Pap Smear

Why this test may be ordered

• To screen for cervical cancer or precancerous changes (dysplasia) before symptoms develop.
• Sometimes the collected cells are also checked for HPV (human papillomavirus), which causes almost all cervical cancers.

Preparation and collection

Do not have a Pap smear while you are on your period. For 2 days before the test, do not use tampons, birth control foam/jelly/cream, other vaginal creams or medicines, douche, or have vaginal sex. A good time to have the test is about 5 days after the last day of your period.

During a Pap smear, your health care provider collects cells from your cervix using a small soft brush or swab. You will lie on an exam table with your knees bent and heels in stirrups. A speculum is inserted into the vagina to widen it so the cervix can be seen. The cell sample is sent to a lab.

You may feel mild discomfort during the Pap smear and have very light bleeding afterward. According to MedlinePlus, there are no known risks to having a Pap smear.

Understanding results

A Pap smear looks for abnormal changes in cervical cells before they become cancer. Your results may be reported as normal (negative), unsatisfactory, unclear, or abnormal (positive). Below are common result patterns. For all results, talk with your healthcare provider to understand what they mean for you.

• Normal (screen-negative): No abnormal changes were found in your cervical cells. This is a lower-likelihood screening result. Limitation: False-negative results are possible: results appear normal but precancer or cancerous cells may be present. Next step: Routine screening as recommended by your healthcare provider. If you also had a normal HPV test, you may be able to wait up to 5 years for your next test, depending on your age and medical history.
• Abnormal (screen-positive): Abnormal changes were found in your cervical cells. This is a higher-likelihood screening result. It does not confirm cancer, but further evaluation is needed. Limitation: False-positive results are possible: results appear abnormal but no precancerous or cancerous cells are present. Next step: Your provider may recommend a follow-up test, such as a colposcopy, to check the abnormal cells. Most abnormal results do not mean you have cervical cancer. Minor changes often go back to normal on their own.
• Unsatisfactory: The lab sample did not have enough cells, or the cells were clumped together or hidden by mucus. The test could not be completed. Limitation: If the sample was unsatisfactory, the test cannot provide a reliable result. Next step: Your provider may ask you to come in for another test in a few months.
• Unclear: Your cervical cells look abnormal, but it is unclear if it is due to HPV. Limitation: Unclear results may be due to pregnancy, menopause, infection, or HPV. An HPV test may help clarify. Next step: Your provider will let you know if other tests (such as an HPV test) need to be done.

• A Pap smear does not diagnose cancer. It is a screening test.
• False-positive results are possible: results appear abnormal but no precancerous or cancerous cells are present.
• False-negative results are possible: results appear normal but precancer or cancerous cells are present.

What to do next

Talk with your provider to learn what your Pap smear results mean. If they are concerned about your results, they may perform a colposcopy (an exam using a special magnifying instrument to look closely at your cervix).

• How often should I have a Pap smear based on my age and health history?
• Should I have a Pap smear, an HPV test, or both?
• What do my results mean and what follow-up do I need?

Evidence source

U.S. National Library of Medicine: Pap Smear