A pap smear or pap test is a screening tool important that helps with early detection for abnormal cells and cancer in women. Early detection normally means before symptoms start to appear. This helps lead to early treatment and preventative measures for women. This can greatly help women avoid cervical cancer and/or lead them to a greater chance of a cure. 

Early diagnosis leads to more effective treatment. This pap smear works by sampling cells from the cervix which then gets checked for abnormal cells/precancerous cells and detects DNA from HPV that helps diagnose its presence and type. These two screenings don’t normally happen at the same time but can be requested at the same time during the pap smear. 

If the pap smear leads to a specific diagnosis, then the patient can seek early treatment. Based on the American Cancer Society (ACS), these screenings have significantly decreased deaths from cervical cancer. 

What To Expect During A Pap Smear?

Pap smears are very simple. First, your doctor will place you in the correct position – sitting in a chair with your feet comfortably placed in the stirrups. For the first time, this position may feel awkward but this particular position allows for the doctor to get a good view of your cervix. 

Once you’re comfortable, the doctor will instruct you to relax your body by taking a few deep breaths. They will then place a speculum instrument into the vagina to open the vaginal canal. This allows the doctor to insert a swab into the cervix to collect cells for a lab examination. 

The pap smear isn’t known to be painful but it can feel a bit uncomfortable – that’s normal! If you’re feeling a little extra nervous, talk to your doctor about how you’re feeling and they will surely accommodate you. It’s entirely normal to feel anxious prior to your first exam. Your doctor will understand!

How To Know When To Have A Pap Smear?

Knowing how to decide when getting a pap smear depends on several factors. For example, based on the United States Preventive Services Task Force it is recommended:

• Age: women at ages 21-29 should have a pap smear every 3 years. Women at ages 30-65 should have an HPV test every 5 years and a pap smear every 3 years or a pap smear and HPV co-test every 5 years. The American Cancer Society recommends women ages 25 to 65 should have an HPV test every 5 years. After the age 65, most women will not need to set appointments for HPV tests or pap smears. This varies from woman to woman and their health status.
• HIV status and whether or not the patient has a weakened immune system because of HIV
• Overall medical history
• DES, or diethylstilbestrol, exposure in the womb

Everyone’s needs vary. Patients who are sexually active with more than one partner or have had abnormal test results in the past may need testing more often. For patients who have had a total hysterectomy (when the uterus and cervix have been completely removed) a pap smear is no longer necessary. Unless the hysterectomy occurred because of precancerous and cancerous cells. They should continue regular testing. 

Talk to your doctor about your needs and risk factors for developing cervical cancer. 

Pap Smear and STIs

Unfortunately, a pap smear was not designed to be a STI check. However, a pap smear and STI test can be done on the same day if you schedule a comprehensive STI check with your doctor. Most of which can be covered by your insurance. 

On the other hand, the main purpose of a pap smear is to check for cervical cancer or cancer cells in women. So the pap smear can detect the presence of HPV. Human papillomavirus is considered a common STI in the US. There are over 150 types of HPV. Some can lead to cervical cancer, some can lead to papillomas or noncancerous warts. Once it enters the cells, it can create change in the cells or create,abnormal cells. This can potentially lead to cervical cancer. If you test negative from both your pap smear and HPV test, your doctor may give you the green light to wait five years until your next screening. 

There is no cure if you test positive for HPV but it often resolves itself over time. There are vaccinations that are available to help protect against HPV infections for up to the age of 21 in men and 26 in women. 

What Age Should You Get A Pap Smear?

Pap smears should start at age 21, or when you become sexually active, and continue every three years after that if the test results are negative. For women on birth control, that will continue every three years and if you are over the age of 30, and test results are normal, you can get tested every five years. 

As for women within the ages of 65 and 70, they can stop getting pap tests if the test comes back negative three times in the years prior.

Additionally, women who have had their cervix removed do not need a pap smear. For any questions about your health status, talk to your healthcare provider about where you stand. 

If you have had positive test results, HIV or other health conditions, your healthcare provider may suggest you get tested more frequently.

Pap Smear Results

Although the pap tests could be uncomfortable, they are very accurate. The accuracy of these results can help to prevent other health issues in the future. A pap test’s results can take one to three weeks to come back. Most results will come back negative yet, sometimes may be positive. If your results are positive, this doesn’t mean you have cancer but it gives you a reason to dig a little deeper to find out if there’s anything to be concerned about. This helps create a plan of action for whatever the result may be. 

At times, results can be unclear. This only means the doctor may recommend more tests to monitor any other changes. 

If test results are considered abnormal. There are a few common abnormalities that could be the reason:

• HPV: this may be present and need additional testing. 
• Atypical squamous cells of undetermined significance: these are only mildly abnormal and don’t meet any criteria for precancerous cells.
• Atypical glandular cells: these are abnormal cells in the endocervix. 
• Squamous cell cancer: this signals the likelihood of cancer cells and depends on the type of abnormal cell found. 
• Squamous intraepithelial lesion: these lesions are possibly precancerous and may need additional testing followed by a colposcopy or even a biopsy. 
• Lesions can be divided by two separate categories. Low grade – a cell that is of little risk of progressing to cancer, and high grade – a cell that is of high risk of progressing to cancer much sooner.

To determine any  of these, further testing is necessary.

Cervical Cancer

There are new diagnoses of invasive cervical cancer in the U.S. yearly. With preventative screenings, reducing the progression of cervical cancer can be very successful. It’s often that in the later stages, there are no symptoms of cervical cancer present. 

There are a few risk factors that can aid in the development of cervical cancer. These can include:

• Smoking
• Unprotected sex
• Several sexual  partners
• A weak immune system due to health concerns like HIV
• Not attending routine screenings
• Chlamydia infection
• Not enough vegetables and fruit in the diet
• Being overweight
• Being under 18 years of age for the first full-term pregnancy
• Using an IUD 
• Using birth control pills for a long time
• Having an HPV infection
• The hormonal drug DES or having a mother who took it
• Douching

Talk to your doctor about your risks with cervical cancer.

The Pap Smear Takeaway

Even though pap smears may cause initial nerves, this is a normal part of any person’s preventative health journey. The more often you have the exam, the more comfortable you’ll feel. To add to that comfort, the more peace of mind you’ll have about a healthy reproductive system. This experience isn’t anything to be ashamed of and pap smears are something that all people experience. 

Call Rosh Maternal & Fetal Medicine To Schedule A Pap Smear

The doctors at Rosh Maternal & Fetal Medicine recommend routine preventive pelvic exams and Pap smears so that you can guarantee you’re not at risk for cervical cancer. If you haven’t had a Pap smear in the last three years, call their office in the Midtown East area of New York City, or schedule an appointment online.

Call us by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today. They’ve helped thousands of women. Come visit your NYC OBGYN.