One of the most important tests a woman can have is a routine Pap test. It can often prevent cervical cancer by detecting cell changes before they turn into cancer. If cervical cancer develops, the Pap test can help find it early, when it's easier to cure.
The Pap test is the single most effective cancer screening test in medical history. Since it was introduced 50 years ago, the number of women in the United States who die of cervical cancer has dropped by 70 percent.
But thousands of women still don't get routine Pap tests. Among women who die of cervical cancer, 8 out of 10 haven't had a Pap test in 5 years or more.
How is a Pap test done?
The Pap test is simple and quick. It can be done as part of a routine pelvic exam.
During the pelvic exam, the doctor widens the vagina with an instrument called a speculum. Then the doctor uses a tiny spoon or brush to take a sample of cells from the cervix. The cell sample is sent to a lab, where it's examined for abnormal changes that could represent or lead to cancer.
A Pap test should be done when you're not menstruating. The best time is between 10 and 20 days after the first day of your period. Also, don't have sex, douche, or use any type of vaginal cream for 2 days before the test. These things could affect your test results.
Who needs a Pap test?
How often do you need a Pap test? It depends on your age, risk factors, and the type of Pap test that is done.
The American Congress of Obstetricians and Gynecologists recommends a Pap test starting at age 21. Women younger than 30 years old should have a Pap test every 2 years. Women aged 30 years and older should have a Pap test every 2 years as well. But, after three normal Pap tests in a row, women in this age group may have Pap tests every 3 years if they do not have risk factors.
After age 65 or 70, you may stop having Pap tests if you've had three or more normal tests in a row and no abnormal results in the last 10 years. If you've had a hysterectomy, ask your doctor if you need to keep getting Pap tests.
If you are 30 years or older, you can be tested for cancer-causing types of human papillomavirus at the same time you have your Pap test. Talk to your doctor about the best screening schedule for you.
What increases the risk of cervical cancer?
Most cases of cervical cancer are caused by the human papillomavirus (HPV). HPV is spread through sex. Low-risk types of HPV cause genital warts. In general, only the high-risk types of HPV cause cancer.
A woman is more likely to get cervical cancer if she:
- Has a high-risk HPV infection
- Has had multiple sex partners (or has sex with someone who's had many sex partners)
- Has HIV or a weak immune system
A vaccine can prevent infection with most high-risk types of HPV. But to be most effective, the vaccine needs to be given before a girl becomes sexually active. It does not protect against every high-risk type, and it cannot cure an existing HPV infection or cervical cancer. So, routine Pap tests are still very important.
Created on 03/10/2000
Updated on 09/08/2011
- American Congress of Obstetricians and Gynecologists. Special procedures: the Pap test.
- American Cancer Society. American Cancer Society guidelines for the early detection of cancer.
- U.S. Preventive Services Task Force. Screening for cervical cancer.