Printer-friendly version- What is a Pap test (cervical cytology)?
- Why is it important for me to have a regular Pap test?
- Who should have a Pap test?
- What happens during a Pap test?
- Getting through the exam.
- What should I do to ensure that the Pap test is reliable?
- I've had the test, what happens next?
- Where can I go for more information?
What is a Pap test (cervical cytology)?
The Pap test (cervical cytology) is a technique used to detect changes in the cells of the cervix. The cervix is the entrance to the uterus, at the top of your vagina. This test is usually done during your routine pelvic exam.
Why is it important for me to have a regular Pap test?
The Pap test detects cervical changes that might develop into cancer over many years. These changes have no specific symptoms. The Pap test is not 100% effective in finding changes though newer types of cervical cytology have fewer errors. Having regular tests is the way to make sure that cervical changes are detected early.
Who should have a Pap test?
You should have regular Pap tests beginning a year after you start having sex or around the age of 18 even if you are not sexually active. All women who have ever been sexually active including lesbians and queer women should have the test, even if you are not sexually active right now.
Recommendations for how often to have the test vary from province to province and among practitioners. Some recommend every year. If you have normal results for three years in a row, then you could change to having the test every two or three years. You should continue having Pap tests throughout your life.
You should be particularly sure to have routine Pap tests if:
- you have already been treated for cervical abnormalities or cancer;
- you have undergone a partial hysterectomy (removal of the uterus without removing the cervix); or
- if you or your mother took DES* during pregnancy.
*DES: Diethylstilbestrol, a drug given to millions of pregnant women between 1941 and 1971 to help prevent miscarriages.
If you are 70 years or over and have had three normal tests within the last ten years, you do not have to continue having tests. But if you are over 70 and have never had a test, then you need to have one.
What happens during a Pap test?
A doctor or nurse practitioner does the test. She should explain each of her actions to you. You take off your panties and then lie on an examination table. If you ask to have the top part of the exam table raised up, you can see the doctor or nurse as she works. She puts on surgical gloves and then carefully inserts an instrument called a speculum into your vagina. Ideally, the speculum should be the smallest size needed to examine your vagina and should be warm to touch.
The doctor or nurse should gently open the speculum so she can see the cervix. Next she uses a small flat wooden tool, a cotton swab, or a small brush to collect cells from your cervix. Sometimes a test for HPV (Human papillomarvirus) is also done at this time. She places the cell samples in a container and sends it to a laboratory where technicians (cytologists) examine the cells under a microscope.
Getting through the exam
Pap tests should not hurt, but they can be unpleasant. Taking long, slow breaths can help you relax the muscles inside your vagina. Tell the doctor or nurse if this is your first exam. If you are too uncomfortable at any time, ask the doctor or nurse to stop.
If you are a survivor of sexual abuse or assault you may have difficulty with the exam. You do not have to disclose that you have this history. However, if you are ready to disclose, it may be helpful for the doctor or nurse to know. For more information about what survivors can do to prepare themselves for pelvic exams please visit Getting Through Medical Examinations: A Resource for Women Survivors of Abuse and their Health Care Providers.
You can also ask a friend or relative to be with you during the exam.
What should I do to ensure that the Pap test is reliable?
To ensure that a good sample is collected:
- do not use vaginal douches and/or contraceptive jelly or cream 48 hours before the test;
- limit sexual activity 24 hours before the test by not having intercourse or anything in your vagina; and
- schedule your appointment for when you are mid-cycle, not during your period.
I've had the test, what happens next?
Written test results are sent to your doctor or nurse. Most results are normal, but approximately one in ten tests will detect abnormal cells. The doctor or nurse will let you know if abnormalities are detected. She will explain the results to you.
You will not be contacted if the results are normal. Continue to see your doctor/nurse practitioner for a Pap test every one to three years, even if the tests are normal, so that any cervical changes can be noticed.
Where can I go for more information?
Revised June 2006.