Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated on May 8, 2021

cartoon of a doctor and uterus

What is a Pap Smear?

For those of you that have never heard of a PAP (Papanicolaou) smear, let me share with you about what goes down… Pap smear = Pap test. This procedure usually checks for cervical cancer or other abnormalities in your cervix. Pap smear tests are usually classified as preventative medicine, which is important for checking your health.

Cells are scraped from the opening of the cervix and examined under a microscope to see if there are any abnormal cells. FYI: the cervix is the lower part of the uterus that opens at the top of the vagina.

What does a pap smear test for?

A pap smear checks for cervical cancer. More specifically, they are implemented to proactively identify the individual’s risk of developing cancer by screening for precancerous or cancerous cells in the cervix. Precancerous cells have the potential to turn into cancer if left untreated. Although pap smears can identify HPV, it can’t identify other Sexually Transmitted Infections (STIs). Furthermore, if you want to get tested for STIs, you need additional tests. Additionally, pap smears do not detect the presence of all types of cancer related to reproductive health (i.e. ovarian cancer). With that said, it is necessary to get regular check-ups with your gynecologist to screen for additional health conditions.

How is a pap smear done?

Before a pap smear begins, you must be in the correct position – sitting on a table and placing your feet in stirrups. This may feel a bit awkward, but all individuals who have gotten a pap smear have experienced it. The position allows the doctor to get a better view of your cervix. 

Once you slide your feet into the stirrups, the doctor will likely tell you to try to relax and take some deep breaths. From there, they gently place an instrument called a speculum into the vagina. By opening the vaginal canal, they are better able to insert a swab to collect cells from the cervix, which are sent to a lab for examination. While this experience typically isn’t painful, it may feel slightly uncomfortable, and that is okay!

If you are nervous for your pap test, communicate this emotion with your doctor. This will serve as a reminder for them to be extra gentle and explain each step of the process before starting. Being that many individuals feel anxious prior to their first exam, the doctor will likely be very understanding – if they aren’t, you may want to find a new doctor that better meets your needs. 

When to schedule a pap test?

While you can get a pap smear during your period, the blood could make the results less accurate. Furthermore, it is a good idea to schedule your appointment on a day when you do not have your period. Other than that, you are free to book a time that works best for your schedule – though it may be a good idea to take the day off of work so that you feel as relaxed as possible during the exam. 

Pap Tests & STIs

Can a pap smear detect STIs?

A pap smear is not a comprehensive STI check. However, you may be able to ask for a test so you can have it done on the same day as your exam. But even if this can’t be done, you should still get tested for gonorrhea, chlamydia, and HIV at least once a year in order to protect both yourself and any sexual partners! All of these should be covered under your insurance. 

What about HPV?

The main purpose of a pap smear is to test for cervical cancer or cancer cells in women. However, it can also detect the presence of Human papillomavirus (HPV), which is the most common STI in the US. HPV is a virus that enters cells and causes them to change, potentially leading to cervical cancer. If the results from both your pap smear and HPV test are negative, your doctor might let you know that you can wait five years until your next screening.

Ages & Pap Smears

What age should you get a pap smear?

Pap screening should start at age 21 and then take place every three years if the initial test comes back negative. If you are on birth control you still need to go every three years. If you are over the age of 30 and both your pap smear and HPV test results are normal (a.k.a co-testing), you can start getting tested every five years. 

At what age can you stop having pap smears?

Most women can stop getting pap tests between the ages of 65 and 70 as long as they had three negative tests within the past 10 years. Additionally, women who have their cervix removed do not need to get a pap smear. If you are unsure about your status, check with your healthcare provider to make sure you’re in the clear. 

Who needs pap smears more often?

Your physician might suggest that you get tested more frequently if you’ve previously had positive test results, you have HIV, or you have a weakened immune system due to other health conditions. 

What do the Results of Pap Tests Mean?

Pap test results usually come out in the form of positive (abnormal) or negative (normal). Positive results indicate the presence of abnormal or precancerous cells. Negative results indicate the presence of normal cells in your cervix. 

If your test comes back negative, your chance of getting cervical cancer in the next few years is on the lower side.  If this is the case, you don’t need additional testing until your next pap smear in three years. 

If your test comes back positive, there might be abnormal or precancerous cells in your cervix. This doesn’t necessarily mean you have cervical cancer, but it could indicate a higher risk due to changes in the cells. Depending on the type of cells found, your physician may order additional tests (i.e. colonoscopy or biopsy). 

How accurate are pap smear results?

The results from a pap smear are very accurate. Although the procedure might be uncomfortable, it can prevent other health issues in the long run. With that said, it is necessary to start getting them at age 21 (or later if you are not sexually active by 21). The earlier an issue is detected, the more likely you will be to find effective treatment. 

What’s the takeaway?

Pap smears are something that all people with uteri experience. While they may cause some initial nerves, once you get through the first exam, the more comfortable and prepared you will be in the future. 

Being that a pap smear is something that so many individuals undergo at some point throughout their life, the experience is nothing to feel ashamed of. Instead of stigmatizing these regular check ups that are simply done to ensure a healthy reproductive system, we might as well embrace them! 

Frequently Asked Questions

How should I prepare for a pap smear?

While there is not much to do prior to a pap smear, there are a few steps you can take to ensure an effective, efficient appointment. First, try to schedule your test on a day when you do not have your period. Additionally, try to avoid having penetrative sex, douching, or placing anything (i.e. creams or meds) up to two days before your appointment. 

How long does a pap smear take?

Typically, a pap smear only takes around 10 to 20 minutes. With that said, you may want to block off extra time in case you need to fill out any intake paperwork or want to ask your doctor questions. 

How much does a pap smear cost?

While health insurance usually covers pap smears, as they are classified as a preventative health exam, you may have a copay of $30-$80 depending on the provider. If you don’t have insurance, look for programs that offer free or low-cost pap smear testing near you. 

How long does it take to get pap smear results?

After a pap smear, the doctor who conducted the exam sends the cell samples to a lab for analysis. It typically takes one to three weeks for the results to come in. These will typically be posted on your patient chart or verbally provided via phone call from your doctor’s office. If you don’t receive your results after three weeks, call your doctor to ask about any updates. 

Is a pap smear painful?

Pap smears shouldn’t hurt, but they might feel uncomfortable. Some describe it as a minor pinch whereas others don’t feel anything at all. Everyone has a different level of pain tolerance, but the consensus is that it should not be extremely painful. If it is, let your doctor know. 

You can also lessen or prevent potential pain by using the restroom and emptying your bladder beforehand. You can even take an over-the-counter pain medication (i.e. ibuprofen) an hour or so before the exam. 

Are there risks to pap smears?

Although pap smears usually detect the presence of abnormal cells, there is a possibility that some cells are missed. Furthermore, getting tested regularly can increase the chances of detecting abnormalities. 

How to reduce the risk of getting cervical cancer?

The best ways to reduce your chances of getting cervical cancer are getting the HPV vaccine and going in for regular pap smears. 

Here are some additional steps you can take to lower your risk for getting cervical cancer:

  • Use condoms to prevent STIs.
  • Get tested for STIs/STDs regularly if you’re sexually active. Make sure your partner gets tested regularly too.
  • Limit your number of sex partners.
  • Don’t douche (this gets rid of beneficial bacteria in your vagina).

Disclaimer: The above information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.