While the thought of getting a pap smear or pelvic exam may not be an exciting one, it’s a crucial step in the prevention of cervical cancer. However, we know that keeping track of the various annual or biannual appointments you need can get overwhelming, so we’re here to clear things up for you. If you’re wondering, "How often do I need to get a pap smear?" you’ve come to the right place. We connected with gynecologists who broke down what to expect from a pap smear appointment, what the goal of these appointments is, and, of course, how often you need them.
What is a pap smear?
First of all, a pap smear (named for the doctor that determined its use) is not the same as a pelvic exam. While a pelvic exam is a checkup of your reproductive parts to look for blood, vaginal discharge, lesions on the vagina or cervix, and other specific illnesses, a pap smear is a specific screening test for cervical cancer. According to board-certified OB-GYN Huong Nghiem-Eilbeck, M.D., of the birth control delivery service Pandia Health, this is a common misconception. “A lot of women think a pap smear is the speculum exam (where a speculum is used to visualize the cervix), but actually, clinicians use the speculum as a tool in order to conduct the actual pap smear,” she says. If you’ve gone for your annual pelvic exam but haven’t gotten a pap test in a few years, this may be another one to add to your list.
As Nicole Sparks, M.D., an OB-GYN and ambassador for The Hello Cup, explains, “This test is important because it can detect early-stage cancer (by finding abnormal cells) before it turns into invasive cancer.” According to data from the American Cancer Society, incidence rates of cervical cancer have dropped by more than 50% since the mid-1970s due in large part to an increase in screening, so these tests are both effective and important.
What can you expect from a pap smear appointment?
“The pap smear itself is not painful but can be uncomfortable for a brief moment,” says Dr. Nghiem-Eilbeck. Your gynecologist will ensure you are comfortable and begin by asking you to place your legs into stirrups. Then, your doctor will examine the outside of your vagina for any concerning lesions before gently placing a speculum into the vagina to look at your cervix. The speculum is the duck-bill tool, which allows the doctor to see the cervix. According to Dr. Sparks, “This may cause a little bit of pressure but not pain.”
At this point, your doctor will use a tiny brush (which looks like a mascara brush) to swab the inside of the cervix and collect cells. When they’re done, they’ll remove the speculum and place the cell sample into a solution and it will be sent to a lab for processing. Dr. Nghiem-Eilbeck tells us that the results are usually available within three to seven days and that the entire procedure should only take a few minutes.
How often do you need a pap smear?
Depending on your age, potential risk factors, and severity of the results (i.e. if a pap smear has come back abnormal before), you may not need to get a pap smear on a yearly basis. Starting in your twenties and through your mid-sixties, you should have a pap smear once every three years, according to both the CDC and The American College of Obstetricians and Gynecologists (ACOG). Dr. Sparks also tells us that “pap smears begin at age 21 regardless of sexual activity.”
Current recommendations from the U.S. Preventive Services Task Force are in line with this timing but add that if you are 30 to 65 years old you should get:
- a pap test every 3 years, or
- an HPV test every 5 years, or
- a pap test and HPV test together (called co-testing) every 5 years.
What happens if your pap smear comes back abnormal?
According to womenshealth.gov, your pap test results will say one of three things: normal, unclear, or abnormal. If results are unclear, your doctor may do more testing right away to rule out any problems, or your doctor may have you come back in six months or a year for another pap test. If the results are abnormal, don’t freak out, as this does not necessarily mean you have cancer. Your doctor will talk to you about possibly doing another pap test right away or, if the cell changes are minor, waiting six months or a year before doing another test. “Most of the time, these abnormal findings are caused by HPV (human papillomavirus) and can improve within a year,” says Dr. Nghiem-Eilbeck. “[Because of this] it's okay to be monitored at a specific later time.” Sometimes, a colposcopy is a next step in the management of an abnormal pap smear, as this will give your doctor a closer look at the cervix, but these are things that your doctor will talk to you about.