The Pap Test
A Pap test (sometimes called Pap smear or cervical smear) is a simple test used to look at cervical cells. Performed in a doctor’s office or clinic during a pelvic exam, the Pap test involves the scraping of the cervix to acquire a sample of cells. A lab checks the cells under a microscope for cell changes and for the HPV infection. If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis.
Most often, abnormal cells found by a Pap test are not cancerous. However, Pap tests can detect cells that have the potential to become cancerous. This early detection allows treatment to begin when it is likely to be most effective.
Annual Pap tests are no longer recommended because it generally takes much longer than that, 10 to 20 years, for cervical cancer to develop. More frequent screening may lead to unnecessary procedures.
In 2012, the U.S. Preventive Services Task Force (USPSTF) released updated cervical cancer screening recommendations. A collaborative group consisting of the American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP) and the American Society for Clinical Pathology (ASCP) also published similar guidelines.
The latest recommendations are as follows:
- All women should begin cervical cancer screening at age 21.
- Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
- Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also acceptable to have a Pap test alone every 3 years.
- Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical pre-cancer should continue to be screened.
- Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
- Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
- Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. These women should consult with their doctor or nurse.