What Is a Pap Smear?

Pap smears are the best (and simplest) way to prevent cervical cancer

Whether it’s your first or fifth time, it’s completely normal to feel nervous or have questions before a Pap smear. But knowing what to expect and why it’s important can help put your mind at ease before your appointment.

“Cervical cancer is one of the most preventable cancers, and staying up to date on your Pap smears is a big part of that,” says Scott Purinton, MD, PhD, chief of gynecologic oncology and director of robotic surgery at Geisinger Medical Center in Danville.

It’s understandable if you’re not looking forward to your next appointment, but rest assured Pap smears are simple, quick and painless — and so important for your vaginal health. Here’s what to know about this valuable procedure.

What is a Pap smear and what’s the purpose?

A Pap smear, or Pap test, is a routine cervical cancer screening that checks for irregular changes in your cervical and vaginal cells.

Cervical cancer starts as abnormal cells in the cervix, the lower part of the uterus that opens into the vagina. Left untreated, these abnormal cells could develop into cancer over time.

“One of the biggest advantages of these tests is their ability to detect abnormal cells before they even become cancerous,” says Dr. Purinton. “When precancerous cells or abnormal changes are found and treated early, it can lead to better outcomes.”

Are Pap smears different than a pelvic exam?

Yes, they’re different — and yes, you need both.

A pelvic exam is typically performed at your annual well-woman visit with your healthcare provider. During this exam, your vulva, vagina, cervix, ovaries, uterus, rectum and pelvis are checked for any abnormalities.

A Pap smear specifically screens for precancerous changes. If you’re due for one, you can get a Pap smear during your annual pelvic exam.

What can I expect during a Pap smear procedure?

During a Pap smear, your provider inserts a speculum into your vagina to view your cervix. Then, your provider gently brushes or swabs cells from your cervix. These cells are examined in a lab for changes and can also be tested for human papillomavirus (HPV), a sexually transmitted infection that can cause cervical cancer.

The Pap smear procedure only takes a few minutes. And while these screenings can be a little uncomfortable and awkward, they should never cause pain.

Do Pap smears test for STIs?

Pap smears don’t screen for STIs like HPV, gonorrhea or chlamydia. Instead, they test for any abnormal cell changes that could lead to cervical cancer. If you want additional testing for STIs, ask your healthcare provider during your appointment.

How often should I get a cervical cancer screening?

Regular cervical cancer screenings are essential to catch changes early. How often you need a Pap smear depends on your age and health history.

National guidelines recommend:

Women ages 21 – 29: You should have a Pap smear every 3 years.
Women ages 30 – 65: Discuss the following options with your doctor:
- Have both a Pap smear and an HPV test every 5 years.
- Have only a Pap smear every 3 years.
- Have only an HPV test every 5 years.
Women older than 65: You might no longer need to be screened, depending on your health history and doctor’s recommendation.

“Some factors can affect how often you should be screened,” says Dr. Purinton. “You may need cervical cancer screenings more frequently if you had a recent abnormal Pap smear or HPV test result, or you have a medical condition like HIV or a weakened immune system.”

Do you need a Pap smear if not sexually active?

Yes, whether you’re sexually active or not, you still need a Pap smear. While most cervical cancers are caused by HPV (which is sexually transmitted), this isn’t the case for all cancers.

National guidelines recommend starting Pap screening at age 21 regardless of sexual activity.

Can you get a Pap smear on your period?

Depending on how heavy your flow is, your period may affect the results of your Pap smear.

“A lot of blood can make your sample harder to read, which could produce inaccurate results,” says Dr. Purinton. “This shouldn’t be an issue if your flow is lighter.”

The best thing you can do is call your provider’s office and talk about your options.

Only due for a pelvic exam? There’s no reason to avoid it while on your period, unless you’re having the exam because of abnormal discharge or another concern.

P.S. Your period does not bother your healthcare provider.

What does an abnormal Pap smear mean?

An abnormal Pap smear means the lab found irregular changes in your cervical cells, but that doesn’t mean you have cancer. It means you may need an additional evaluation.

An abnormal result can be caused by different things. Abnormal changes in your cervical cells could be precancerous, but they also could be a result of inflammation, infection or hormone-related changes.

“Most abnormalities are minor and either resolve on their own or are easily treated,” says Dr. Purinton. “If treatment is needed, options are usually outpatient and effective.”

Importance of regular cervical cancer screenings

Cervical cancer is preventable — and receiving regular Pap tests is the best way to do that. Cervical cancer screenings detect precancerous changes early, when they’re simplest to treat to stop progression.

So, remind your mom, sisters, friends — every woman in your life — to schedule their Pap smear appointment (especially if it’s been a few years).

And if you still have questions, don’t be afraid to ask your provider.

“There are no bad questions when it comes to your health,” says Dr. Purinton. “We want you to be open and honest so we can help you achieve your best reproductive health.”