Today we’re diving into a topic often shrouded in questions: pap smears. What are they, and do you need one? Let’s break it down so you can make informed decisions about your health. First, I am frequently asked by my patients when they should start bringing their daughters in. From my standpoint, the earlier the better. Officially, ACOG recommends the first GYN visit between the ages of 13-15. STI screening should start when a female is sexually active and the topic of this post – pap smears – start at age 21.
What is a pap smear?
A pap smear or “Papanicolaou” test is a sampling of the cells of the cervix that screens for precancerous and cancerous changes of the cervix. A pap smear can detect any abnormal cells, which could lead to cervical cancer. These changes are caused by HPV or Human Papilloma Virus.
Do you know the part of your reproductive system that connects your uterus to your vagina? That’s the cervix! Cervical health means routine, complete cervical cancer screening. Performing Pap and HPV tests is the most thorough way to screen for cervical cancer, guide treatment and save lives.
Why do you need one?
I know, cervical cancer might not be a topic you like to consider. Yet, early detection is key to successful treatment. That is where pap smears come in! 50% of women diagnosed with cervical cancer have never had a pap smear. It is so important to get checked for that reason. It gives us a chance to address any issues before they become more serious.
- Up to 80% of the population will carry the HPV virus at some point.
- Most people will clear the virus before it causes any severe abnormalities of the cervix.
- Most mild cervical precancerous changes will resolve on their own without intervention.
- Precancerous changes progress very slowly. It takes a long time to develop into cancer.
- More frequent screening is not better in this regard. More screening only leads to more unnecessary and invasive intervention and does not diagnose or prevent cancer.
Who should get a pap smear?
In the US, it’s recommended for everyone with a cervix age 21 and older regardless of if they have been sexually active or not. If normal, the pap can be done every 3 years and once you turn 30, potentially every 5 years if it’s combined with HPV. The new ACS guidelines are recommending cervical cancer screening starting for everyone at age 25 and testing every 5 years with high risk HPV testing only.
- Screening should start at age 21 regardless of sexual activity
- If normal, a pap is done every 3 years from ages 21-29
- Women age 30-65, a pap smear should be done every 3 years OR if a provider chooses to screen with BOTH a pap AND HPV testing, both of these tests can be done every 5 years if they are both normal
What’s the difference in a pap smear vs. a pelvic exam?
A pap smear is done with every pelvic exam. So just because you had a pelvic exam (i.e. to evaluate bleeding, discharge, pain, etc) does not mean you had a pap smear. A pap smear is a specific test done during a pelvic exam with a speculum to visualize the cervix at your Well-Woman exam. If normal, it is NOT done every year.
What does a pap smear feel like?
No need to stress – a pap smear is usually quick and straightforward. You’ll lie down on the exam table, and your doctor will use a speculum to open your vagina, allowing your doctor to see your cervix. Then, they’ll collect a sample of cells from your cervix using a small brush or spatula. You might feel a little discomfort, but it’s usually over in an instant. It can seem very intimidating, but it only takes about 10 seconds, and a good doc can walk you through it gently and quickly. Not all speculum exams include a pap smear!
Is it uncomfortable?
I get it – the thought of a pap smear can make anyone a tad nervous. But truth be told, the discomfort is usually minimal and only lasts briefly. It’s like a quick pinch that can save you from much bigger worries down the road. Most people feel crampy discomfort with it, but not much more than that.
When do results come in?
Once the sample is collected, it’s sent to a lab for analysis. It might take a week or so to get your results. If everything’s normal, you’ll be good to go until your next scheduled pap smear. If there are any abnormalities, don’t panic – it doesn’t necessarily mean cancer. Sometimes, the cells need a closer look or some simple treatments.