Why and When Do You Need a Pap Test?

Why and When Do You Need a Pap Test?
Amir Marashi OB-GYN (Obstetrician-Gynecologist) Brooklyn, NY

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A Pap test is a very common screening that collects a small sample of cells from the cervix, which is the opening to the uterus. The entire reason for a Pap test is to analyze these cells and to check for any abnormalities that could cause cervical cancer. The test checks for any cancerous or precancerous changes, which are generally caused by the human papillomavirus (HPV). When cervical cancer is detected early, treatment is normally very quick and effective, and cervical cancer can be cured. It’s a highly efficient test that can also detect abnormalities and infections in the endometrium and endocervix.

Who Needs to Have a Pap Test?

It’s recommended that women begin having regular Pap tests at age 21 until age 65. Usually, pap tests are necessary every three years. Women aged between 30 and 65 and who have had normal Pap tests, combined with a negative test for the human papillomavirus, may only need a pap test every five years.

Although pap tests are extremely effective, lots of women are at a very low risk for developing cervical cancer. It’s rare for women to develop cervical cancer before age 21, even if they have been sexually active for several years. Sometimes abnormal cells discovered in younger women will become normal again and without the need for treatment. Cervical cancer is also rarely detected in women over age 69. Women whose cervix has been removed when they had a hysterectomy may not find the test useful, unless they had a hysterectomy because of cancerous or precancerous cells in the cervix.

What Is the Procedure for Having a Pap Test?

The procedure for having a Pap test is very straightforward and can be done during your regular pelvic exam. Your gynecologist uses a speculum, which is a device to widen the opening of your vagina, so they can visually examine your cervix. A tiny brush and plastic spatula collects a sample of cells, which are then placed in a solution and sent to a lab for testing. There is no need to worry when you have a Pap test because it's very quick. 

What Happens Next?

It usually takes the lab at least two weeks to analyze the cells. You may not hear anything from your doctor’s office unless there is a problem. Otherwise, you can always contact your doctor to find out the results. If the results are normal, you can forget about having another Pap test for another three years!

What If the Results Are Abnormal or Unsatisfactory and You Need Another Pap Test?

If the results are abnormal, the first thing to do is not panic! Your doctor can tell you if a repeat Pap test is needed and if any other tests are required. An abnormal result doesn’t necessarily mean any cancer cells were detected. Sometimes not enough cells may have been collected for a thorough examination, and there are many other reasons why a Pap test may return an abnormal result. Other possibilities include inflammation or infection, and menopausal women may need to take estrogen before repeating the test because it can influence the results. Quite often, a gynecologist will recommend a colposcopy if you have an abnormal smear or if they think your cervix looked abnormal during your pelvic exam.

What Is a Colposcopy?

A colposcopy is a procedure where a large microscope is used to view the cervix more clearly. It’s a very simple and quick procedure that is painless. The microscope helps the gynecologist identify any areas requiring further examination more clearly and to see if more treatment is needed. If necessary, your gynecologist can take a small biopsy from the cervix, which is a tiny sample of tissue that can be analyzed more closely. Some types of biopsies, for example, a cone biopsy can actually treat the problem, removing the abnormal tissue entirely.

Reducing Your Risk of Cervical Cancer

The most effective form of protection against developing cervical cancer is to ensure you are protected against the human papillomavirus (HPV). The vaccine is provided in three injections over a period of six months, but even if you have the vaccine, you will still need regular smears because the vaccine cannot protect against all forms of the virus that can cause cervical cancer.