Cervical Cancer Screening (Pap Test)

What is cervical cancer? 

Cervical cancer is a type of cancer that develops in either the cervix itself or on the walls of the cervix. Most cervical cancer cases are caused by the human papillomavirus (HPV) which is passed during sex. While penile-vaginal sex is the most common route of transmission, HPV can also be spread during oral and anal sex. Often the early stages of cervical cancer go unnoticed. However, as the cancer grows, other symptoms begin to appear such as: 

• Vaginal bleeding after sex, between periods, and after menopause 
• Pelvic pain or pain during sex 
• Difficult or painful urination or bowel movements 
• Backache or pain in the abdomen 

List adapted from the National Cancer Institute 

What’s involved in a cervical cancer screening?  

Cervical cancer screening, also known as cervical cytology, Pap test, or Pap smear, is a test where cells are collected from the cervix to determine if they are potentially cancerous. Health care providers collect these cells by swabbing the cervix. They can then send them to a lab to test for abnormal cells that may be cancerous.   

When is cervical cancer screening recommended?  

Current guidelines recommend that people with a cervix start cervical cancer screening at 21 years of age and repeat the test every three years. If you’re between 30 to 65 years of age, health care providers may do both a Pap test and a human papillomavirus (HPV) test every five years.  

How are cervical cancer screenings performed?  

Steps for a cervical cancer screening typically includes:  

1. You change out of your everyday clothes into a hospital gown. 
2. You then lie on the exam table and place your feet in footrests, called stirrups, attached to the table.  
3. A health care provider then uses a speculum to open the vagina to have a clearer view of the cervix and vaginal canal. You may feel slight pressure or cramping during this process. 
4. A provider may then use a small brush or swab to remove cells from the cervix. You may feel slight discomfort during this portion of the exam, but you should not feel pain. 
5. The provider then puts the cells into a liquid and sends them to the lab for evaluation. 

You may experience light bleeding from the vagina after the screening. Recently, the FDA approved self-collection for cervical cells using a swab or brush. However, this must be done in a health care setting. If you'd prefer self-collection, ask your provider for more information. 

What are the possible cervical cancer screening results?  

Results from the screening are typically available within one to three weeks. There are three common results: 

• Normal: Also called a negative result, no precancerous or cancerous cells were detected.   
• Unsatisfactory: This may happen when the lab has trouble evaluating your cells. If your results are unsatisfactory, a health care provider may ask you to return for another test in two to four months.  
• Abnormal: Also referred to as a positive result, this means that the cervical cells look different from the normal cells.   

What happens if your cervical cancer screening results are abnormal?  

The abnormal result is typically due to a HPV infection or early cervical cell changes that can be monitored or treated. Detection of abnormal cells doesn’t mean that you have cervical cancer.  

A health care provider may recommend monitoring, more testing, or treatment based on your personal health factors. Some of these include your earlier screening results and your age.  

Further observation may include a repeat cervical cancer screening with or without HPV testing within one to three years of the abnormal test result.  

How can you lower your risk of cervical cancer?  

To reduce your risk, a health care provider may recommend for you to receive the HPV vaccine (Gardasil-9). Additionally, they may advise that you use condoms regularly and continue regular cervical cancer screenings.  

Cervical cancer is highly preventable and curable when treated early. Cervical cancer develops very slowly over several years, so regular screenings are critical for early detection, diagnosis, and treatment.   

What else is there to know about cervical cancer screenings?  

Before your screening, a health care provider may ask you to avoid sexual intercourse, douching, or any vaginal medicines for two days beforehand. You can have cervical cancer screenings done at any time during the menstrual cycle, including during your period. More frequent screenings may be needed if you or someone in your family has a history of cervical cancer; you have an HIV infection; or you’ve previously had abnormal cervical cancer screening results.