Pap Test

Cervical Smear

What To Think About

• It is important to have regular pelvic examinations and Pap tests starting about the time you start having sex or by age 18. For more information, see the medical test Pelvic Examination.
• Ask your health professional how often you should be tested. You should be tested every 1 to 3 years, depending on your risk factors.
• After you have had three or more consecutive, normal pelvic and Pap tests, these tests may be performed less frequently, depending on your risk factors for cervical problems and the advice of your health professional.
• A vaccine (Gardasil) is available to prevent infection with the kinds of the human papillomavirus (HPV) most likely to cause cervical cancer. But sexually active women who get the vaccine should keep getting regular Pap tests.
• Normal Pap test results do not completely rule out the presence of abnormal cells (dysplasia) or cervical cancer. The test may fail to find abnormal cells when they are present (false-negative). Having 3 normal Pap tests in a row reduces the chance of false-negative results. Or the test may show abnormal cells when they are not present (false-positive). Talk with your health professional about the meaning of your Pap test results.
• If you have an abnormal Pap test, your health professional may recommend a test that looks at the cervix through a magnifying instrument (colposcopy). For more information, see the medical test Colposcopy and Cervical Biopsy.
• Some women with abnormal Pap tests or women older than age 30 may be tested for human papillomavirus (HPV), a sexually transmitted infection (STI) that causes genital warts. Some high-risk types of HPV can cause cervical cancer. The HPV test may or may not be done at the same time as the Pap test. The results of the HPV test can help doctors decide if further tests or treatments are needed. For more information, see the medical test Human Papillomavirus (HPV) Test.
• A liquid-based Pap test method also may be done. For this method, the tools used to collect the cells from the cervix are washed with a special liquid that is saved and sent to a lab for examination under a microscope. The cells collected in this way can also be tested for human papillomavirus (HPV). However, studies show that liquid-based Pap tests may produce more false-positive results.
• A Pap test alone is not used to diagnose dysplasia or cervical cancer. Other tests are needed, such colposcopy and cervical biopsy.
• A Pap test is not used to screen for sexually transmitted infections (STIs) or cancer other than cervical cancer. If an STI is suspected, other specialized testing may be needed to confirm a diagnosis. For more information, see the medical tests Vaginal Wet Mount, Tests for Bacterial Vaginosis (BV), Herpes Tests, Syphilis Tests, Chlamydia Tests, and Gonorrhea Test.
• Vaginal self-examination (VSE) may help you better understand your body, know what is normal for you, and find early symptoms of infections or other abnormal conditions that might mean you need to see a health professional. VSE should be used along with (but not replace) a regular pelvic examination and Pap test done by a health professional. For more information, see the medical test Vaginal Self-Examination (VSE).

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Author:	Maria G. Essig, MS, ELS Ralph Poore	Last Updated: November 23, 2007
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology Anne C. Poinier, MD - Internal Medicine
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