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Cancer Treatment Centers of America

Pap test

A Pap test, or Pap smear, is a test for cervical cancer or precancerous conditions of the cervix. The test is performed along with a pelvic exam and is done in a doctor’s office or clinic.

For the test, a woman lies on an exam table with her knees bent and her feet in stirrups. A doctor or nurse practitioner then gently inserts a speculum and uses it to widen the patient’s vagina to examine the vagina and cervix. The doctor or nurse practitioner then obtains a sample of cells from the cervix, using a scraping tool or small brush. The sample is put into a small bottle or onto a slide and sent to a laboratory for analysis.

Pap tests take about five minutes to perform. Patients may experience slight discomfort and mild cramping.

Women who are 30 years old or older may have a human papillomavirus (HPV) test performed in addition to the Pap test. Learn about HPV, as well as the HPV vaccine to prevent HPV infections.

Women should begin to have Pap tests at the age of 21 and continue to have the exam once every three years until the age of 65. However, beginning at the age of 30, women who have a normal Pap test and a HPV test may only need to have the tests every five years. Women who have the following risk factors may need to have Pap tests more frequently:

  • HIV infection
  • Exposure to diethylstilbestrol (DES), a man-made form of estrogen, before birth
  • A weakened immune system caused by chemotherapy, organ transplant or chronic corticosteroid use
  • A cervical cancer diagnosis
  • A previous abnormal Pap test that showed precancerous cells

Abnormal (positive) test results may indicate the cells examined are:

  • Atypical, but not necessarily cancerous
  • Precancerous
  • Cancerous (i.e., squamous cell cancer or adenocarcinoma cells)

Patients who have abnormal results should undergo additional testing, including a colposcopy, so their doctor can further examine the cervix, vagina and vulva and obtain additional samples for lab analysis.

Note: The Pap test is only used to screen for cervical cancer. It is not used to screen for other gynecologic cancers such as ovarian, vulvarvaginal or uterine cancer.

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