What to Know Before Your Upcoming Pap Test

You did it — you scheduled your first Pap test. As the day approaches, your nerves might be kicking in.

“Though these tests have been standards of care for decades, many women get nervous with anticipation, especially the first time,” says Dr. Rebecca A. Keith, a board-certified physician who sees patients at Beaufort Memorial Obstetrics and Gynecology Specialists. “Understanding the purpose and what to expect can help you feel more confident heading in for your exam.”

Read on to learn who needs Pap tests and what to expect during your exam.

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What Is a Pap Test and What Does It Detect?

The purpose of a Pap test (also called a Pap smear) is to screen for cervical cancer by identifying precancerous cells. Proper treatment keeps these from turning into cancer cells.

According to the American Cancer Society, nearly 13,500 American women are diagnosed with cervical cancer every year. The number has dropped by 50% over the past few decades, largely due to increased testing.

Along with a Pap test, your women’s health provider may suggest an HPV test. This looks for human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to cervical cancer. Treating this infection is a proactive way to prevent cervical cancer.

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When and How Often Do You Need a Pap Test?

The Centers for Disease Control and Prevention recommends your first Pap test at age 21. Depending on your results, you should follow this schedule.

• Ages 21 to 29 — You should have Pap tests at least every three years. If you have an abnormal test result, your healthcare provider may recommend more frequent testing.
• Ages 30 to 65 — As long as your tests are normal, you can continue to get tested every three years. However, you have options. “Some women prefer HPV testing only or a combination of HPV and Pap smears,” Dr. Keith says. “This allows you to go five years between tests, which many women appreciate.”
• After age 65 — Continue your prescribed testing schedule. You may not need further testing after three normal Pap smears or two consecutive HPV tests.

Exceptions to the Rules

Though most women benefit from scheduled Pap tests or an HPV test every five years, there are exceptions. These include:

• Women with abnormal symptoms — Don’t wait for your scheduled screening if you experience symptoms such as pelvic pain, vaginal discharge or abnormal bleeding. Contact your healthcare provider immediately.
• Women with a history of cervical cancer — If you’ve had cervical cancer in the past, your healthcare provider may recommend more frequent testing.
• Women without a cervix — After a total hysterectomy, you may not need further testing. If your surgery was used to treat cervical cancer or precancer, ongoing testing may be necessary.

How to Prepare for Your Appointment

“Pap tests are very helpful tools,” Dr. Keith says, “and you play a role in making them as useful as possible.”

For two days leading up to your exam, avoid the following:

• Douching
• Sexual intercourse
• Spermicidal foam
• Tampons
• Vaginal medication

It’s also helpful to urinate just before your test. Having an empty bladder will make you more comfortable throughout the exam. No preparation is needed for an HPV test.

What to Expect During the Exam: Is It Painful?

Though you may feel discomfort or pressure, a Pap test shouldn’t be uncomfortable. The National Institutes of Health compares the experience to the discomfort of menstrual cramps.

During your test, the following takes place:

• Preparation — While you lie on an exam table, your healthcare provider inserts an instrument called a speculum into your vagina. This helps to hold your vagina open during the test.
• Removal — Your healthcare provider removes a few cells from your cervix with a small brush. Immediately afterward, your healthcare provider sends the tissue samples to a laboratory.
• Testing — Laboratory technicians study the cell samples for signs of precancer or other abnormalities.

After your test, light bleeding or spotting is normal. This should go away on its own.

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Understanding Your Results

It can take up to three weeks to receive your Pap test results. When your results arrive, they will fall into one of three categories.

• Normal — Also called a negative test result, a normal test uncovers no abnormal cells in the cervix.
• Abnormal — A positive test indicates abnormal cells. Abnormal results rarely indicate cancer. The most common cause, according to the National Cancer Institute, is atypical squamous cells of undetermined significance. This means it’s unclear what caused the abnormality. Further testing determines the root cause and enables early treatment, which often prevents cancer development.
• Unsatisfactory — The laboratory cannot give a definitive result. A second Pap test, a few months later, is necessary.

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Warning Signs of Cervical Cancer

“Regular Pap and HPV tests help detect and deal with cervical problems,” Dr. Keith says, “but cervical cancer can develop between screenings.”

To prevent cancer from spreading, talk with your care team anytime you experience cervical cancer symptoms. Common warning signs of cervical cancer include:

• Abnormal menstrual bleeding
• Heavier and longer-lasting periods
• Long-term pale, pink or watery vaginal discharge

Pap Tests: A Part of Ongoing Women’s Wellness

Pap tests are proven to help prevent cervical cancer. Scheduling your first one is a big step in taking ownership of your health.

1. From ages 21 to 65, most women should undergo cervical cancer screening every three to five years. Your healthcare provider will help develop a schedule that fits your needs.
2. During the test, your healthcare provider removes a small sample of cells from your cervix. Laboratory experts then examine the cells, looking for abnormalities.
3. Your test results will be normal, abnormal or unsatisfactory. An abnormal Pap test rarely means cancer is present.

Request an appointment with a Beaufort Memorial women’s health provider.