample will be tested for the most common high-risk HPV types as opposed to a Pap test sample, which tests for abnormal cells.
The HPV test is an option for people with a cervix between the ages of 30-65 every five years. Alternatively, this age group can opt for a Pap test and an HPV test (known as co-testing) every 5 years. The HPV test is not recommended for people with a cervix between the ages of 21-29 because of how common HPV is among this age group. The infections usually go away on their own within a few years and do not cause any lasting changes in cervical cells.
*If you see a primary health care provider or another health care provider for your routine OB-GYN exam, these questions still apply.
Source: American College of Obstetricians and Gynecology
January is Cervical Cancer Awareness Month. Visit preventcancer.org/cervical for more information about cervical cancer, screening options and more.