A Pap test is a procedure to remove a small sample of cells from the cervix so they can be examined under a microscope.
A Pap test (also called a Pap smear or cervical cytology) is a test that checks for changes in the cells of the cervix that could lead to cervical cancer. A Pap test is a routine preventive test that is often done by health care providers as part of a pelvic exam. Pap tests do not test for sexually transmitted infections (STIs), although STI testing can be done at the same visit.
How a Pap test works
During a Pap test, a health care provider uses a soft brush or swab to collect a small sample of cells from the cervix. The cervix is the lower part of the uterus that connects to the vagina. The sample of collected cells is sent to a lab to look for abnormal (changed) or precancerous cells.
It is important to get regular Pap tests to catch problems early so they can be treated. Health care providers will recommend Pap tests based on your age and risk factors, such as medical conditions or past Pap test results.
If the Pap test results are abnormal, further tests such as colposcopy or biopsy may be needed.
When to get a Pap test
Health care providers recommend starting Pap tests at age 21.
General Pap test guidelines:
Age 21–29: A Pap test every 3 years is recommended.
Age 65 and older: You can stop having Pap tests if:
You have had Pap tests regularly up until age 65, and all of your results were normal.
You have had 3 normal Pap tests in a row, or 2 normal combined Pap and HPV tests in the last 10 years (with the most recent test in the past 5 years).
You do not have any medical conditions that weaken your immune system, like human immunodeficiency virus (HIV) or taking certain medicines that lower your body’s ability to fight infections.
Some people need Pap tests more often, including:
People who have had an abnormal Pap or HPV test in the past
Those taking medicines that weaken the immune system (for example, after an organ transplant)
People with HIV
If you are a woman with HIV and age 21 or older, you should have a yearly Pap test after diagnosis. If your results are normal after 3 consecutive tests, you can switch to Pap tests every 3 years.
If you are a woman with HIV and age 30 or older, continue having Pap tests every 3 years if tests are normal.
Your health care provider may recommend a different testing schedule based on the type of test used and your results.
A Pap test may be ordered for reasons other than checking for cervical cancer. If you have unusual vaginal bleeding or heavy menstrual bleeding, your provider might do a Pap test to help find the cause.
Getting ready for a Pap test
Before a Pap test, make sure that you:
Know your medical history and sexual health history.
Bring lists of medicines you are taking and recent health changes.
Understand the reason for the test and ask any questions before the test.
Tell your provider about any allergies, bleeding problems, surgeries, medical problems, and if you are pregnant or may be pregnant.
Some people may find this type of exam difficult for personal, emotional, or physical reasons. If you have any concerns or think the procedure may be hard for you because of past trauma, pain, or anxiety, please talk with your care team before scheduling. They can discuss options to help you feel safe and supported.
How to prepare for the Pap test
To make sure that the Pap test gets the best results:
Schedule the appointment when you are not on your period if possible. You can have a Pap test during your period, but you may have to reschedule if you are bleeding heavily.
Avoid sexual activity, douching, using vaginal creams or gels, or using tampons for 48 hours before the exam.
Wear comfortable clothes.
Bring a trusted adult or friend for support if you want.
Ask your doctor if you can take a pain medicine like ibuprofen.
You will undress from the waist down and put on a hospital gown.
You will lie on your back on an exam table.
You will put your feet in footrests called stirrups.
Your provider will place a small tool called a speculum in your vagina. This helps the provider get a better view of the cervix. This may feel uncomfortable. Breathing deeply or focusing on something relaxing can help.
The provider will use a small brush or swab to collect cells. This may cause mild pressure or discomfort.
The procedure usually takes only a few minutes.
After the Pap test
After the Pap test:
You may have light spotting or cramping for a day.
You can usually return to normal activities right away.
Avoid inserting anything into the vagina for 24 hours if recommended.
Your provider will tell you when to expect your test results and what they mean.
What Pap test results mean
After the procedure, you will find out if the results were normal, abnormal, or inconclusive.
Normal: means no abnormal cells were found.
Abnormal: means that the test showed some abnormal cells. Some cells may be precancerous, meaning that the cells may become cancerous over time. Sometimes, abnormal cells may suggest an infection. Your provider will tell you if you need more tests or treatment. Follow-up testing, such as a repeat Pap test, HPV test, or colposcopy may be needed.
Inconclusive: Sometimes Pap test results are unclear. Your provider may ask that you repeat the Pap test.
Possible risks of a Pap test
A Pap test is safe. But, like any procedure, there are some risks, such as:
Light bleeding or spotting
Mild cramping or discomfort
Rarely, an infection (very uncommon)
When to call your care team
You should call your care team if you have:
Heavy bleeding
Bleeding that lasts for more than 7 days
Bad-smelling discharge
Severe pain or cramping
A fever of 100.4 degrees F (38 degrees C) or higher
Questions about Pap test results
Questions to ask your care team
How often should I have a Pap test?
What happens during the Pap test?
Is there anything I need to do to prepare for the Pap test?
Are there ways to make the procedure more comfortable?
Can I get tested for STIs at the same visit?
How will I learn about my test results?
What happens if my results are abnormal?
When should I come back for a follow-up visit?
Are there other tests or screenings I should have?
Key points about Pap tests
A Pap test is a routine, safe, and quick way to check for changes in the cells of the cervix that could lead to cervical cancer.
A Pap test does not check for sexually transmitted infections (STIs).
Most people do not need a Pap test until age 21.
During a Pap test, your health care provider uses a small brush or swab to collect cells from your cervix.
The test may cause some mild discomfort, but it goes away quickly.
Test results help prevent serious problems like cervical cancer.
Human papillomavirus is a common virus spread through skin-to-skin contact. Some types cause warts, others can cause cancer. Learn about HPV and HPV vaccines.
